注意缺陷多动障碍共患抑郁障碍儿童的执行功能特点  

Executive function characteristic in children and adolescents with attention-deficit/hyperactivity disorder comorbid depressive disorders

作　　者：刘栋梁[1,2] 高倩[1] 程嘉[1] 钱英[1] 李海梅[1] 刘璐[1] 孙黎[1] 钱秋谨[1] 王玉凤[1] 

机构地区：[1]北京大学第六医院北京大学精神卫生研究所国家精神心理疾病临床医学研究中心(北京大学第六医院)卫生部精神卫生学重点实验室(北京大学),北京100191 [2]天津市公安局安康医院,天津300240

出　　处：《中国心理卫生杂志》2016年第11期829-834,共6页Chinese Mental Health Journal

基　　金：国家重点基础研究发展计划(973计划)(2014CB846104);国家科技支撑计划项目(2015BAI13B01);国家自然科学基金资助项目(81571340)

摘　　要：目的:探讨注意缺陷多动障碍(ADHD)共患抑郁障碍儿童的执行功能特点。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)诊断标准的ADHD共患抑郁障碍(ADHD+DD)、ADHD未共患抑郁障碍(ADHD-DD)儿童,以及年龄、性别匹配的正常对照儿童各30例,采用Rey复杂图形测试、连线测试、Stroop色词命名任务对其执行功能的各个维度进行评估。结果:ADHD-DD组完成连线测试任务B试所需时间长于对照组[(125.0±60.8)svs.(92.6±50.0)s,P<0.05],ADHD+DD组及ADHD-DD组的转换时间z分高于对照组[(0.2±0.7),(0.3±1.0)vs.(-0.5±1.1),P<0.01]。ADHD+DD组及ADHD-DD组完成Stroop色词命名任务4试耗时均长于对照组[(40.3±10.8)s,(40.8±10.2)s vs.(34.0±7.6)s,P<0.05]。ADHD+DD组及ADHD-DD组在任何任务成绩上的差异均无统计学意义(P>0.05)。结论:ADHD患儿在反应抑制能力、定势转换能力方面均存在明显的缺陷,共病抑郁障碍可能并不加重ADHD患儿的执行功能缺陷。Objective： To study the executive function （EF） characteristics in children and adolescents with attention-deficit/hyperactivity disorder （ADHD） comorbid depressive disorder （DD）. Methods： Children with a di- agnosis of ADHD comorbid DD （ADHD ＋ DD）, ADHD without comorbid DD （ADHD-DD） and normal controls （n = 30 for each group） took part in the study. All three groups were matched by age and gender. The diagnoses were made according to Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition （DSM-IV） criteria. The Rey-Osterrieth complex Figure Test, the Trail Making Test and the Stroop Color Word Test were administered to assess multiple dimensions of executive functions. Results： ADHD-DD group took a longer time than normal controls in time of test B Trail Making Test [ （ 125.0 ± 60. 8） s vs. （92. 6 ± 50. 0） s, P 〈 0. 05]. Both ADHD ＋ DD and ADHD-DD groups had higher z-scores than normal controls on the shift time of the Trail Making Test [ （0. 2±0. 7）, （0. 3± 1.0） vs. （ - 0. 5 ± 1.1）, P 〈 0.01 ]. Both ADHD ＋ DD and ADHD-DD groups spent longer time than normal controls in the naming color of the color-word card （ Stroop part 4） [ （40. 3 ± 10. 8） s, （40. 8 ±10. 2）s vs. （34. 0 ± 7.6） s, P 〈 0. 05]. There were no statistical differences between the ADHD ＋ DD group and ADHD-DD group on any executive function tasks （P 〉 0. 05）. Conclusion： The findings support the hypothesis that ADHD is related to executive function deficit, whether or not comorbid depressive disorder. Comorbid depressive disorder might not have additional influence on the executive function characteristics of children and adolescents with ADHD.

关 键 词：注意缺陷多动障碍 抑郁障碍 执行功能 共病 

分 类 号：R749.94[医药卫生—神经病学与精神病学]