ADHD儿童家庭环境与成人早期疾病结局及共患人格障碍的关系  

Relation of family environment of ADHD children to early adult disease outcomes and comorbid personality disorders

作　　者：常卫利[1] 李岳玲 曹庆久[3] 王玉凤[3] CHANG Weili;LI Yueling;CAO Qingiu;WANG Yufeng(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Lake Erie College of Osteopatic Medicine Affiliated Hospital,Pennsylvania 16509,United States;Peking University Sixt Hospital,Peking University Institute of Mental Healti,NHC Key Laboratory of Mentl Healti(Peking University),National Clinical Reseach Center for Mental Disorders(Pe­king University SixA Hospital),Beijing 100083,China)

机构地区：[1]郑州大学第一附属医院,郑州450000 [2]Lake Erie College of Osteopathic Medicine Affiliated Hospital,Pennsylvania 16509,United States [3]北京大学第六医院,北京大学精神卫生研究所,国家卫生健康委员会精神卫生学重点实验室(北京大学),国家精神心理疾病临床医学研究中心(北京大学第六医院),北京100083

出　　处：《中国心理卫生杂志》2020年第7期602-606,共5页Chinese Mental Health Journal

基　　金：“十一·五”国家科技支撑计划项目资助(2007BAI17803);卫生行业科研专项经费项目资助(200802073)。

摘　　要：目的:探讨儿童期家庭环境是否会影响儿童注意缺陷多动障碍(ADHD)患者在成人早期的功能缓解及伴发人格障碍的发生情况。方法:选取符合美国精神障碍诊断与统计手册第4版(DSM-IV)ADHD诊断标准的儿童286例,用家庭环境量表中文版(FES-CV)评估儿童期家庭环境,在成人早期随访ADHD的功能缓解情况及人格障碍的伴发情况。采用logistic回归分析儿童期家庭环境与儿童ADHD成人早期结局的关系。结果:平均随访6.2年后,符合成人ADHD诊断的134例(46.9%),符合人格障碍诊断的116例(40.6%)。Logistic回归结果显示,FESCV矛盾性因子分与儿童ADHD持续到成人早期呈正向关联(OR=1.14,95%CI:1.01~1.28,P<0.05),与成人早期人格障碍呈正向关联(OR=1.17,95%CI:1.03~1.31,P<0.05),成功性因子分与成人早期人格障碍负向关联(OR=0.85,95%CI:0.73~0.99,P<0.05)。结论:儿童期家庭环境中的矛盾性表达越强,儿童ADHD持续到成人早期的风险越高,成人早期出现人格障碍的风险越高;成功性表达越强,成人早期出现人格障碍的风险越低。Objective:To explore whether family environment in childhood could affect prognosis of attention deficit hyperactivity disorder(ADHD)and the incidence of personality disorders in adults.Methods:Totally 286 ADHD children patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders,Fourih Edition(DSM-IV)were recruited.Data of family environment in childhood were collected with the Family Envi­ronment Scale-Chinese Version(FES-CV)at baseline.Pognosis of ADHD and the incidence of personality/disor­ders in adults were collected during ealy adulthood follow-up.Logistic regression was used to analyze the relation­ship between family environment variables in childhood and early adult outcome of ADHD.Results:After a mean follow-up of 6.2 years,134(46.9%)patients were diagnosed as adult ADHD,and 116(40.6%)patients were di­agnosed as personality disorder.The results of logistic regression showed that FES-CV contradiction scores were positively associated with ADHD in children(OR=1.14,95%CI:1.01-1.28,P<0.05)and was positively asso­ciated with personality disorder in adults(OR=1.17,95%CI:1.03-1.31,P<0.05),and success scores were neg­ative associated with ealy adult personality disorder.Conclusion:In terms of family environmental vaiables in childhood,the stronger the contradiction expression,the higher the risk of ADHD from children to early adulthood and the higher the risk of personality disorder in early adulthood.The stronger the successful expression,the lower the risk of personality disorder in early adulthood.

关 键 词：注意缺陷多动障碍 成人 儿童期家庭环境 人格障碍 成功性 矛盾性 

分 类 号：R749.94[医药卫生—神经病学与精神病学]