3~12岁儿童注意缺陷多动障碍发生的家庭环境相关因素分析  

Analysis of family environment-related factors of attention deficit hyperactivity disorder in children aged 3-12

作　　者：郑宇霞[1] 张霞 杨艳飞[1] 周玲[1] 王惠萍[1] 王左华 Zheng Yuxia;Zhang Xia;Yang Yanfei;Zhou Ling;Wang Huiping;Wang Zuohua(Department of Neurology,Children's Hospital of Kunming,Kunming 650228,China)

机构地区：[1]昆明市儿童医院神经内科,昆明650228

出　　处：《中华行为医学与脑科学杂志》2023年第10期909-914,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：昆明市卫生健康委员会卫生科研项目(2021-06-04-003,2021-06-01-001);昆明市儿童神经免疫疾病医学技术中心(2022-SW(技术)-19)。

摘　　要：目的观察3~12岁儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)发生情况,并分析导致ADHD发生的家庭环境相关因素。方法选取2020年6月至2021年12月于昆明市儿童医院儿科门诊就诊的580例儿童,根据DSM-5儿童ADHD的诊断标准,将被试分为ADHD组(n=37)和无ADHD组(n=543)。采用一般资料调查表、家庭功能评定量表(family assessment device,FAD)调查评估儿童一般资料和家庭功能情况,应用SPSS 25.0软件进行统计分析,采用t检验、Mann-Whitney U检验进行组间比较,采用二元Logistic回归分析模型分析3~12岁儿童ADHD发生的家庭环境相关因素。结果580例于儿科门诊就诊的3~12岁儿童中有37例为ADHD,占6.38%。ADHD组儿童母乳喂养时间较无ADHD组短[5.00(2.50,6.00)月,9.00(7.00,11.00)月,U=7.751],主要照护者受教育程度较无ADHD组低,单亲/重组家庭、家长主要教育方式为批评训斥占比较无ADHD组高,FAD评分较无ADHD组高[(172.35±4.27),(166.29±5.58),t=6.478],均差异有统计学意义(均P<0.05)。Logistic回归分析结果显示,母乳喂养时间越长(β=-0.561,P<0.001,OR=0.571,95%CI=0.480~0.678)是3~12岁儿童ADHD发生的保护因素,主要照护者受教育程度小学与初中、家长主要教育方式为批评训斥、家庭功能差(FAD评分高)是3~12岁儿童ADHD发生的家庭环境相关危险因素。结论母乳喂养时间较短、主要照护者受教育程度较低、家长主要教育方式为批评训斥、家庭功能差等家庭环境因素均会增加3~12岁儿童ADHD发生风险。Objective To observe the occurrence of attention deficit hyperactivity disorder(ADHD)in children aged 3-12 and analyze the related factors of family environment leading to ADHD.Methods A total of 580 children from June 2020 to December 2021 were selected from the pediatric outpatient clinic of the Children's Hospital of Kunming.According to the diagnostic criteria for children with ADHD in DSM-5,all the subjects were divided into ADHD group(n=37)and non-ADHD group(n=543).The general data questionnaire and family assessment device(FAD)were used to investigate the relevant data of children.SPSS 25.0 software was used for statistical analysis,and t test,Mann-Whitney U test were used for inter group comparison,and binary Logistic regression model was used to analyze the related factors of family environment of ADHD in children aged 3-12 years.Results Among 580 children aged 3-12 in pediatric clinic,37 cases were diagnosed ADHD,accounting for 6.38%.Compared with the non-ADHD group,the breast-feeding time of children in the ADHD group was shorter,the education level of primary caregivers was lower(5.00(2.50,6.00)months,9.00(7.00,11.00)months)(U=7.751),the proportions of families with single parent/reconstituted and parents with criticism and reprimand as the main educational method were higher,and the FAD score((172.35±4.27),(116.29±5.58),t=6.478)was higher(all P<0.05).The results of Logistic regression analysis showed that longer breast-feeding time(β=-0.561,P<0.001,OR=0.571,95%CI=0.480~0.678)was the protective factor of ADHD in children aged 3-12 years.Primary and junior high schools as the education level of main caregivers,criticism and reprimand as the main education methods of parents,and poor family function(high FA score)were the related risk factors of family environment of ADHD in children aged 3-12 years.Conclusion Family environment factors,such as short breast-feeding time,low education level of main caregivers,criticism and reprimand of parents,poor family function,can increase the incidence risk of AD

关 键 词：儿童 注意缺陷多动障碍 家长主要教育方式 家庭功能 

分 类 号：R749.94[医药卫生—神经病学与精神病学]