中国精神障碍分类方案与诊断标准在儿童注意缺陷多动障碍中的应用研究  

CCMD-3 diagnostic criteria in clinical diagnosis and epidemic survey of attention deficit hyperactivity disorder.

作　　者：苏林雁[1] 高雪屏[1] 罗学荣[1] 张纪水[1] 李雪荣[1] 

机构地区：[1]中南大学湘雅二医院精神卫生研究所,长沙410011

出　　处：《中国实用儿科杂志》2003年第9期530-533,共4页Chinese Journal of Practical Pediatrics

基　　金：国家自然科学基金资助 (项目号 :3 9770 2 77)

摘　　要：目的　探讨中国精神障碍分类方案与诊断标准第三版 (CCMD 3)对注意缺陷多动障碍 (ADHD)临床诊断和流行病学调查中的适用性。方法　CCMD 3对门诊就诊的ADHD儿童和流行病学调查筛查出的ADHD进行再诊断。门诊就诊的ADHD儿童经两位儿童精神病学专科医师临床诊断 ,共 73例 ,为临床组 ;长沙市某小学和某中学学生使用康奈氏简明父母和 (或 )教师问卷筛查阳性 ,经两位医师临床诊断 ,共 5 8例 ,为流调组 ;在校儿童中去除临床诊断为ADHD者 ,共 5 17例 ,为对照组。请三组儿童父母填CCMD 3诊断表。结果　临床组符合CCMD 3诊断标准者 5 9例 ,占 80 8%。流调组符合CCMD 3诊断标准者 35例 ,占 6 0 3%。临床组注意障碍因子、多动因子得分高于流调组 ,两ADHD组得分高于对照组 ,差异有高度显著性。符合临床诊断而不符合CCMD 3诊断标准者有 76 % ,是因为多动因子达不到CCMD 3诊断标准。结论　CCMD 3将符合诊断的项目减少为 4项 ,对症状的描述更符合我国习惯 ,因此比DSM Ⅳ和ICD 10更适用于我国。在诊断ADHD时应考虑民族、文化、年龄、性别、起病年龄以及家长对ADHD的认识等因素。Objective To assess the applicability of CCMD 3 diagnostic criteria to attention deficit hyperactivity disorder (ADHD) in Chinese children.Methods The sample was divided into three groups:73 clinic referrals with ADHD children in clinical group;58 school students with ADHD in prevalent group,and 517 school students without ADHD in control group.Those children had received CCMD 3 re diagnoses.Results Fifty nine (80 8%) children in clinical group met CCMD 3 ADHD diagnosis criteria,while 35 (60 3%)cases in prevalent group did.The scores of CCMD 3 diagnostic scale in clinical group were higher than prevalent group.And those of the two ADHD groups were higher than the control group.Some ADHD children did not meet CCMD 3 diagnosis criteria because their rating scale score of hyperactive was lower than the abnormal thresholds.Conclusion These findings suggest that age,sex ,cultural and race differences may be the significant factors for diagnosing children as ADHD.CCMD 3 ADHD diagnostic criteria are more propitious for Chinese children than DSM IV and ICD 10

关 键 词：注意缺陷多动障碍 精神障碍 分类方案 诊断标准 流行病学 调查 临床应用 

分 类 号：R749.94[医药卫生—神经病学与精神病学]