摘要
背景:对立违抗障碍(ODD)以对抗等行为为特征,常与注意缺陷多动障碍(ADHD)并存。有研究报道ADHD合并ODD比单纯ADHD有更广泛的损害;有研究认为血清低5-羟色胺水平可能与ADHD的攻击性行为有关,国内报道较少。目的:探讨ADHD合并ODD的临床特征及与5-羟色胺的关系。设计:2002-06/2003-05以伴有和不伴有ODD的ADHD患儿为研究对象的对照性研究。单位:湘雅二医院精神卫生研究所。对象:研究对象来源于2002-06/2003-05在中南大学儿童精神卫生专科门诊就诊的7-14岁ADHD患儿共61例(男53例,女8例),按DSM-Ⅳ关于对立违抗障碍的症状学标准,将ADHD儿童分为不伴ODD组(n=33,ADHD组)和伴ODD组(n=28,ADHD+ODD组)。方法:由患儿父母(n=61)填写Achenbach儿童行为量表(CBCL),由班主任(n=31)填写教师报告表(TRF),检测当日早餐被试者进不含巧克力、牛奶的正常饮食,空腹采静脉血2mL,用外标法定量测定5-HT浓度,采用LD-10AD高效液相色谱仪测定。主要观察指标:伴有和不伴有ADHD儿童CBCL,TRF、中国韦氏儿童智力量表(C-WISC),以及血清5-羟色胺水平差异。结果:经父母和教师评定,ADHD+ODD组在CBCL和TRF攻击性行为分量表、外向性行为问题及行为问题总分显著高于单纯ADHD组,差异有显著性意义(t=2.28～3.76,P<0.05～0.01);
BACKGROUND:Oppositional defiant disorder(ODD) often occurs as a comorbid condition of attention deficit hyperactivity disorder(ADHD),characterized by defiant behaviors.ADHD children with ODD have more extensive impairments than those with ADHD alone. Some studies suggest that decreased serum 5 hydroxytryptamine(5 HT) level is related to aggressive behavior in ADHD, but no relevant report is available in China.OBJECTIVE:To investigate the clinical features of ADHD with ODD,and their relations with serum 5 HT.DESIGN:A randomized case controlled study taking the ADHD children with or without ODD as the subjects for study.SETTING:Mental Health Institute of the Second Xiangya Hospital.PARTICIPANTS:Sixty one ADHD children(53 boys and 8 girls) aged 7 to 14 years visiting the Children's Clinic of Mental Health Institute of Central South University from June 2002 to May 2003 were recruited and divided into two groups based on the symptomatic criteria of ODD recommended by the Diagnostic and Statistical Manual of Mental Disorder(DSM Ⅳ):ADHD group(n=33,without ODD) and ADHD+ODD group(n=28). INTERVENTIONS:The parents of the enrolled children(n=61) were asked to complete the Achenbach child behavior checklist (CBCL),and the teachers(n=31) completed the teacher's report form (TRF).Two milliliters of fasting venous blood was drawn from these children and the serum separated by centrifugation for quantification of 5 HT using external standard method,and whole blood 5 HT was analyzed by LD 10AD high performance liquid chromatography(HPLC).MAIN OUTCOME MEASURES:Scores of CBCL,TRF and Chinese Wechsler Intelligence Scale for Children(C WISC) and serum 5 HT levels.RESULTS:In the ADHD+ODD group,the scores of CBCL and TRF for externalizing, aggressive behaviors and total scores for behavioral problems rated by the parents and teachers were significantly higher than those of the ADHD group(t=2.28 to 3.76,P< 0.05 to 0.01);the former group also had significantly higher scores of CBCL for anxiety/depression and internalizing
出处
《中国临床康复》
CSCD
北大核心
2005年第4期221-223,共3页
Chinese Journal of Clinical Rehabilitation
基金
国家自然科学基金(项目号39770277)~~
