重庆市儿童注意缺陷多动障碍及阈下状态调查

Investigation of attention deficit hyperactivity disorder and subthreshold states among children in Chongqing

中文关键词:  儿童  注意缺陷多动障碍  阈下注意缺陷多动障碍  流行病学

英文关键词:Children  Attention deficit hyperactivity disorder  Subthreshold attention deficit hyperactivity disorder  Epidemiology

中文摘要:

      背景 注意缺陷多动障碍（ADHD）是一种以与年龄不相称的注意力易分散、不分场合地过度活动以及情绪冲动为主要表现的神经发育障碍。临床中，将阈下ADHD（sADHD）定义为存在ADHD症状、但未达到ADHD诊断标准。sADHD儿童的执行功能存在缺陷，其品行、学习、焦虑问题较正常儿童多，工作记忆甚至比ADHD患儿更差。目前，国内对sADHD的流行病学调查研究有限，少有研究同时调查儿童ADHD和sADHD的发生情况。目的 调查重庆市6~13岁儿童ADHD和sADHD发生情况，分析二者在该群体中的分布特征，以期为制定预防ADHD和sADHD的措施提供参考。方法 于2023年10月—11月，采用分层整群随机抽样法选取重庆市江北区6所小学1~6年级的3 398名在校学生为研究对象。采用SNAP-IV评定量表短版本（18项版）（SNAP-IV）和中文版学龄儿童情感障碍与精神分裂症检查表目前和终生版（K-SADS-PL）评定ADHD和sADHD发生情况。结果 重庆市儿童ADHD检出率为1.90%（95% CI：0.014~0.024）。男生ADHD检出率高于女生，差异有统计学意义（χ²=7.733，P=0.005）。不同年级和年龄的儿童ADHD检出率比较，差异均无统计学意义（χ²=7.347、12.362，P均>0.05）。重庆市儿童sADHD检出率为6.32%（95% CI：0.054~0.072）。男生sADHD检出率高于女生，差异有统计学意义（χ²=21.005，P<0.01）。不同年级的儿童sADHD检出率比较，差异有统计学意义（χ²=20.559，P=0.001）。不同年龄的儿童sADHD检出率比较，差异无统计学意义（χ²=12.070，P=0.060）。结论 不同年级和不同年龄的儿童ADHD检出率相当；二年级儿童sADHD检出率较高，男生ADHD和sADHD检出率均高于女生。

英文摘要:

      Background Attention deficit hyperactivity disorder （ADHD） is a neurodevelopmental disorder characterized by age-inappropriate inattention， excessive activities incongruous with setting， and emotional impulsivity. Subthreshold ADHD （sADHD） is clinically defined as the presence of ADHD symptoms that do not meet the full diagnostic criteria for ADHD. Children with sADHD exhibit deficits in executive function， demonstrate more conduct， learning， and anxiety-related problems compared to typically developing children， and show even poorer working memory performance than children diagnosed with ADHD. Currently， there is limited epidemiological research on sADHD in China， with few studies simultaneously investigating the prevalence of both ADHD and sADHD in children.Objective To investigate the prevalence of ADHD and sADHD among children aged 6–13 years in Chongqing， analyzing their distribution characteristics within this population， with the aim of providing references for developing preventive measures against both ADHD and sADHD.Methods From October to November 2023， a total of 3 398 students in grades 1–6 from six primary schools in Jiangbei District， Chongqing were selected using a stratified cluster random sampling method. The occurrence of ADHD and sADHD was evaluated by using the short version （18-item version） of the Swanson， Nolan， and Pelham IV rating scales （SNAP-IV） and the Chinese vision of Schedule for Affective Disorder and Schizophrenia for School-aged Children-Present and Lifetime Version （K-SADS-PL）.Results The ADHD detection rate among children in Chongqing was 1.90% （95% CI： 0.014–0.024）. Boys showed a significantly higher ADHD detection rate than girls （χ²=7.733， P=0.005）. No statistically significant differences were found in ADHD detection rates across different grades or age groups （χ²=7.347， 12.362， P>0.05）. The sADHD detection rate was 6.32% （95% CI： 0.054–0.072）. Similarly， boys exhibited significantly higher sADHD detection rates than girls （χ²=21.005， P<0.01）. Significant differences emerged across different grades （χ²=20.559， P=0.001）， while no statistically significant difference was observed in age groups （χ²=12.070， P=0.060）.Conclusion The ADHD detection rates were comparable across all grade levels and age groups from 6–13 years old. Second-grade children demonstrated notably higher sADHD rates compared to other grades， while boys demonstrated higher prevalence rates than girls for both ADHD and sADHD. ［Funded by Science and Health Joint Medical Research Project in Jiangbei District， Chongqing City in the Second Half of 2023 （number， 2023JBKWLH022）］