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目的研究抽动障碍(TD)儿童共患注意缺陷多动障碍(ADHD)的临床特点,以了解TD与ADHD之间的关系,拟探讨两者的发病机制。方法将TD患儿按美国精神病学会出版的《精神障碍诊断与统计手册》第5版(DSM-V)进行诊断分类,然后分别比较分析短暂性TD(TTD)组、慢性TD(CTD)组及Tourette综合征(TS)组中ADHD的患病率及分型。结果TTD组90例患儿共患ADHD14例,检出率为15.6%;CTD组84例患儿共患ADHD24例,检出率为28.6%;TS组80例患儿共患ADHD36例,检出率为45.0%;对照组100例儿童共患ADHD2例,检出率为2.0%。TTD组的14例ADHD中符合注意障碍型(IT)的5例,多动与冲动型(HIT)的10例;CTD组中有24例ADHD,其中符合IT的9例,HIT的17例;TS组中有36例ADHD,其中符合IT的10例,HIT的29例;对照组中有2例ADHD,其中符合IT的1例,符合HIT的2例。结论 TD患儿的ADHD共患率高,两者存在相同的病理基础的可能。
Objective To study the clinical features of children with tonic disturbance of attention deficit hyperactivity disorder (ADHD) in tic disorder (TD) so as to understand the relationship between TD and ADHD and to explore the pathogenesis of both. Methods The children with TD were diagnosed according to DSM-V published by the American Psychiatric Association, and then were compared for the diagnosis of transient TD (TTD), chronic TD (CTD) and Prevalence and classification of ADHD in Tourette syndrome (TS) group. Results In the TTD group, 14 cases of ADHD were found in 14 cases, the detection rate was 15.6%. In CTD group, 84 cases of ADHD were found in 24 cases, the detection rate was 28.6%. In TS group, The rate was 45.0%. In the control group, 100 cases of children had comorbid ADHD in 2 cases, the detection rate was 2.0%. Among the 14 patients with TTD, 5 were eligible for attention deficit disorder (IT), 10 were hyperactive and impulsive (HIT); 24 were ADHD in CTD group, 9 were IT and 17 were HIT; There were 36 ADHD cases in TS group, 10 in IT group and 29 in HIT group. There were 2 ADHD cases in control group, 1 in IT group and 2 in HIT group. Conclusion The prevalence of ADHD in children with TD is high, and both may have the same pathological basis.