Clinical features of various subtypes of attention deficit hyperactivity disorders in children
CHEN Yan-Zhao, WEN Fei-Qiu, ZHOU Ke-Ying, YANG Chun-He, ZHANG Wei, LI Ning
Department of Pediatrics, Shenzhen People's Hospital, Second Medical College of Jinan University, Shenzhen, Guangdong 518020, China. Email: feiqiuwen16@hotmail.com
Abstract：OBJECTIVE: To study the features of various subtypes of attention deficit hyperactivity disorders (ADHD) in children. METHODS: Sex composition, risk factors, comorbidities, intelligence quotient and behavioral problems were investigated in 175 children with ADHD who met the Diagnostic Statistical Manual of Mental Disorder Criteria (DSM-IV). The children were classified into three groups: ADHD predominantly inattentive (ADHD-I, n=82), ADHD predominantly hyperactive-impulsive (ADHD-HI, n=24) and ADHD combined type (ADHD-C, n=69). RESULTS: There were no significant differences in the sex composition among the three groups. The rates of birth abnormality in the ADHD-I and the ADHD-C groups were higher than those in the ADHD-HI group. Negative parenting practices were noted more frequently in the ADHD-HI and the ADHD-C groups than the ADHD-I group. There were no significant differences in the performance intelligence quotient (PIQ), verbal intelligence quotient (VIQ) and full intelligence quotient (FIQ) among the three groups. However, the incidence of imbalance between VIQ and PIQ in the ADHD-I group was higher than the other two groups. The rate of comorbidities with oppositional defiant disorder (ODD) and tic disorder (TD) in the ADHD-C and the ADHD-HI groups was higher than that in the ADHD-I group. Both the ADHD-I and the ADHD-C groups had a higher rate of comorbidities with learning disorder (LD) than the ADHD-HI group. The implusive/hyperactive and conduct problems were more severe and the hyperactivity index was higher in the ADHD-C and the ADHD-HI groups than those in the ADHD-I group, while the learning difficulties in the ADHD-I group were the most severe. CONCLUSIONS: The children with ADHD-C or ADHD-HI have higher incidences of comorbidities with ODD and TD than those with ADHD-I who the learning difficulties and the imbalance between VIQ and PIQ are more severe.［Chin J Contemp Pediatr, 2010, 12 (9):704-708］
CHEN Yan-Zhao,WEN Fei-Qiu,ZHOU Ke-Ying et al. Clinical features of various subtypes of attention deficit hyperactivity disorders in children[J]. CJCP, 2010, 12(09): 704-708.
［1］American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders［M］.4th ed (DSM-IV).Washington DC:American Psychiatric Association,1994．
［2］Barkley RA,Fischer M,Edelbrock CS,Smallish L.The adolescent outcome of hyperactive children diagnosed by research criteria:I.An 8-year prospective follow-up study［J］. J Am Acad Child Adolesc Psychiatry, 1990, 29(4):546-557．
［3］Biederman J,Faraone S,Milberger S,Curtis S,Chen L,Marrs A,et al.Predictors of persistence and remission of ADHD into adolescence: results from a four-year prospective follow-up study［J］. J Am Acad Child Adolesc Psychiatry, 1996, 35(3):343-351．
［13］Weiss M, Worling D, Wasdell M. A chart review study of the inattentive and combined types of ADHD［J］. J Atten Disord, 2003, 7(1):1-9.
［14］McBurnett K, Pfiffner LJ, Willcutt E, Tamm L,Lerner M,Ottolini YL,et al. Experimental cross validationn of DSM-IV types of attention deficit hyperactivity disorder［J］. J Am Acad Adolesc Psychiatry, 1999, 38(1):17-24.
［15］Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder:impact of remission definition and symptom type［J］.Am J Psychiatry, 2000, 157(5):816-818.
［16］沈晓明.临床儿科学 ［M］.北京:人民卫生出版社,2005.
［17］Scahill L, Schwab-Stone M, Merikangas KR, Leckman JF, Zhang H, Kasl S, et al. Psychosocial and clinical correlates of ADHD in a community sample of school-age children［J］. J Am Acad Child Adolesc Psychiatry, 1999, 38(8):976-984.
［20］August GJ, Realmuto GM, Joyce T, Hektner JM. Persistence and desistance of oppositional defiant disorder in a community sample of children with ADHD［J］. J Am Acad Child Adolesc Psychiatry, 1999, 38(10):1262-1270．
［26］Todd RD, Sitdhiraksa N, Reich W, Ji TH, Joyner CA, Heath AC, et al. Discrimination of DSM-IV and latent class attention-deficit/hyperactivity disorder subtypes by educational and cognitive performance in a population-based sample of child and adolescent twins［J］. J Am Acad Child Adolesc Psychiatry, 2002, 41(7):820-828.
