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

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Chinese Journal of Contemporary Pediatrics ›› 2010, Vol. 12 ›› Issue (09) : 704-708.

CLINICAL RESEARCH

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

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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］

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Attention deficit hyperactivity disorders / Clinical feature / Child

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CHEN Yan-Zhao, WEN Fei-Qiu, ZHOU Ke-Ying, YANG Chun-He, ZHANG Wei, LI Ning. Clinical features of various subtypes of attention deficit hyperactivity disorders in children[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(09): 704-708

References

［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．
［4］Tannock R.Attention deficit hyperactivity disorder:advances in cognitive,neurobiological,and genetic research［J］. J Child Psyshol Psychiatry, 1998, 39(1):65-99．
［5］苏林雁,禹顺英,罗学荣,黄春香,唐效兰.儿童注意缺陷多动障碍DSM-Ⅳ亚型的临床特征比较研究［J］.中国心理卫生杂志, 2001, 15(5):377-380.
［6］丁军,罗学荣,韦臻,叶海森,袁秀洪,管冰清，等.不同类型注意缺陷多动障碍的男性儿童行为特征研究［J］.中国儿童保健杂志, 2009, 17(2):131-133.
［7］Barkley RA.Hyperactive Children:A Handbook for Diagnosis and Treatment［M］. 2nd ed New York: Guiford Press, 1982: 132-134.
［8］林传鼎,张厚粲.韦氏儿童智力量表中国修订本［M］.北京:师范大学出版,1986: 1-10.
［9］中华医学会.儿童注意缺陷多动障碍防治指南［M］.北京：北京大学出版社,2007: 53-61.
［10］杨莉,吉宁,管丽丽,陈芸,钱秋谨,王玉凤.注意缺陷多动障碍共患病的年龄特征［J］.北京大学学报(医学版),2007, 39(3):229-232.
［11］杨德森.基础精神学［M］.长沙:湖南科技出版社,1994：478-488.
［12］钱秋谨,杨莉,王玉凤.注意缺陷多动障碍患儿748例各亚型的临床特点［J］.中国实用儿科杂志,2005, 20(9):530-533.
［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.
［18］任桂英,钱名威.家庭环境与ADHD儿童心理特征相关性的研究［J］.中国心理卫生杂志,2004, 16 (4):268-272.
［19］翟静,郭传琴,刘贤臣,曹会龙,戴郑生.中学生家庭因素与行为问题的对照研究［J］.中国行为医学科学,2001, 10(3):229-231．
［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．
［21］何淑华,静进.儿童注意缺陷多动障碍智力的META分析［J］.中国儿童保健杂志,2002,10(5):292-294.
［22］钱秋谨,张浩波,王玉凤,杨莉,管丽丽,陈芸.单胺氧化酶基因多态性与注意缺陷多动障碍智商的相关性研究［J］.中国实用儿科杂志,2009, 24(1):26-30.
［23］钱秋谨,王玉凤,李君,杨莉,管丽丽,陈芸,吉宁,刘璐.5-羟色胺系统基因多态对注意缺陷多动障碍患儿智商的影响［J］.实用儿科临床杂志,2009, 24(6):454-457.
［24］Paternite CE, Loney J, Roberts MA. External validation of oppositional disorder and attention deficit disorder with hyperactivity［J］.Abnorm Child Psychol, 1995, 23(4)：453-471.
［25］杨英,沈理笑,刘学政,黄文萍.注意缺陷多动障碍儿童智力水平分析［J］.临床儿科杂志,2008, 26(4):334-336.
［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.