目的 对门诊注意缺陷多动障碍( attention deficit hyperactivity disorder, ADHD) 儿童就医行为及药物治疗影响因素进行研究, 以提高治疗依从性, 改善预后。方法 2008年5月-2011年5月在本院心理卫生科首诊确诊并使用药物治疗的699例ADHD患儿采用自制量表进行一般社会学资料收集并进行心理测验。2012年7月采用回顾性访谈的方法对使用药物治疗的患儿家长进行电话随访及现场问卷调查。结果 共有病例699例, 有效随访490例。453例(92.45%)选用哌甲酯治疗。依从性好者185例(37.75%), 用药6个月以上178例。ADHD患儿就诊年龄与母亲受教育程度(r=-0.140, P<0.01)、总智商(r=-0.089, P<0.05)及ADHD亚型(r=-0.092, P<0.05)负相关。停药原因前三位为:担心药物副作用, 儿童行为问题无明显改善, 不规律使用药物。家长接受心理教育(Waldχ²=6.148, P<0.05)及家长对药物治疗的看法(Waldχ²=3.785, P<0.05)对依从性有影响。结论 混合型ADHD总智商偏低, 药物治疗依从性差, 家长对ADHD及药物治疗的认知程度低, 未接受心理教育是ADHD治疗结果的影响因素, 提升家长对药物治疗的正确认知, 可能有助于提高治疗依从性。

Objective To study the influencing factors of care-seeking and medication on children with attention deficit hyperactivity disorder(ADHD), to improve compliance of medication and prognosis. Methods All patients diagnosed and prescribed medicine at first time as ADHD in mental health department during May 2008 to May 2011.General information and psychological test were administered at the same time, retrospective interviews by self-designed questionnaire on July.2012. Results There were 699 ADHD patients, 490 patients were successfully followed, 453 patients(92.45%) accepted methylphenidate hydrochloride(MPH) therapy, 185 patients (37.75%) had good compliance.178 patients insisted on taking the medicine for more than 6 months.Earlier age of care-seeking of children with ADHD was related to education degree of mother(r=-0.140, P<0.01), full intelligence quotient(r=-0.089, P<0.05) and ADHD subtype(r=-0.092, P<0.05).The main three causes for families to stop medication were afraid of the side effects of drugs, behavior problems could not be improved, irregular use of drugs.Compliance of medication was influenced by psychological education (Waldχ²=6.148, P<0.05)and parents 'views on medication(Waldχ²=3.785, P<0.05). Conclusions Low education degree of mother with ADHD children, low score of full intelligence quotient and combined ADHD are related to earlier age of care-seeking.The compliance of medication in ADHD families is low, psychological education and changing views on medication may be helpful.