目的 探讨家庭环境及发育因素对注意缺陷多动障碍(ADHD)发病的影响,为疾病的早期预防和治疗提供依据。方法 对2014-2017年在上海交通大学医学院附属精神卫生中心儿少门诊就诊的132例ADHD儿童及82名健康对照儿童的家庭环境、父母压力、围生期及发育情况进行统计分析。结果 ADHD组和对照组在母孕次(t=3.540),孕期意外(χ2=18.678),出生意外(χ2=6.523),重大疾病(χ2=5.527),抚养情况(χ2=22.760),抚养人(χ2=11.831),管教方式(χ2=10.440),父母关系(χ2=8.198)及父母压力(t=5.217)方面的差异有统计学意义(P<0.05或P<0.01)。Logistic回归分析显示,母孕期异常(OR=7.233,95%CI:1.640~31.898)、管教方式不合理(OR=3.759,95%CI:1.429~9.887)、教养态度不一致(OR=2.860,95%CI:1.041~7.859)是发病的危险因素,母乳喂养(OR=0.128,95%CI:0.032~0.514)、养育情况属于一般(OR=0.026,95%CI:0.003~0.223)及好养型(OR=0.021,95%CI:0.002~0.225)是ADHD的保护因素。结论 围生期异常、家庭教育、家庭关系等因素是影响ADHD发病的相关因素,应引起重视。
Abstract
Objective To explore the influence of family environment and developing-related factors on the children's attention deficit hyperactivity disorder (ADHD),so as to provide the basis for early prevention and treatment of ADHD. Methods Totally 132 ADHD children in Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine were enrolled in this study from 2014 to 2017. And 82 healthy children were selected as control group. The family environment,parental stress and early development two groups were analyzed and compared by multivariate Logistic regression. Results There were significant differences between two groups on maternal pregnancies (t=3. 540),pregnancy accidents (χ2=18. 678),birth accidents (χ2=6. 523),major diseases (χ2=5. 527),dependency (χ2=22. 760),primary dependants (χ2=11. 831),parenting style (χ2=10. 440),parental relationship (χ2=8. 198) and parental stress (t=5. 217) (P<0. 05). Logistic regression analysis revealed that the abnormal conditions during maternal pregnancy(OR=7. 233,95%CI:1. 640—31. 898),negative discipline (OR=3. 759,95%CI:1. 429—9. 887) and different parenting attitudes (OR=2. 860,95%CI:1. 041—7. 859) were risk factors for ADHD. Breastfeeding (OR=0. 128,95%CI:0. 032—0. 514),general parenting(OR=0. 026,95%CI:0. 003—0. 223) and easy parenting(OR=0. 021,95%CI:0. 002—0. 225) were protective factors of ADHD. Conclusion The perinatal abnormality,family education and family relationship are the influencing factors of ADHD,which should be paid more attention.
关键词
注意缺陷多动障碍 /
发育相关危险因素 /
家庭环境 /
围生期
Key words
attention deficit hyperactivity disorder /
development-related risk factors /
family environment /
perinatal period
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基金
重大慢性非传染性疾病防控研究(2016YFC1306102);国家自然科学基金面上项目(81771477);上海市精神卫生中心院级课题一般项目(2018-YJ-14);上海市卫生和计划生育委员会科研课题(201640286)
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