目的 探讨学龄前发育性协调障碍(DCD)儿童睡眠及行为问题的共病特征,为早期筛查与干预提供依据。方法 采用横断面研究设计,于2021年6月24日—7月12日对上海市浦东新区24 230名3~6岁儿童进行调查,采用美国精神医学学会精神障碍诊断与统计手册(第5版)(DSM-5)标准结合发育性协调障碍问卷(2007版和小龄版)对DCD进行诊断。采用儿童睡眠习惯问卷(CSHQ)和Conners父母症状问卷(PSQ)分别对儿童睡眠问题和多动行为进行评估。结果 共检出“疑似”DCD儿童2 129例,检出率为8.8%。“疑似”DCD儿童总体睡眠问题检出率(84.2% vs.70.0%,χ2=191.484,P<0.001)及多动症状检出率(7.1% vs.2.8%,χ2=113.54,P<0.001)均显著高于非DCD儿童;“疑似”DCD儿童的CSHQ及PSQ各维度得分均高于非DCD儿童(P<0.001),多因素分析结果显示在调整儿童出生和家庭情况后,DCD与各维度得分的关联仍存在统计学意义(P<0.001)。结论 学龄前DCD儿童较正常发育儿童存在更多睡眠与行为问题,但其相互作用关系仍需要进一步探讨,应构建基于多维度评估的早期筛查体系,并制定整合运动康复与行为管理的个性化干预策略。
Abstract
Objectives To investigate the comorbid sleep and behavioral problems in preschool children with developmental coordination disorder (DCD), in order to provide evidence for early screening and intervention. Methods A cross-sectional study was conducted among 24 230 children aged 3 - 6 years in Shanghai Pudong New Area from June 24 to July 12, 2021.DCD was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria combined with the Developmental Coordination Disorder Questionnaire (DCDQ)(DCDQ'07 andLittle DCDQ versions).The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep problems, while the Conners Parent Symptom Questionnaire (PSQ) was utilized to evaluate hyperactivity symptoms. Results A total of 2 129 children (8.8%) were identified as suspected DCD.Compared to non-DCD children, those with suspected DCD exhibited significantly higher rates of overall sleep problems (84.2% vs. 70.0%, χ2=191.484, P<0.001) and hyperactivity symptoms (7.1% vs. 2.8%, χ2=113.54, P<0.001).Additionally, suspected DCD children scored higher across all CSHQ and PSQ subscales (P<0.001).Multivariate analysis confirmed that the association between DCD and these scores remained statistically significant (P<0.001) after adjusting for birth and family-related covariates. Conclusions Preschool children with DCD demonstrate more pronounced sleep and behavioral difficulties than their typically developed peers.However, the bidirectional mechanisms warrant further investigation.An early screening system incorporating multidimensional assessments should be established, along with individualized intervention strategies integrating motor rehabilitation and behavioral management.
关键词
发育性协调障碍 /
共病 /
睡眠障碍 /
行为问题 /
学龄前儿童
Key words
developmental coordination disorder /
comorbidity problems /
sleep disturbances /
behavioral problems /
preschool children
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基金
国家自然科学基金面上项目 (82473638);上海市科学技术委员会标准类项目 (21DZ2202000);上海市卫生健康委员会医学新技术与转化种子计划(2024ZZ1016)
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