Sullivan Kelly, Hatton Deborah, Hammer Julie, Sideris John, Hooper Stephen, Ornstein Peter, Bailey Donald
The University of North Carolina, Chapel Hill, North Carolina, USA.
Am J Med Genet A. 2006 Nov 1;140(21):2275-88. doi: 10.1002/ajmg.a.31388.
Parent- and teacher-report of attention-deficit/hyperactivity disorder (ADHD) symptoms were examined using problem behavior and DSM-IV symptom inventory questionnaires for 63 children with full mutation fragile X syndrome (FXS) and 56 children without disabilities matched on mental age (MA). Prevalence rates of ADHD symptoms varied depending on type of measure (problem behavior or DSM-IV criteria), subscale (ADHD-inattentive or ADHD-hyperactive), scoring method (continuous T-scores or categorical scores based on DSM-IV algorithm), and rater (parent or teacher). Overall, 54-59% of boys with FXS met diagnostic behavioral criteria for either ADHD-inattentive type only, ADHD-hyperactive type only, or ADHD-combined type based on parent or teacher report. Boys with FXS were rated as having clinically high scores or met diagnostic criteria at higher rates than expected for the general population and had higher raw scores than their MA-matched peers. Parent ratings of boys with FXS resulted in higher ADHD-inattentive type and ADHD-hyperactive type T-scores than teachers. Boys who were rated as meeting DSM-IV criteria were more likely to be taking psychotropic medication and to have younger mental ages. Parents were substantially more likely than teachers to rate boys as meeting DSM-IV criteria for ADHD-inattentive type, while teachers were only slightly more likely than parents to rate boys as meeting DSM-IV criteria for ADHD-hyperactive type. Teachers were more likely than parents to rate boys as meeting DSM-IV criteria for ADHD when boys had lower levels of FMRP.
我们使用问题行为问卷和《精神疾病诊断与统计手册》第四版（DSM-IV）症状清单问卷，对63名患有完全突变型脆性X综合征（FXS）的儿童以及56名心理年龄（MA）匹配的无残疾儿童的注意缺陷多动障碍（ADHD）症状进行了家长和教师报告评估。ADHD症状的患病率因测量类型（问题行为或DSM-IV标准）、子量表（注意力不集中型ADHD或多动型ADHD）、评分方法（连续T分数或基于DSM-IV算法的分类分数）以及评估者（家长或教师）的不同而有所差异。总体而言，根据家长或教师报告，54%-59%患有FXS的男孩符合仅注意力不集中型ADHD、仅多动型ADHD或混合型ADHD的诊断行为标准。患有FXS的男孩被评定为临床高分或符合诊断标准的比例高于一般人群的预期，且原始分数高于其心理年龄匹配的同龄人。家长对患有FXS男孩的评定结果显示，其注意力不集中型ADHD和多动型ADHD的T分数高于教师评定结果。被评定为符合DSM-IV标准的男孩更有可能正在服用精神药物，且心理年龄更小。家长比教师更有可能将男孩评定为符合注意力不集中型ADHD的DSM-IV标准，而教师仅比家长略微更有可能将男孩评定为符合多动型ADHD的DSM-IV标准。当男孩的脆性X智力低下蛋白（FMRP）水平较低时，教师比家长更有可能将男孩评定为符合ADHD的DSM-IV标准。
