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[注意缺陷多动障碍:智力概况与注意力分散因素]

[Attention deficit hyperactivity disorder: intellectual profile and the freedom from distraction factor].

作者信息

López-Villalobos J A, Serrano-Pintado I, Delgado Sánchez-Mateos J, Ruiz-Sanz F, Sánchez-Azón M I, Sacristán-Martín A M

机构信息

Unidad de Salud Mental, Complejo Hospitalario de Palencia, Hospital San Telmo, España.

出版信息

Rev Neurol. 2007;44(10):589-95.

Abstract

INTRODUCTION

Attention deficit hyperactivity disorder (ADHD) usually presents a neuropsychological profile in which the freedom from distraction factor (FDF) is affected to a greater extent than the verbal comprehension factor (VCF) and the perceptual organisation factor (POF).

AIM

To determine the intellectual profile of clinical cases with ADHD through a specific analysis of the FDF, in which we evaluated the differences compared with the VCF and the POF, between types of ADHD and with WISC-R criteria, as well as the variables that affect the probability of FDF < VCF and POF.

PATIENTS AND METHODS

Our study involved a clinical sample of 167 cases of ADHD between 6 and 16 years of age. The cases were defined according to DSM-IV criteria and the evaluation was performed using WISC-R, the Child Symptom Inventory and the social and occupational activity assessment scale. Both descriptive and exploratory statistics were used. Means were compared using ANOVA and/or t tests. Alpha was accepted if it was equal to or below 0.05 and a logistic regression method was used (alpha model parameters below or equal to 0.05). In each factor a 95% confidence interval and odds ratio were determined.

RESULTS

The criterion FDF < VCF and FOP accounted for 71.3% of the cases with ADHD and FDF < (VCF + POF) / 2 represented 81.4% (sensitivity: 81.4%). The FDF is significantly lower than both the mean that corresponds to factorial criteria derived from the WISC-R and the VCF and POF in the cases that were analysed. The mean FDF scores were significantly higher in ADHD-H (a type in which hyperactive-impulsivity predominates) than in ADHD-C (combined type) and ADHD-I (inattentive type). Comorbidity, social or school activity and intellectual quotient do not have a significant influence on the probability that FDF < VCF and POF.

CONCLUSIONS

The FDF is a neuropsychological dimension that is useful in evaluating ADHD.

摘要

引言

注意力缺陷多动障碍(ADHD)通常呈现出一种神经心理学特征,其中注意力分散不受干扰因子(FDF)受到的影响程度大于言语理解因子(VCF)和知觉组织因子(POF)。

目的

通过对FDF的具体分析来确定ADHD临床病例的智力特征,我们评估了与VCF和POF相比、不同类型ADHD之间以及与韦氏儿童智力量表修订版(WISC - R)标准之间的差异,以及影响FDF < VCF和POF概率的变量。

患者与方法

我们的研究纳入了167例6至16岁的ADHD临床样本。病例根据《精神疾病诊断与统计手册》第四版(DSM - IV)标准进行定义,并使用WISC - R、儿童症状量表以及社会和职业活动评估量表进行评估。同时使用了描述性统计和探索性统计方法。采用方差分析和/或t检验比较均值。若α等于或低于0.05则予以接受,并使用逻辑回归方法(α模型参数低于或等于0.05)。在每个因子中确定95%置信区间和比值比。

结果

FDF < VCF和FOP标准占ADHD病例的71.3%,FDF <(VCF + POF)/ 2占81.4%(敏感性:81.4%)。在分析的病例中,FDF显著低于对应于源自WISC - R的因子标准的均值以及VCF和POF。ADHD - H(以多动冲动为主型)的FDF平均得分显著高于ADHD - C(混合型)和ADHD - I(注意力不集中型)。共病、社会或学校活动以及智商对FDF < VCF和POF的概率没有显著影响。

结论

FDF是一个在评估ADHD方面有用的神经心理学维度。

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