儿童符合注意力缺陷/多动障碍及多动障碍的国际疾病分类第十版（ICD - 10）/精神疾病诊断与统计手册第四版（DSM - IV）标准的频率如何？基于全国样本中家长报告的患病率——BELLA研究结果
How often do children meet ICD-10/DSM-IV criteria of attention deficit-/hyperactivity disorder and hyperkinetic disorder? Parent-based prevalence rates in a national sample--results of the BELLA study.
作者信息
Döpfner Manfred, Breuer Dieter, Wille Nora, Erhart Michael, Ravens-Sieberer Ulrike
机构信息
Department of Child and Adolescent Psychiatry, University of Cologne, Robert Koch Strasse 10, 50931, Cologne, Germany.
出版信息
Eur Child Adolesc Psychiatry. 2008 Dec;17 Suppl 1:59-70. doi: 10.1007/s00787-008-1007-y.
BACKGROUND
There is a lack of representative prevalence rates for attention deficit-/hyperactivity disorder (ADHD) according to DSM-IV criteria and hyperkinetic disorder (HD) according to ICD-10 criteria for German subjects.
OBJECTIVE
To report the results of analyses of categorical data on the prevalence rates of the symptoms of ADHD/HD and additional diagnostic criteria, as well as of the diagnoses of ADHD and HD according to symptoms and other diagnostic criteria, according to the ICD-10 and DSM-IV. Further, to report administrative prevalence rates of the diagnosis and rates of co-existing behavioural and emotional problems.
METHOD
Within the BELLA module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS), a representative sample of parents of 2,452 children and adolescents aged 7-17 years completed an ADHD symptom checklist (FBB-HKS/ADHS) and additional questionnaires for the assessment of coexisting behavioural and emotional problems.
RESULTS
The prevalence rates for the diagnoses of ADHD according to DSM-IV criteria were 5.0% and the rate for HD according to ICD-10 criteria was 1.0%. Higher prevalence rates were found in boys and in younger children. The addition of other diagnostic criteria (impairment, pervasiveness, onset, duration) resulted in a significant decrease of the prevalence rates of ADHD and HD to 2.2 and 0.6%, respectively. Higher prevalence rates were found in families of lower socioeconomic status and families from urban areas. The lifetime administrative prevalence rate was 6.5%. Children with ADHD had an increased risk for coexisting behavioural and emotional problems, especially for aggressive and antisocial behaviour problems, but also for anxiety and mood problems.
CONCLUSION
The results of the national sample are in line with community studies in other countries. The effects of the additional diagnostic criteria of impairment, situational pervasiveness, symptom onset and symptom duration on the prevalence rates have to be considered in other epidemiological studies.
背景
对于德国人群，缺乏依据《精神疾病诊断与统计手册》第四版（DSM-IV）标准的注意力缺陷/多动障碍（ADHD）以及依据国际疾病分类第十版（ICD-10）标准的多动障碍（HD）的代表性患病率数据。
目的
报告依据ICD-10和DSM-IV对ADHD/HD症状及其他诊断标准的患病率分类数据的分析结果，以及依据症状和其他诊断标准对ADHD和HD的诊断结果。此外，报告该诊断的行政管理患病率以及共患行为和情绪问题的发生率。
方法
在德国儿童和青少年健康访谈与检查调查（KiGGS）的BELLA模块中，2452名7至17岁儿童和青少年的家长组成的代表性样本完成了一份ADHD症状清单（FBB-HKS/ADHS）以及用于评估共患行为和情绪问题的其他问卷。
结果
依据DSM-IV标准诊断的ADHD患病率为5.0%，依据ICD-10标准诊断的HD患病率为1.0%。男孩和年幼儿童的患病率更高。增加其他诊断标准（损害、广泛性、起病、病程）后，ADHD和HD的患病率显著下降，分别降至2.2%和0.6%。社会经济地位较低家庭和城市家庭的患病率更高。终生行政管理患病率为6.5%。患有ADHD的儿童共患行为和情绪问题的风险增加，尤其是攻击和反社会行为问题，还有焦虑和情绪问题。
结论
全国样本的结果与其他国家的社区研究一致。在其他流行病学研究中必须考虑损害、情境广泛性、症状起病和症状病程等额外诊断标准对患病率的影响。
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