Cui Yong-hua, Zheng Yi
Department of Psychiatry, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
Zhonghua Er Ke Za Zhi. 2010 May;48(5):342-5.
To explore risk factors of patients with Tourette syndrome (TS) to develop the comorbidity attention-deficit hyperactivity disorder (ADHD) (TS + ADHD), so as to provide evidence for its prevention and intervention.
A total of 150 patients with TS were divided into two groups (TS group; TS + ADHD group) according to DSM-IV with 75 patients in each group. All the enrolled patients were investigated using self-designed questionnaire and Family Environment Scale-Chinese Edition (FES-CV). Forty-six factors were used as variables and were quantified. Data were analyzed by SPSS10.0 and the odds ratios of different factors to TS + ADHD were calculated by using univariate and multivariate analysis.
(1) Families of children with TS + ADHD had lower score in cohesion, expression, intellectual-cultural orientation, active-recreational orientation, moral religious emphasis and organization, but had higher conflict score in FES-CV than the control group. (2) Single-factor analysis indicated that 8 factors were associated with TS + ADHD including ADHD family history positive (OR = 24.318), low family education (OR = 18.617), longer delay of treatment (OR = 10.796), maternal smoking (OR = 9.094), family conflict (OR = 5.781), hypoxia at birth (OR = 2.562), lower culture level of parents (OR = 1.941) and poor expressiveness (OR = 0.967). (3) Five factors including ADHD family history positive (OR = 13.805), family conflict (OR = 8.459), low family education (OR = 5.477), lower culture level of parents (OR = 2.164) and maternal smoking (OR = 2.075) were selected for the multivariate regression analysis.
The key risk factors of co-occurrence of TS with ADHD were positive ADHD family history, family conflict, low family education, lower culture level of parents and maternal smoking.
探讨抽动秽语综合征(TS)患者并发注意缺陷多动障碍(ADHD)(TS+ADHD)的危险因素,为其预防和干预提供依据。
按照《精神疾病诊断与统计手册》第四版(DSM-IV)将150例TS患者分为两组(TS组;TS+ADHD组),每组75例。采用自行设计的问卷和家庭环境量表中文版(FES-CV)对所有入组患者进行调查。将46个因素作为变量并进行量化。采用SPSS10.0软件进行数据分析,通过单因素和多因素分析计算不同因素与TS+ADHD的比值比。
(1)TS+ADHD患儿家庭在亲密度、情感表达、知识性、娱乐性、道德宗教观及组织性方面得分低于对照组,而在矛盾性方面得分高于对照组。(2)单因素分析显示,8个因素与TS+ADHD相关,包括ADHD家族史阳性(OR=24.318)、家庭教育程度低(OR=18.617)、治疗延迟时间长(OR=10.796)、母亲吸烟(OR=9.094)、家庭矛盾(OR=5.781)、出生时缺氧(OR=2.562)、父母文化程度低(OR=1.941)及表达能力差(OR=0.967)。(3)多因素回归分析入选5个因素,包括ADHD家族史阳性(OR=13.805)、家庭矛盾(OR=8.459)、家庭教育程度低(OR=5.477)、父母文化程度低(OR=2.164)及母亲吸烟(OR=2.075)。
TS与ADHD共病的关键危险因素为ADHD家族史阳性、家庭矛盾、家庭教育程度低、父母文化程度低及母亲吸烟。