Cardo Esther, Servera Mateu, Vidal Carmen, de Azua Begoña, Redondo Marta, Riutort Laura
Laboratorio de Neurociencias/IUNICS, Hospital Son Llàtzer, Ctra. Manacor km 4, Palma de Mallorca, Spain.
Rev Neurol. 2011 Mar 1;52 Suppl 1:S109-17.
To compare the prevalence of attention deficit disorder and hyperactivity disorder (ADHD) using different diagnostic criteria (DSM-IV-TR versus ICD-10) and two specific scales based on DSM IV (ADHD-IV Rating Scales and SNAP-IV p90) in school-age children (6-12 years).
. A population-based study applying stratified multistage sample design (by courses), proportional to the type of school (public, private and enterd) and demographic areas (rural, city). From a target population of approximately 30 000 subjects a sample of 1509 children.
The prevalence rates of ADHD were within the expected range: 3.6% (95% CI = 2.6-4.6%) using DSM-IV criteria, 1.2% (95% CI = 0.6-1.8%) using the ICD-10, 4.6% (95% CI = 3.5-5.7%) using ADHD Rating Scales-IV with a cut-off of 90 percentile 4.11% (95% CI = 3.2-5.1%) using the scale SNAP-IV. However, we found some differences in reference to gender and subtype according to the criteria and instrument used.
We propose to use standard scales, scale by age, sex and evaluator that includes maturation and sociocultural factors help us draw conclusions about the true prevalence of ADHD.
比较使用不同诊断标准(《精神疾病诊断与统计手册》第四版修订版[DSM-IV-TR]与《国际疾病分类》第十版[ICD-10])以及基于DSM-IV的两个特定量表(ADHD-IV评定量表和SNAP-IV p90)对学龄儿童(6至12岁)注意力缺陷障碍和多动障碍(ADHD)的患病率。
一项基于人群的研究,采用分层多阶段抽样设计(按课程),与学校类型(公立、私立和其他)及人口统计学区域(农村、城市)成比例。从约30000名受试者的目标人群中抽取了1509名儿童作为样本。
ADHD的患病率在预期范围内:使用DSM-IV标准为3.6%(95%置信区间=2.6 - 4.6%),使用ICD-10为1.2%(95%置信区间=0.6 - 1.8%),使用ADHD-IV评定量表且临界值为第90百分位数时为4.6%(95%置信区间=3.5 - 5.7%),使用SNAP-IV量表时为4.11%(95%置信区间=3.2 - 5.1%)。然而,根据所使用的标准和工具,我们发现性别和亚型方面存在一些差异。
我们建议使用标准量表,该量表按年龄、性别和评估者划分,纳入成熟度和社会文化因素,有助于我们得出关于ADHD真实患病率的结论。