Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan.
Int J Psychiatry Clin Pract. 2009;13(4):318-25. doi: 10.3109/13651500903094567.
Objective. To investigate the association between two attention deficit/hyperactivity disorder (ADHD) subtypes-combined and inattentive subtypes-and parental stress in a Taiwanese population. Method. One hundred and nine children with ADHD were interviewed using the MINI Kid questionnaire. The children were divided into combined and inattentive subtypes. The level of parenting stress was measured with the self-report Parenting Stress Index and Parental Symptom Scale (Symptom Check List, SCL-90). The data were used to identify child and parental risk factors. Results. Combined subtype was highly associated with parental stress. Parents of children in this group were significantly younger, had a poorer understanding of ADHD, and had significantly higher levels of marital discord, parenting stress, parental symptoms, and life stress (all P<0.05). Multivariate analysis revealed that age of mother, child with comorbidity diagnosis, and parents with poor understanding of ADHD were significantly associated with the combined subtype relative to inattentive subtype (all P<0.05). Conclusion. The combined subtype of ADHD is associated with more parental psychopathology and stress than the inattentive subtype and the presence of combined subtype may indicate that such a child is at greater risk than the inattentive subtype for comorbid conditions such as oppositional defiant disorder and conduct disorder.
目的。探讨台湾人群中两种注意缺陷多动障碍（ADHD）亚型——混合型和注意力不集中型与父母压力之间的关系。
方法。109 名 ADHD 儿童使用 MINI Kid 问卷进行访谈。将儿童分为混合型和注意力不集中型。使用父母压力指数（Parenting Stress Index）和父母症状量表（Symptom Check List，SCL-90）的自我报告来衡量育儿压力水平。利用这些数据来识别儿童和父母的风险因素。
结果。混合型与父母压力高度相关。该组儿童的父母年龄较小，对 ADHD 的认识较差，婚姻不和、育儿压力、父母症状和生活压力明显较高（均 P<0.05）。多变量分析显示，母亲年龄、合并症诊断的儿童以及对 ADHD 认识较差的父母与注意力不集中型相比，与混合型显著相关（均 P<0.05）。
结论。与注意力不集中型相比，ADHD 混合型与更多的父母心理病理学和压力相关，并且混合型的存在可能表明该儿童比注意力不集中型更易出现对立违抗性障碍和品行障碍等合并症。
