《全国儿童健康调查中的注意力缺陷多动障碍与视力问题》
ADHD and Vision Problems in the National Survey of Children's Health.
作者信息
DeCarlo Dawn K, Swanson Mark, McGwin Gerald, Visscher Kristina, Owsley Cynthia
机构信息
*OD, MSPH, FAAO †MS, PhD ‡PhD §MSPH, PhD Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (DKDeC, GMcG, CO); Department of Optometry, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama (DKDeC, MS); Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama (GMcG); and Department of Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (KV).
出版信息
Optom Vis Sci. 2016 May;93(5):459-65. doi: 10.1097/OPX.0000000000000823.
PURPOSE
To compare the prevalence of attention deficit/hyperactivity disorder (ADHD) in children with normal vision and with vision problems not correctable with glasses or contact lenses (vision problems) as determined by parent report in a nationwide telephone survey.
METHODS
This cross-sectional study included 75,171 children without intellectual impairment aged 4 to 17 years participating in the 2011 to 2012 National Survey of Children's Health, conducted by the U.S. Centers for Disease Control and Prevention. Demographic information and information regarding vision and ADHD status were obtained by parent interview. Questions asked whether they had ever been told by a doctor or health care provider that the child had a vision problem not correctable with glasses or contact lenses, ADHD, intellectual impairment, or one of 13 other common chronic conditions of childhood. A follow-up question asked about condition severity. The main outcome measure was current ADHD.
RESULTS
The prevalence of current ADHD was greater (p < 0.0001) among children with vision problems (15.6%) compared with those with normal vision (8.3%). The odds of ADHD compared with those of children with normal vision were greatest for those with moderate vision problems (odds ratio [OR], 2.6; 95% confidence interval [95% CI], 1.7 to 4.4) and mild vision problems (OR, 1.8; 95% CI, 1.1 to 2.9). Children with severe vision problems had similar odds of ADHD to those of children with normal vision perhaps because of the small numbers in this group (OR, 1.6; 95% CI, 0.8 to 3.1). In multivariable analysis adjusting for confounding variables, vision problems remained independently associated with current ADHD (OR, 1.8; 95% CI, 1.2 to 2.7).
CONCLUSIONS
In this large nationally representative sample, the prevalence of ADHD was greater among children with vision problems not correctable with glasses or contacts. The association between vision problems and ADHD remains even after adjusting for other factors known to be associated with ADHD.
目的
在一项全国性电话调查中，通过家长报告来比较视力正常的儿童与患有无法通过眼镜或隐形眼镜矫正的视力问题（视力问题）的儿童中注意力缺陷多动障碍（ADHD）的患病率。
方法
这项横断面研究纳入了75171名年龄在4至17岁、无智力障碍的儿童，他们参与了美国疾病控制与预防中心开展的2011至2012年全国儿童健康调查。通过家长访谈获取人口统计学信息以及有关视力和ADHD状况的信息。问题询问他们是否曾被医生或医疗服务提供者告知孩子患有无法通过眼镜或隐形眼镜矫正的视力问题、ADHD、智力障碍或其他13种常见儿童慢性病之一。一个后续问题询问了病情严重程度。主要结局指标是当前的ADHD。
结果
与视力正常的儿童（8.3%）相比，患有视力问题的儿童中当前ADHD的患病率更高（p<0.0001）（15.6%）。与视力正常的儿童相比，ADHD的几率在患有中度视力问题的儿童中最高（优势比[OR]，2.6；95%置信区间[95%CI]，1.7至4.4）以及患有轻度视力问题的儿童中（OR，1.8；95%CI，1.1至2.9）。患有严重视力问题的儿童患ADHD的几率与视力正常的儿童相似，可能是因为该组人数较少（OR，1.6；95%CI，0.8至3.1）。在对混杂变量进行调整的多变量分析中，视力问题仍然与当前的ADHD独立相关（OR，1.8；95%CI，1.2至2.7）。
结论
在这个具有全国代表性的大样本中，患有无法通过眼镜或隐形眼镜矫正的视力问题的儿童中ADHD的患病率更高。即使在对已知与ADHD相关的其他因素进行调整后，视力问题与ADHD之间的关联仍然存在。
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