Acquazzino Melissa A, Miller Meghan, Myrvik Matthew, Newby Robert, Scott John Paul
*Department of Pediatrics, Section of Hematology/Oncology, University of South Dakota Sanford School of Medicine, Sanford Children's Hospital, Sioux Falls, SD †Section of Pediatric Hematology ‡Department of Psychiatry and Behavioral Medicine §Department of Neurology ∥Section of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI.
J Pediatr Hematol Oncol. 2017 Jul;39(5):350-354. doi: 10.1097/MPH.0000000000000847.
Neuropsychological deficits, including difficulties with attention, are well described in children with sickle cell disease (SCD). Very little is known about attention deficit hyperactivity disorder (ADHD) in children with SCD. The objective of this study was to determine the proportion of ADHD in children with SCD referred for neuropsychological evaluation. This prospective, cross-sectional study included patients (age, 4 to 18 y) with SCD and completion of a neuropsychological evaluation between December 2013 and March 2016. Patients were referred for neuropsychological evaluation because of concern regarding school performance, development, and/or behavior. The diagnosis of ADHD was made by a neuropsychologist on the basis of the diagnostic criteria in the Diagnostic Statistical Manual-Fourth or Fifth Editions. ADHD medication usage rate was obtained by medical record review. Of the 89 patients with SCD referred for neuropsychological evaluation, 25% (95% confidence interval, 16%-35%) met diagnostic criteria for ADHD. Only 21% of the patients with SCD and ADHD were prescribed an ADHD medication. Our study supports routine ADHD screening in children with SCD who have poor school performance or behavioral concerns. Despite the benefits of pharmacologic treatment, the majority of patients with SCD and ADHD did not receive a medication for management of their ADHD.
神经心理缺陷，包括注意力方面的困难，在镰状细胞病（SCD）患儿中已有充分描述。对于SCD患儿的注意力缺陷多动障碍（ADHD）却知之甚少。本研究的目的是确定因神经心理评估而转诊的SCD患儿中ADHD的比例。这项前瞻性横断面研究纳入了2013年12月至2016年3月期间年龄在4至18岁、完成神经心理评估的SCD患者。患者因对学业成绩、发育和/或行为的担忧而被转诊进行神经心理评估。ADHD的诊断由神经心理学家根据《精神疾病诊断与统计手册》第四版或第五版中的诊断标准做出。通过查阅病历获得ADHD药物使用率。在89例因神经心理评估而转诊的SCD患者中，25%（95%置信区间，16%-35%）符合ADHD诊断标准。SCD合并ADHD的患者中只有21%被开具了ADHD药物。我们的研究支持对学业成绩差或有行为问题的SCD患儿进行常规ADHD筛查。尽管药物治疗有好处，但大多数SCD合并ADHD的患者并未接受用于治疗其ADHD的药物。
