Sundarlall Ravindra, der Westhuizen Debbie Van, Fletcher Lizelle
Faculty of Health Sciences, University of Pretoria, South Africa.
S Afr J Psychiatr. 2016 May 31;22(1):836. doi: 10.4102/sajpsychiatry.v22i1.836. eCollection 2016.
ADHD (attention-deficit/hyperactivity disorder) is gradually being acknowledged as a functionally impairing disorder across the lifespan, underscored by heritability. Nonetheless, lack of ADHD (adult attention-deficit/hyperactivity disorder) data from South Africa is alarming which could be due to either the unawareness of ADHD symptoms or underutilisation of available screening measures. Undiagnosed ADHD may influence family- and working lives unpleasantly. Parenting a child with ADHD may intensify parental stress through functional impairment notwithstanding the diagnosis of ADHD.
Eighty-one biological parents of children diagnosed with attention-deficit/hyperactivity disorder were screened using self-reporting measurements. ADHD self-report scale (ASRS-V 1.1) identified either positive or negative subgroups; the Weiss functional impairment rating scale (WFIR-S) for functional impairment and the Jerome driving questionnaire (JDQ) for risk-taking behaviour specifically driving.
Of the 39 (48%) parents who experienced impairment in all seven areas of functioning, 23 (59%) screened negative for ADHD, while 16 (41%) screened positive. A significant association was found between parents who screened either positive or negative for ADHD and functional impairment across five of the seven individual categories namely family, work, self-concept, life-skills and social functioning.
This study emphasised the high incidence of functional impairment in parents of ADHD children. Although a substantial number of parents screened negative for ADHD, they still reported impairment in functioning; probably due to undiagnosed ADHD with comorbid psychiatric disorders, and/or parental stress due to the complex behaviour of the child. Parents of children diagnosed with ADHD should be screened for functional impairment followed by referral for psychiatric assessment and parent management training to achieve better clinical outcomes.
注意缺陷多动障碍（ADHD）正逐渐被认为是一种会在整个生命周期造成功能损害的疾病，遗传因素凸显了这一点。尽管如此，南非缺乏成人注意缺陷多动障碍（ADHD）的数据令人担忧，这可能是由于对ADHD症状缺乏认识或未充分利用现有的筛查措施。未被诊断出的ADHD可能会对家庭和工作生活产生不良影响。养育患有ADHD的孩子可能会因功能损害而加剧父母的压力，尽管孩子已被诊断为ADHD。
使用自我报告测量方法对81名被诊断患有注意缺陷多动障碍儿童的亲生父母进行筛查。ADHD自我报告量表（ASRS-V 1.1）确定阳性或阴性亚组；使用韦斯功能损害评定量表（WFIR-S）评估功能损害，使用杰罗姆驾驶问卷（JDQ）评估冒险行为，特别是驾驶方面的冒险行为。
在39名（48%）在所有七个功能领域都有损害的父母中，23名（59%）ADHD筛查为阴性，而16名（41%）筛查为阳性。在ADHD筛查为阳性或阴性的父母与七个单独类别中的五个类别（即家庭、工作、自我概念、生活技能和社会功能）的功能损害之间发现了显著关联。
本研究强调了ADHD儿童父母中功能损害的高发生率。尽管相当数量的父母ADHD筛查为阴性，但他们仍报告有功能损害；这可能是由于未被诊断出的ADHD合并精神疾病，和/或由于孩子复杂行为导致的父母压力。应对被诊断患有ADHD儿童的父母进行功能损害筛查，然后转介进行精神评估和父母管理培训，以取得更好的临床效果。
