抽动秽语综合征共患注意缺陷多动障碍的 临床特征分析
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国家重点研发计划项目(2016YFC1306100);北京市医院管理局重点医学专业发展专项 经费资助(ZYLX201607);北京市医院管理局“登峰”人才培养计划专项经费资助(DFL20151801);北京 市医院管理局“青苗”计划专项经费资助(QML20171904)


Analysis of clinical features in patients with tourette syndrome comorbid attention deficit hyperactivity disorder
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    目的 调查影响抽动秽语综合征(TS)共患注意缺陷多动障碍(ADHD)患者的临床特征。 方法 本研究包括回顾性研究和横断面调查研究两部分,回顾2005—2007 年在北京安定医院就诊并登 记入库的TS 患者的人口学资料和病例特征,并对TS 患者及家长进行横断面调查研究;由临床医生对患 者进行简明儿童少年神经精神访谈问卷(MINI-Kid)、DSM-5 诊断评估以及斯诺佩评估量表(SNAP- Ⅳ)评 估,由家长完成Conners父母症状问卷评估,由患者本人完成Conners自评量表和儿童自我意识量表评 估,并由临床医生对患者采用耶鲁布朗大体抽动严重程度量表(YGTSS)进行抽动症状严重程度评估并 记录其是否规律治疗TS,以及是否服用治疗ADHD药物。结果 221例患者纳入分析,其中138例(62.4%) 为TS 共患ADHD 患者,TS 共患ADHD组患者在围产期不良事件、发病年龄、首次诊断年龄、首次治疗年 龄、是否规律治疗及精神疾病家族史方面与TS 未共患ADHD 组差异有统计学意义,其症状严重程度与 围产期不良事件、是否规律治疗、是否接受ADHD 药物治疗及精神疾病家族史有关。明显症状组患者 接受ADHD 治疗比例低于轻微症状组。结论 TS 共患ADHD 治疗效果与围产期不良事件、是否规律治 疗、是否接受ADHD治疗以及精神疾病家族史有关。

    Abstract:

    Objective To investigate the clinical features of patients with tourette syndrome( TS) with comorbid attention deficit hyperactivity disorder. Methods This study included two parts, retrospective study and cross-sectional study. The demographic data and case characteristics of TS patients who were admitted to Anding Hospital and registered during 2005-2007 was reviewed. A cross-sectional survey of TS patients and their parents was conducted. Patients were assessed by clinicians for Mini International Neuropsychiatric Interview for children and adolescents( MINI-Kid), DSM-5 diagnostic assessment, and the Snowman Assessment Scale( Swanson Nolan and Palham Scale- Ⅳ, SNAP- Ⅳ) assessment. Parents complete the Conners Parents Symptom Questionnaire Assessment. The patients completed the Conners Self-rating Scale and the Child Self- Consciousness Scale Assessment. The clinicians evaluated the severity of tic symptoms using the Yale Global Tic Severity Scale( YGTSS) and recorded whether they regularly treated TS and took ADHD medications. Results A total of 221 patients were included in the analysis, of which 138( 62.4%) were TS co-morbidities ADHD patients. There were statistically significant differences between TS co-morbid with ADHD patients and non-comorbid ADHD group in perinatal adverse events, age of onset, age at first diagnosis, first-time treatment, regular therapy and family history of mental illness. The severity of TS comorbid with ADHD was effected by perinatal adverse events, whether had the regular treatment, accepted ADHD drug treatment and family history of mental illness. The proportion of patients with overt symptoms who received ADHD was lower than those with mild symptoms. Conclusions The treatment effect of TS co-morbidities ADHD is related to perinatal adverse events, regular therapy, ADHD treatment and family history of mental illness.

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陈旭 何凡 郑毅.抽动秽语综合征共患注意缺陷多动障碍的 临床特征分析[J].神经疾病与精神卫生,2018,18(7):
DOI :10.3969/j. issn.1009-6574.2018.07.001.

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  • 在线发布日期: 2018-10-29