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抽动障碍儿童心理行为问题及相关因素研究

沈玥赤 苏堂枫 肖沛 宋然然 徐三清

沈玥赤, 苏堂枫, 肖沛, 宋然然, 徐三清. 抽动障碍儿童心理行为问题及相关因素研究[J]. 中国学校卫生, 2022, 43(10): 1535-1538. doi: 10.16835/j.cnki.1000-9817.2022.10.022
引用本文: 沈玥赤, 苏堂枫, 肖沛, 宋然然, 徐三清. 抽动障碍儿童心理行为问题及相关因素研究[J]. 中国学校卫生, 2022, 43(10): 1535-1538. doi: 10.16835/j.cnki.1000-9817.2022.10.022
SHEN Yuechi, SU Tangfeng, XIAO Pei, SONG Ranran, XU Sanqing. Psychological and behavioral problems and associated factors in children with tic disorders[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(10): 1535-1538. doi: 10.16835/j.cnki.1000-9817.2022.10.022
Citation: SHEN Yuechi, SU Tangfeng, XIAO Pei, SONG Ranran, XU Sanqing. Psychological and behavioral problems and associated factors in children with tic disorders[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2022, 43(10): 1535-1538. doi: 10.16835/j.cnki.1000-9817.2022.10.022

抽动障碍儿童心理行为问题及相关因素研究

doi: 10.16835/j.cnki.1000-9817.2022.10.022
基金项目: 

国家自然科学基金项目 81804188

详细信息
    作者简介:

    沈玥赤(1995-),女,湖北恩施人,在读硕士,主要研究方向为儿童神经病学及心理学

    通讯作者:

    徐三清,E-mail:sanqingx@163.com

  • 利益冲突声明  所有作者声明无利益冲突。
  • 中图分类号: B844.1  R179  R748

Psychological and behavioral problems and associated factors in children with tic disorders

  • 摘要:   目的  研究抽动障碍儿童的心理行为问题及相关因素,为合理干预治疗提供依据。  方法  采用病例对照研究方法,选择2020年6月至2021年6月华中科技大学同济医学院附属同济医院儿科神经门诊就诊的69名抽动障碍(TD)儿童作为病例组,并按性别与年龄匹配同期69名非TD的正常儿童作为对照组,通过填写一般情况调查表、儿童焦虑性情绪筛查量表 41项(SCARED-41)、长处和困难问卷(SDQ-25)及儿童抑郁量表 10项(CDI-10)等,分析TD儿童的心理行为问题及相关因素。  结果  TD组与对照儿童组SCARED-41总分、SDQ-25总分及SDQ-25困难部分、CDI-10总分分别为(22.1±12.5,13.3±12.3)(21.1±6.0,15.9±3.4)(15.6±6.3,9.3±3.6)(3.7±2.9,2.6±2.9)分,差异有统计学意义(t/Z值分别为3.8,13.9,6.9,-2.6,P值均 < 0.05)。对TD组儿童的多重线性回归分析显示,母亲学历大学本科对SDQ-25情绪症状、大学专科对SDQ-25亲社会行为(B值分别为-2.20,2.14),父母管教态度宽松对SCARED-41广泛性焦虑、担心对SDQ-25多动(B值分别为-7.44,3.00),电子设备使用时长对SCARED-41躯体化/惊恐、学校恐怖和SDQ-25品行问题(B值分别为0.49,0.30,0.20)及运动强度小强度对CDI-10(B=-0.15)等量表得分影响有统计学意义(P值均<0.05)。  结论  TD儿童容易出现焦虑/抑郁情绪及行为问题,并与母亲学历、父母管教态度、电子设备使用时长及运动强度等因素相关。
    1)  利益冲突声明  所有作者声明无利益冲突。
  • 表  1  抽动障碍儿童心理行为问题影响因素多重线性回归分析(B值,n=69)

    Table  1.   Multiple linear regression analysis of influencing factors of psychological and behavioral problems in TD group(B, n=69)

    自变量 选项 SCARED-41 SDQ-25 CDI-10
    躯体化/惊恐 广泛性焦虑 分离性焦虑 社交恐怖 学校恐怖 情绪症状 品行问题 多动 同伴交往问题 亲社会行为
    母亲学历 高中/同等学历 -0.18 -0.78 -0.33 -0.19 -0.82 0.43 0.25 -0.16 0.15 1.22 -0.48
    大学专科 -2.36 -1.31 -1.76 -2.26 -0.76 0.45 -0.17 -0.52 -1.48 2.14* -1.60
    大学本科 -2.14 -2.52 -1.33 -1.77 -0.62 -2.20* -0.10 -1.24 -0.91 1.57 -2.24
    研究生 -1.36 -2.67 -2.55 -2.20 -1.76 -1.54 -0.17 -2.00 -2.05 0.43 -2.02
    父母管教态度 严格 0.25 -0.60 -0.34 0.18 0.65 0.01 0.30 1.40 0.32 0.65 0.06
    担心 -1.37 -1.98 -1.46 -1.39 0.36 1.20 0.40 3.00* 1.16 -0.85 0.57
    宽松 -6.49 -7.44* -5.32 -5.08 -1.33 -2.38 0.56 1.95 -0.40 -2.05 0.57
    运动强度 轻微运动 0.08 0.02 -1.46 0.63 0.38 -1.24 -0.25 -0.64 -0.82 1.29 -1.88
    小强度运动 -2.20 -2.68 -2.22 -1.68 -0.50 -1.78 -0.96 -0.82 -0.13 1.12 -0.15*
    中等强度运动 2.54 1.62 -0.41 0.11 0.21 -1.44 0.09 -1.25 -1.17 -0.10 -2.83
    电子设备使用时间 0.49* 0.30 -0.90 0.19 0.30** 0.02 0.20* -0.07 0.01 -0.10 0.24
    :*P<0.05;**P<0.01。母亲学历、父母管教态度、运动强度分别以初中、合理、未参与运动为对照。
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  • [1] 刘智胜, 秦炯, 王家勤, 等. 儿童抽动障碍诊断与治疗专家共识(2017实用版)[J]. 中华实用儿科临床杂志, 2017, 32(15): 1137-1140. doi: 10.3760/cma.j.issn.2095-428X.2017.15.005

    LIU Z S, QIN J, WANG J Q, et al. Experts consensus of treatment and diagnosis of tic disorders in children (2017 practical version)[J]. Chin J Appl Clin Pediatr, 2017, 32(15): 1137-1140. (in Chinese) doi: 10.3760/cma.j.issn.2095-428X.2017.15.005
    [2] 徐通, 周翊. 儿童抽动障碍病因及发病机制[J]. 中国实用儿科杂志, 2012, 27(7): 502-505. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK201207008.htm

    XU T, ZHOU Y. Etiology and pathogenesis of tic disorders in children[J]. Chin J Pract Pediatr, 2012, 27(7): 502-505. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZSEK201207008.htm
    [3] 李韵, 刘秀勤, 陈丽清, 等. 抽动障碍患儿焦虑情绪特点及影响因素[J]. 中华行为医学与脑科学杂志, 2018, 27(5): 416-420. doi: 10.3760/cma.j.issn.1674-6554.2018.05.007

    LI Y, LIU X Q, CHEN L Q, et al. Anxiety traits and influencing factors of children with tic disorders[J]. Chin J Behav Med Brain Sci, 2018, 27(5): 416-420. (in Chinese) doi: 10.3760/cma.j.issn.1674-6554.2018.05.007
    [4] 刘秀勤, 李韵, 杨丽容, 等. 抽动障碍患儿一级亲属焦虑特点及对患儿焦虑情绪的影响[J]. 中华行为医学与脑科学杂志, 2018, 27(10): 892-895. doi: 10.3760/cma.j.issn.1674-6554.2018.10.006

    LIU X Q, LI Y, YANG L R, et al. The anxious traits of the first-degree relatives and its influence on anxiety emotion of children with tic disorders[J]. Chin J Behav Med Brain Sci, 2018, 27(10): 892-895. (in Chinese) doi: 10.3760/cma.j.issn.1674-6554.2018.10.006
    [5] GIRGIS J, MARTINO D, PRINGSHEIM T. Influence of sex on tic severity and psychiatric comorbidity profile in patients with pediatric tic disorder[J]. Dev Med Child Neurol, 2022, 64(4): 488-494. doi: 10.1111/dmcn.15088
    [6] American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5) [M]. 5th ed. Arlington, VA: American Psychiatric Association, 2013: 81.
    [7] 王凯, 苏林雁, 朱焱, 等. 儿童焦虑性情绪障碍筛查表的中国城市常模[J]. 中国临床心理学杂志, 2002, 10(4): 270-272. doi: 10.3969/j.issn.1005-3611.2002.04.009

    WANG K, SU L Y, ZHU Y, et al. Norms of the screen for child anxiety related emotional disorders in Chinese urban children[J]. Chin J Clin Psychol, 2002, 10(4): 270-272. (in Chinese) doi: 10.3969/j.issn.1005-3611.2002.04.009
    [8] 柳之啸, 李京, 王玉, 等. 中文版儿童抑郁量表的结构验证及测量等值[J]. 中国临床心理学杂志, 2019, 27(6): 1172-1176. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201906020.htm

    LIU Z X, LI J, WANG Y, et al. Structural verification and measurement invariance of Chinese version of Children's Depression Inventory[J]. Chin J Clin Psychol, 2019, 27(6): 1172-1176. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZLCY201906020.htm
    [9] PATERSON J, MEDVEDEV O N, SUMICH A, et al. Distinguishing transient versus stable aspects of depression in New Zealand Pacific Island children using Generalizability Theory[J]. J Affect Disorder, 2018, 227: 698-704. doi: 10.1016/j.jad.2017.11.075
    [10] 寇建华, 杜亚松, 夏黎明. 儿童长处和困难问卷(父母版)上海常模的信度和效度[J]. 上海精神医学, 2005, 17(1): 25-28. doi: 10.3969/j.issn.1002-0829.2005.01.007

    KOU J H, DU Y S, XIA L M. Reliability and validity of Children Strengths and Difficulties Questionnaire in Shanghai norm[J]. Arch Psychiatry, 2005, 17(1): 25-28. (in Chinese) doi: 10.3969/j.issn.1002-0829.2005.01.007
    [11] LIU Z S, CUI Y H, SUN D, et al. Current status, diagnosis, and treatment recommendation for tic disorders in China[J]. Front Psychiatry, 2020, 11: 774.
    [12] CONTE G, VALENTE F, FIORIELLO F, et al. Rage attacks in tourette syndrome and chronic tic disorder: a systematic review[J]. Neurosci Biobehav Rev, 2020, 119: 21-36. doi: 10.1016/j.neubiorev.2020.09.019
    [13] ESSOE J K, GRADOS M A, SINGER H S, et al. Evidence-based treatment of Tourette's disorder and chronic tic disorders[J]. Expert Rev Neurother, 2019, 19(11): 1103-1115. doi: 10.1080/14737175.2019.1643236
    [14] MATHEWS C A, BIMSON B, LOWE T L, et al. Association between maternal smoking and increased symptom severity in Tourette's syndrome[J]. Am J Psychiatry, 2006, 163(6): 1066-1073. doi: 10.1176/ajp.2006.163.6.1066
    [15] SILVESTRI P R, CHIAROTTI F, GIUSTINI S, et al. Alexithymia and tic disorders: a study on a sample of children and their mothers[J]. Eur Child Adolesc Psychiatry, 2019, 28(4): 461-470. doi: 10.1007/s00787-018-1209-x
    [16] BROEREN S, NEWALL C, DODD H F, et al. Longitudinal investigation of the role of temperament and stressful life events in childhood anxiety[J]. Dev Psychopathol, 2014, 26(2): 437-449. doi: 10.1017/S0954579413000989
    [17] MIRZAEI M, YASINI A S, MIRZAEI M, et al. Prevalence of depression, anxiety and stress among adult population: results of yazd health study[J]. Iran J Psychiatry, 2019, 14(2): 137-146.
    [18] PARKES A, SWEETING H, WIGHT D. Parenting stress and parent support among mothers with high and low education[J]. J Fam Psychol, 2015, 29(6): 907-918. doi: 10.1037/fam0000129
    [19] 左本琴. 3~4岁幼儿社会性发展及其与家庭环境的关联研究[D]. 上海: 华东师范大学, 2011.

    ZUO B Q. The study on the development of sociality in young children aged 3-4 and the relevance with family environment[D]. Shanghai: East China Normal University, 2011. (in Chinese)
    [20] 中华医学会儿科学分会发育行为学组. 注意缺陷多动障碍早期识别、规范诊断和治疗的儿科专家共识[J]. 中华儿科杂志, 2020, 58(3): 188-193.

    Subspecialty Group of Developmental and Behavioral Pediatrics, Society of Pediatrics, CMA. Consensus on pediatric clinical practice of early identification, standardized diagnosis and treatment of attention deficit hyperactivity disorder[J]. Chin J Pediatr, 2020, 58(3): 188-193. (in Chinese)
    [21] DIETZ L J, WEINBERG R J, BRENT D A, et al. Family-based interpersonal psychotherapy for depressed preadolescents: examining efficacy and potential treatment mechanisms[J]. J Am Acad Child Adolesc Psychiatry, 2015, 54(3): 191-199. doi: 10.1016/j.jaac.2014.12.011
    [22] GRAZIANO P A, ROS-DEMARIZE R, HARE M M. Condensing parent training: a randomized trial comparing the efficacy of a briefer, more intensive version of Parent-Child Interaction Therapy (I-PCIT)[J]. J Cons Clin Psychol, 2020, 88(7): 669-679.
    [23] REDMAYNE M, SMITH E, ABRAMSON M J. The relationship between adolescents' well-being and their wireless phone use: a cross-sectional study[J]. Environ Health, 2013, 12: 90.
    [24] KESARI K K, SIDDIQUI M H, MEENA R, et al. Cell phone radiation exposure on brain and associated biological systems[J]. Indian J Exp Biol, 2013, 51(3): 187-200.
    [25] OBERLE E, JI X R, KERAI S, et al. Screen time and extracurricular activities as risk and protective factors for mental health in adolescence: a population-level study[J]. Prev Med, 2020, 141: 106291.
    [26] FIELD T. Exercise research on children and adolescents[J]. Complement Ther Clin Pract, 2012, 18(1): 54-59.
    [27] BIDDLE S J, ASARE M. Physical activity and mental health in children and adolescents: a review of reviews[J]. Br J Sports Med, 2011, 45(11): 886-895.
    [28] ALVES J, ALVES G V. Effects of physical activity on children's growth[J]. J Pediatr, 2019, 95(Suppl 1): 72-78.
    [29] SERRA L, RAIMONDI S, DI DOMENICO C, et al. The beneficial effects of physical exercise on visuospatial working memory in preadolescent children[J]. AIMS Neurosci, 2021, 8(4): 496-509.
    [30] CHEN P, WANG D, SHEN H, et al. Physical activity and health in Chinese children and adolescents: expert consensus statement (2020)[J]. Br J Sports Med, 2020, 54(22): 1321-1331.
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出版历程
  • 收稿日期:  2022-04-11
  • 修回日期:  2022-08-12
  • 网络出版日期:  2022-10-28
  • 刊出日期:  2022-10-25

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