目的 调查学龄前儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患病情况及家长和教师对ADHD症状汇报的一致性。方法 对某市幼儿园的790名儿童家长和教师采用Conners简明症状问卷进行调查,并对问卷总分和各条目分进行卡方检验与Kappa一致性检验,分析比较患病率及家长和教师评估的一致性。结果(1)学龄前ADHD患病率为5.0%,男女患病率之比为3.5:1,三种分型及不同年龄间的患病率差异均不显著(c2=3.24,p＞0.05；c2=2.85,p＞0.05)；(2)家长报告的确诊率(27.8%)高于教师(13.9%)；双方均报告为阳性的确诊率为22.2%；(3)家长报告总分及各项目得分普遍高于教师,且两者汇报的一致性较低(Kappa系数均＜0.4)。结论 加强对学龄前ADHD的早期发现早期干预,同时,临床诊断中注意整合家长与教师两者信息,避免过度依赖家长信息而造成过度诊断。
Objective The prevalence of attention deficit hyperactivity disorder (ADHD) was investigated in preschool children and the consistency of ADHD symptoms reported by parents and teachers. Methods The Conners Concise Symptom Scale was used to fill in 790 children from one city’s kindergartens by parents and teachers. The scale"s total score and item scores were tested by chi-square test and Kappa consistency test to evaluate the prevalence and parent"s and teachers" evaluation. Results (1) The prevalence of preschool ADHD is 5.0%. The prevalence ratio of male and female is 3.5:1, and the prevalence of the three types is not significantly different (c2=3.24,p＞0.05；c2=2.85,p＞0.05). (2) Parents" diagnosis rate (27.8%) is higher than that of teachers (13.9%)；Both parents and teachers report a positive diagnosis rate of 22.2%. (3) All items reported by parents are higher than those of teachers. Both consistencies are low (Kappa coefficients <0.4).SConclusion The early detection and intervention of preschool ADHD should be strengthened. At the same time, the information of parents and teachers should be integrated in clinical diagnosis to avoid over-diagnosis caused by over-reliance on parents" information.