4种常见评定量表在儿童注意缺陷多动障碍诊断与随访管理中的应用

Application of four commonly used rating scales in diagnosis and follow-up management of children with attention deficit hyperactivity disorder

摘要:

目的：通过介绍及比较4种常用注意缺陷多动障碍评定量表，促进普儿科、儿童保健、发育行为儿科医师等对其了解和选择应用。方法：检索并回顾性分析相关文献。结果：4种量表中Conners评定量表诞生最早、Vanderbilt量表最晚；SNAP评定量表、注意缺陷多动障碍诊断量表父母版及Vanderbilt量表均参考了美国精神障碍诊断与统计手册关于注意缺陷多动障碍的诊断标准；Vanderbilt量表增加了部分共患病筛查内容及家长/教师随访量表；Conners评定量表及注意缺陷多动障碍诊断量表父母版国内常模制定及心理测量学研究相对完善，而国外Vanderbilt量表心理测量学研究提示其具有较好的心理测量学特点，但国内尚缺乏Vanderbilt量表心理测量学相关研究。结论：需进一步引入并标化新版量表，如Vanderbilt量表，以提高临床诊断及随访管理水平。未来还可制定符合我国国情的注意缺陷多动障碍评定量表及应用规范，进一步适应我国医-教-家庭的关系及实际情况，提升我国注意缺陷多动障碍的全方位诊治及管理。

Abstract:

Objective：To introduce and compare four commonly used rating scales for attention deficit hyperactivity disorder（ADHD），and to help physicians engaged in general pediatrics，child care，and developmental and behavioral pediatrics to understand and select these scales. Methods：Related articles were searched for and analyzed retrospectively. Results：Conners’ Rating Scale was developed the earliest，and Vanderbilt Rating Scale was developed the latest. Swanson，Nolan and Pelham Rating Scales，ADHD Diagnostic Scale-Parent Version，and Vanderbilt Rating Scale were developed with reference to the diagnostic criteria for ADHD in the Diagnostic and Statistical Manual of Mental Disorders. The contents of the screening of comorbidities and parent/teacher follow-up scales were added to Vanderbilt Rating Scale. The national norm and psychometric studies of Conners’ Rating Scale and ADHD Diagnostic Scale-Parent Version are relatively complete in China，and the psychometric studies of Vanderbilt Rating Scale in foreign countries have shown that this scale has good psychometric features，but there is a lack of related studies in China. Conclusion：New scales，such as Vanderbilt Rating Scale，should be introduced and standardized to improve clinical diagnosis and follow-up management. Rating scales and application standards which meet the basic conditions of China should be developed in the future to adapt to the actual situation of the relationship between medicine，education，and family and promote the comprehensive diagnosis，treatment，and management of ADHD in China.