强迫性障碍与注意缺陷多动障碍男性儿童的延迟厌恶任务测试

摘要

目的：了解强迫性障碍（OCD）和注意缺陷多动障碍（ADHD）男性患儿延迟厌恶的特点以及与正常对照组的差异。方法：选取符合疾病和有关健康问题的国际统计分类第十次修订本（ICD-10）诊断标准的门诊8～16岁 OCD 男性患儿40例，ADHD 男性患儿40例，以及年龄、性别、智商匹配的正常对照儿童40例，运用选择延迟任务1、2分别进行常态和高态生态效度的延迟厌恶研究，任务的等待时间和得分反映各组常态生态效度和高态生态效度下延迟厌恶功能。结果：OCD 组选择延迟任务1 [（30.9±3.2）vs.（27.6±3.8）]和选择延迟任务2[（31.3±4.4）vs.（28.5±4.9）]得分均高于正常对照组（P ＜0.001），ADHD 组选择延迟任务1 [（25.0±4.3）vs.（27.6±3.8）]和选择延迟任务2[（26.2±4.6）vs.（28.5±4.9）]得分低于正常对照组（P ＜0.001）。结论：OCD 男孩更倾向于选择等待时间长而得分高的任务，而 ADHD 男孩更倾向于选择等待时间短而得分低的任务，提示该任务反映的多动／冲动控制的发病机制在 OCD 和 ADHD 延迟厌恶中可能不同。%Objective:To clarify the characteristics and differences between obsessive-compulsive disorder (OCD)and attention-deficit/hyperactivity disorder (ADHD)in male children.Methods:Forty boys with OCD and 40 boys with ADHD were selected from out-patient department,and 40 normal boys matched with age,gender and IQ were recruited as the controls.Patients'diagnosis was made according to the International Statistical Classifica-tion of Diseases and Related Health Problems,Tenth Revision (ICD-10).The choice delay tasks (CDT1 /2)were assessed respectively for the measurements of normal or high ecological validity of delay aversion.In CDT1 /2, waiting time and scores of the tasks were indicators reflecting the delay aversion.Results:The scores of CDTs were higher in children with OCD than in the controls [CDT1,(30.9 ±3.2)vs.(27.6 ±3.8);CDT2,(31.3 ±4.4)vs. (28.5 ±4.9);P <0.01].The scores of CDTs were lower in children with ADHD than in the controls [CDT1, [(25.0 ±4.3)vs.(27.6 ±3.8)];CDT2,[(26.2 ±4.6)vs.(28.5 ±4.9);P <0.001].Conclusion:The results in-dicate that the children with OCD have a trend to choose the task with longer waiting time and higher score,and the children with ADHD trend to choose the task with shorter waiting time and lower score.The results suggest that the pathogenesis of hyperactivity/impulse control may be different between OCD and ADHD in delay aversion.