Attention Deficit Hyperactivity Disorder in Children With Sickle Cell Disease Referred for an Evaluation
Attention Deficit Hyperactivity Disorder in Children With Sickle Cell Disease Referred for an Evaluation
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DOI：
10.1097/mph.0000000000000847
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发表时间：
2017-07-01
影响因子：
1.2
通讯作者：
Scott, John Paul
中科院分区：
文献类型：
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作者：
Acquazzino, Melissa A.;Miller, Meghan;Scott, John Paul
神经心理缺陷，包括注意力困难，在镰状细胞病（SCD）儿童中有很好的描述。关于SCD儿童的注意缺陷多动障碍（ADHD）知之甚少。本研究的目的是确定神经心理学评估的SCD儿童中ADHD的比例。这项前瞻性横断面研究纳入了SCD患者（年龄4 - 18岁），并在2013年12月至2016年3月期间完成了神经心理学评价。由于对学校表现、发展和/或行为的关注，患者被转诊进行神经心理学评估。ADHD的诊断是由神经心理学家根据诊断统计手册第四版或第五版中的诊断标准做出的。通过病历回顾获得ADHD药物使用率。在89名接受神经心理学评估的SCD患者中，25%（95%置信区间，16%-35%）符合ADHD的诊断标准。只有21%的SCD和ADHD患者接受了ADHD药物治疗。我们的研究支持在患有SCD的儿童中进行常规ADHD筛查，这些儿童的学校表现或行为问题较差。尽管药物治疗有好处，但大多数患有SCD和ADHD的患者没有接受药物治疗。
Neuropsychological deficits, including difficulties with attention, are well described in children with sickle cell disease (SCD). Very little is known about attention deficit hyperactivity disorder (ADHD) in children with SCD. The objective of this study was to determine the proportion of ADHD in children with SCD referred for neuropsychological evaluation. This prospective, cross-sectional study included patients (age, 4 to 18 y) with SCD and completion of a neuropsychological evaluation between December 2013 and March 2016. Patients were referred for neuropsychological evaluation because of concern regarding school performance, development, and/or behavior. The diagnosis of ADHD was made by a neuropsychologist on the basis of the diagnostic criteria in the Diagnostic Statistical Manual-Fourth or Fifth Editions. ADHD medication usage rate was obtained by medical record review. Of the 89 patients with SCD referred for neuropsychological evaluation, 25% (95% confidence interval, 16%-35%) met diagnostic criteria for ADHD. Only 21% of the patients with SCD and ADHD were prescribed an ADHD medication. Our study supports routine ADHD screening in children with SCD who have poor school performance or behavioral concerns. Despite the benefits of pharmacologic treatment, the majority of patients with SCD and ADHD did not receive a medication for management of their ADHD.