BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medicati...BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.展开更多
目的系统评价虚拟现实技术用于轻度认知障碍患者的康复效果,为规范有效康复训练提供参考。方法计算机检索Web of Science、PubMed、Cochrane Library、Embase、中国知网、万方数据库、维普数据库及中国生物医学文献数据库有关虚拟现实...目的系统评价虚拟现实技术用于轻度认知障碍患者的康复效果,为规范有效康复训练提供参考。方法计算机检索Web of Science、PubMed、Cochrane Library、Embase、中国知网、万方数据库、维普数据库及中国生物医学文献数据库有关虚拟现实技术对轻度认知障碍患者干预效果的随机对照试验,检索时限为建库至2022年12月。符合质量标准的文献采用RevMan5.4软件进行Meta分析。结果共纳入16篇文献,747例轻度认知障碍患者。Meta分析结果显示,与常规认知训练或护理措施相比,虚拟现实认知训练可以提高轻度认知障碍患者的总体认知功能[SMD=0.97,95%CI(0.44,1.50),P<0.05],亚组分析显示,干预周期<8周[SMD=1.79,95%CI(0.50,3.00),P<0.05],干预总时长≥15 h[SMD=1.49,95%CI(0.64,2.33),P<0.05],半沉浸式虚拟现实技术[SMD=3.59,95%CI(3.34,3.85),P<0.05]效果更显著;虚拟现实认知训练改善执行功能[SMD=-0.89,95%CI(-1.62,-0.15),P<0.05];注意力[SMD=0.81,95%CI(0.24,1.39),P<0.05];生活质量[SMD=0.61,95%CI(0.33,0.88),P<0.05];但在记忆功能方面差异无统计学意义[SMD=0.38,95%CI(-0.19,0.95),P>0.05]。结论虚拟现实技术可以提高轻度认知障碍患者的总体认知功能。建议采用半沉浸式虚拟现实干预,干预周期少于8周,总时长至少15 h;虚拟现实技术对执行功能、注意力、生活质量有改善作用,但无法强化其记忆功能。展开更多
目的探讨注意缺陷多动障碍(attention-deficit/hyperactivity disorder,ADHD)儿童的认知与功能损害特征。方法选取2019年1月—2020年12月在广西壮族自治区妇幼保健院门诊确诊的ADHD患儿(ADHD组,n=320),采用韦氏儿童智力量表(Wechsler in...目的探讨注意缺陷多动障碍(attention-deficit/hyperactivity disorder,ADHD)儿童的认知与功能损害特征。方法选取2019年1月—2020年12月在广西壮族自治区妇幼保健院门诊确诊的ADHD患儿(ADHD组,n=320),采用韦氏儿童智力量表(Wechsler intelligence scale for children,WISC)第4版(WISC-Ⅳ)、中文版SNAP-Ⅳ评定量表父母版(Chinese version of Swanson Nolan and Pelham,versionⅣscale,parent form,SNAP-Ⅳ)和Weiss功能缺陷量表父母版(Weiss functional impairment rating scale,parent form,WFIRS-P)对儿童的认知特征、ADHD症状和功能损害情况进行评估,以同期接受常规健康体检的同年龄段儿童作为正常对照(对照组,n=120)。结果与对照组比较,ADHD组WISC-Ⅳ中言语理解指数、知觉推理指数、工作记忆指数、加工速度指数及总智商均较低,SNAP-Ⅳ中注意缺陷、多动/冲动、对立违抗项目得分及WFIRS-P中家庭、学习/学校、生活技能、自我观念、社会活动、冒险活动项目得分均较高,差异均有统计学意义(均P<0.05)。在ADHD组,智力水平<90分亚组的SNAP-Ⅳ和WFIRS-P各项目得分均显著高于智力水平≥90分亚组,差异均有统计学意义(均P<0.05)。结论ADHD儿童存在认知相对低下和功能损害情况,且智力水平较低者ADHD核心症状及功能损害更严重。展开更多
基金Supported by Ningbo Science and Technology Plan Project Public Welfare Plan(Municipal Level),No:2019C50099Ningbo Medical Key Supporting Discipline Child Health Science,No:2022-F26。
文摘BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.
文摘目的探讨注意缺陷多动障碍(attention-deficit/hyperactivity disorder,ADHD)儿童的认知与功能损害特征。方法选取2019年1月—2020年12月在广西壮族自治区妇幼保健院门诊确诊的ADHD患儿(ADHD组,n=320),采用韦氏儿童智力量表(Wechsler intelligence scale for children,WISC)第4版(WISC-Ⅳ)、中文版SNAP-Ⅳ评定量表父母版(Chinese version of Swanson Nolan and Pelham,versionⅣscale,parent form,SNAP-Ⅳ)和Weiss功能缺陷量表父母版(Weiss functional impairment rating scale,parent form,WFIRS-P)对儿童的认知特征、ADHD症状和功能损害情况进行评估,以同期接受常规健康体检的同年龄段儿童作为正常对照(对照组,n=120)。结果与对照组比较,ADHD组WISC-Ⅳ中言语理解指数、知觉推理指数、工作记忆指数、加工速度指数及总智商均较低,SNAP-Ⅳ中注意缺陷、多动/冲动、对立违抗项目得分及WFIRS-P中家庭、学习/学校、生活技能、自我观念、社会活动、冒险活动项目得分均较高,差异均有统计学意义(均P<0.05)。在ADHD组,智力水平<90分亚组的SNAP-Ⅳ和WFIRS-P各项目得分均显著高于智力水平≥90分亚组,差异均有统计学意义(均P<0.05)。结论ADHD儿童存在认知相对低下和功能损害情况,且智力水平较低者ADHD核心症状及功能损害更严重。
