주의력결핍 과잉행동장애 아동과 청소년에서의 환경 및 가족적 위험 요인

Abstract

Objectives The aim of this study was to analyze the environmental and familial variables associated with attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. Methods Children and adolescents aged 6-18 with in attention, hyperactivity, or impulsivity who visited the Department of Psychiatry at Soonchunhyang University Bucheon Hospital from April 2006 to April 2012, were interviewed for diagnosis of ADHD. Diagnostic and Statistical Manual of Mental Disorders, 4th edition symptom criteria for ADHD were assessed using a semistructured interview, the schedule for affective disorders and schizophrenia for school-age children present and lifetime version (K-SADS-PL). Environmental and familial variables were obtained using questionnaires for parents. Results In total, 262 children and adolescents with ADHD (n=139) and control subjects (n=123) were recruited. In a multivariate logistic regression model, results of this study showed that maternal psychiatric problem during pregnancy, dystoia, forceps/vacuum use during delivery,and unplanned pregnancy were risk factors for ADHD. Conclusion Findings of this study showed an association of some prenatal factors (such as unplanned pregnancy or maternal psychiatric problem during pregnancy) and some perinatal factors (dystocia and forceps/vacuum use during delivery) with increased risk of ADHD. The identified risk factors are environmental, and therefore potentially preventable. Conduct of further prospective studies is needed in order to clarify the potential role of these risk factors for ADHD.