همه گيرشناسي اختلالهاي رفتاري ايذايي و كمبود توجه در دانش آموزان دبستاني شهر گناباد

Epidemiology of attention deficit and disruptive behaviour disorders in elementary school children of Gonabad town, north east iran (1996-1997)

پژوهش حاضر با هدف تعيين ميزان شيوع اختلالهاي رفتاري ايذايي و كمبود توجه در دو مرحله بر روي 400 دانش‌آموز دبستاني(302 پسر،198 دختر)شهر گناباد انجام شد كه در آن از پرسشنامه‌هاي‌"آموزگاران‌"و"پدران و مادران‌"( CSI-4 )به‌ عنوان ابزار غربالگري استفاده گرديد.در مرحله نخست(بررسي مقدماتي)،متن فارسي پرسشنامه‌ها توسط تني چند از متخصصان ارزيابي و اصلاح شد سپس توسط مادران و آموزگاران 100 دانش‌آموز تكميل شد.آنگاه صد كودك مزبور توسط روانپزشك مصاحبه و پرسشنامه مربوط به والدين توسط روانپزشك براي آنها تكميل گرديد.سپس با مقايسه تشخيص‌ روانپزشك با نتايج پرسشنامه‌ها"حساسيت‌"و"ويژگي‌"آزمونها بر اساس بهترين نقطه برش براي هر اختلال رفتار ايذايي تعيين‌ شد.نتايج داده‌هاي اين مرحله نشان داد كه به كارگيري هر دو چك ليست با نقاط برش تعيين شده از قابليت غربالگري مناسبي‌ برخوردار است.در مرحله دوم،دو فرم پرسشنامه توسط مادران و آموزگاران 300 دانش‌آموز ديگر كه به طور تصادفي انتخاب‌ شده بودند تكميل گرديد.با استفاده از نتايج كل نمونه،ميزان شيوع اختلالهاي مورد نظر تعيين شد.نتايج نشان داد كه 17 درصد از افراد مورد بررسي دچار اختلالهاي رفتار ايذايي و كمبود توجه هستند.اختلال بيش‌فعالي-كمبود توجه با 9 درصد از شايعترين اختلالها بود.همچنين بين ميزان شيوع اختلالهاي رفتار ايذايي و كمبود توجه و عوامل جمعيت‌شناختي‌ جنسيت،پايه تحصيلي،سن،وضعيت اجتماعي-اقتصادي پدر و مادر،وضعيت تحصيلي،سابقه اختلالهاي روانپزشكي‌ پدر و مادر و برادران و خواهران دانش‌آموز ارتباط معني‌داري وجود داشت.

Using the persian version of Gadow's child syptom Inventory (SCI-4), an attempt was made to determine the prevalence of attention deficit and disruptive behaviours among elementary school children of Gonabad town in the north eastern khorasan province of Iran. Subjects consisted of 400 children (202 boys and 198 girls) ages 7 to 12 years attending grades 1-5 of public primary schools. They had been randomly chosen to represent the population of primary school pupils of the town. During the first phase of the study, 100 of the children selected for study were rated by their mothers and teachers using the CSI-4. the same children were then interviewed by a trained psychiatrist who also filled the CSI-4 for each of them. Using the latter ratings as a criterion, the sensitivity andspecificity of ratings made by mothers and teachers were deetermined and a cut-off point was established for diagnosis of hyperactivit and disruptive behaviour disorder. Applying this cut-off point to the total sample of children rated by their teacers and mothers (N=400) it was found that %21.8 of boys as compared with %12.1 of girls meet the DSM-IV criteria for attention deficit and disruptive behaviour disorders. The majority of children (%9.9 of boys and %8.1 of girls) identified as behaviourally disturbed manifested symptoms of hyperactivity / attention deficit disorder. The second most prevalent category of behaviorla disturbance was conduct disorder (manifested by %8.99 of boys and %4.0 of girls). Defiant oppositional disorder was shown only by %5.9 of boys and %3.0 of girls. Among boys, the highest rates of disorder were shown by the six children aged 12 plus (%100). All of whom were below their age level in terms of academic progress and has been rated as, academically very werak, by their teachers. Rates of behaviour disorder tended to be higher among children from lower socioeconomic backgrounds.