A Correlative Study Of The Psychological And Social Factors In Patients With Comorbid Attention Deficit Hyperactivity Disorder And Tic Disorder

Objectives: The purpose of this study was to investigate the cognitive function, psychological and behavioral characteristics, the quality of life and the family environment characteristics of the patients with comorbid attention deficit hyperactivity disorder (ADHD) and tic disorder (TD) (CAT); The study was designed to multiplvariate analyze the biological-psychological-social risk factors of CAT and to examine the relationship between cognitive behavior, personality, self-concept and the family environment characteristics of the patients with CAT.Methods: The total of 270 subjects were randomly assigned either 60 children with comorbid ADHD and TD (CAT), 79 children with ADHD, 60 children with TD and 71 normal children(NG). All of those cases were investigated using assessment scales as follows: the common information questionnaire(self-designed), the China-Wechsler Intelligence Scale for Children(C-WISC), the Integrated Visual and Auditory Continuous Performance Test(IVA-CPT), the child behavior checklist (CBCL), the Eysenck Personality Questionnaire(EPQ), the Piers-Harris Children's Self-Concept Scale(PHCSS), the Inventory of Subjective Life quality(ISLQ) and the Family environment Scale-Chinese Version(FES-CV). Statistical analyses were performed by the chi-square test, analysis of variance (ANOVA) and Binary logistic regression with SPSS / PC package .Results: (1)The scores of the Verbal Intelligence Quotient(VIQ,100.30±14.50),Performance Intelligence Quotient(PIQ,97.60±13.94),Full Intelligence Quotient (FIQ,99.15±14.46) of the CAT group were in normal range. The scores were higher than the ADHD group and lower than the TD group, but the difference had no statistically significant. (2) The CAT group showed obviously decreased tendency in the full scale response control quotient (FRCQ,83.43±20.98) and full scale attention quotient (FAQ,64.88±16.88) of the IVA-CPT compared with the TD(96.47±17.83, 85.37±18.54) and normal group(98.42±12.67, 99.33±12.98), but didn't display significant changes contrasted with the ADHD group (78.01±20.26, 67.19±19.63). (3) Compared with the TD and normal group, the scores of depression, obsession, social recession, hyperactivity, aggression and anti-discipline in CBCL in the CAT and ADHD group increased remarkably. The scores of obsession and aggression in the CAT group were higher than the ADHD group obviously. (4) The CAT group displayed more increased tendency than the TD and normal group in the scores of Neuroticism and Psychoticism and lower than the TD group in the scores of Lie in EPQ. (5) The scores of Self-concept of the CAT group decreased notably contrasted with the TD and normal group. The CAT group showed lower than the ADHD group but the contrast had no statistically significant. (6) The CAT group exhibited significant reduction compared with the TD and normal group but no obvious difference with the ADHD group in subjective living satisfaction degree. (7) Compared with the TD and normal group, the CAT group had the obvious family functional defection. The scores of the CAT group were higher than ADHD in conflict and lower than ADHD in independence, intellectual-cultural orientation and active-recreational orientation. But the difference had no statistically significant. (8) There were significantly negative correlation between cohesion and obsession, social recession, hyperactivity, aggression,anti-discipline of CBCL, expressiveness and depression, hyperactivity,aggression, active-recreational orientation and aggression. There were significantly negative correlation between conflict and lie of EPQ and behavior factor of PHCSS. (9) The factors which entered regression equation were as follows: circumstance in duration of pregnancy in biological factor, the attitude of mother to child's miss conduct, the attitude of father to child's miss conduct,parents'anticipation,per capita family income and conflict,intellectual-cultural orientation of FES-CV in social environment factors, hyperactivity,aggression,FAQ,Psychoticism in EPQ,total score of PHCSS, companion communication of ISLQ in psychological and behavioral factors. It indicated that these factors were the main risk factors of CAT.Conclusion: CAT was different from ADHD and TD in the cognitive function,psychological and behavioral characteristics and the family environment characteristics. Children with CAT evidenced normal intelligence, but decreased notably the continuous attention, more externalizing and internalizing behavior problem compared with ADHD,TD and normal children. Meanwhile, they showed more sensitive suspicious personality, emotional instability, and inferior self-concept. These disorders affected seriously the mental function, social function and the quality of life of children with CAT. CAT was correlated with general biological-psychological-social risk factors. The most important factors affecting CAT were the attitude of mother to child's miss conduct, parents'anticipation, conflict and intellectual-cultural orientation of family environment, Psychoticism of personality.