Clinical Analysis Of Attention Deficit Hyperactivity Disorder In Children With Duchenne Muscular Dystrophy

ObjectiveDuchenne muscular dystrophy?DMD?is an inherited X chromosome-linked recessive myopathy in young people,and there is no specific treatment.At present,the focus of DMD research mainly includes cardiac,respiration,digestive system and so on.There are few studies on patients'psychological behavior.In recent years,a large number of studies found that DMD patients suffered from central nervous system damage,and often combined with attention deficit hyperactivity disorder?ADHD?,autism spectrum disorders,obsessive compulsive disorder,anxiety,depression and other mental and behavioral disorders.ADHD is a common neuropsychic and behavioral disorder in children.At present,the comorbidity rate of children complicated with DMD and ADHD was 11.7%to 32%,much higher than that in normal children.DMD patients with ADHD can lead to poor coordination,fail to complete clinical evaluation and adhere to rehabilitation therapy as required,and may also affect the social function of children at the same time,resulting in low survival and treatment for children.Therefore,it is great significance to the early diagnosis and early treatment intervention of the DMD combined with ADHD.At present,there is no research on DMD combined with ADHD in China.To assess comorbidity rate of children complicated with DMD and ADHD,and to analyze related influential factors and the effects of ADHD on quality of life of children with DMD.MethodsA total of 102 children diagnosed with DMD were enrolled in the study?March^October,2017?.The Diagnostic and Statistical Manual of Mental Disorders IV?DSM-IV?were adopted to evaluate the prevalence of ADHD in children with DMD.The ADHD diagnosis was found in the ADHD group,and the other was the non-ADHD group.The effects of age,gene mutation types,gene mutation sites,using steroid,only-child,main caregivers,family income and parental education on ADHD were analyzed.Using Pediatric quality of life inventory^TM3.0 neuromuscular module(PedsQL^TM3.0 NMM)and PedsQL^TM4.0scale to investigate the quality of life on children with DMD?aged 5⁷?.Results1?102 cases of DMD children are all male,age 4 to 12.8 years old.Their average age is?8±2.2?years old,and 97 cases can walk,5 cases can not walk.35 children were diagnosed as ADHD.And the comorbidity rate of children complicated with DMD and ADHD was 34.31%?35/102?,including 14 children with attention deficit disorder?40.0%?,10 children with hyperactivity disorder?28.6%?and 11 children with mixed disorder?31.4%?.2?35 cases of DMD children in ADHD group,aged 4.2 to 11.3 years old.And the average age is?6.8±1.7?years old.67 cases of DMD children in non-ADHD group,aged 4 to 12.8 years old.And the average age is?8.7±2.2?years old.The single factor analysis showed that between ADHD group and non-ADHD group in age,whether taking hormone the main caregivers,their differences were statistically significant?P<0.05?.And two groups of gene mutation,gene mutation,whether the education for the child,family income,parents degree,there were no significant differences?P>0.05?.The results of multiple factor Logistic regression analysis showed that age and grandparents were the influential factors of ADHD in children with DMD?P<0.05?.The results of multiple factor logistic regression analysis showed that the influential factors of children complicated with DMD and ADHD were age and grandparents as main caregivers?P<0.05?.3?There was no significant difference in disease dimension,communication dimension,family dimension,physiological function,emotional function and social function score between ADHD group and non-ADHD group?P>0.05?.The scores of physical function and psychological function in ADHD group were significantly lower than that of in non-ADHD group?P<0.05?.ConclusionsADHD has a high prevalence rate in children with DMD.The children complicated with DMD and ADHD were affected by age and family environment,and always show poor quality of life.