Rasmussen P, Gillberg C
Institute for the Health of Women and Children, Department of Child and Adolescent Psychiatry, University of Göteborg, Sweden.
J Am Acad Child Adolesc Psychiatry. 2000 Nov;39(11):1424-31. doi: 10.1097/00004583-200011000-00017.
There is a need for controlled longitudinal studies in the field of attention disorders in the general population.
In a community-based follow-up study, 55 of 61 subjects aged 22 years, who had attention-deficit/hyperactivity disorder (ADHD) with and without comorbid developmental coordination disorder (DCD) at initial workup at age 7 years, were compared, on a multitude of outcome variables, with 46 of 51 age-matched subjects without such diagnoses. None of the subjects had received stimulant treatment. Psychiatrists performing the follow-up study were blind to original diagnostic group status.
In the ADHD/DCD group 58% had a poor outcome compared with 13% in the comparison group (p < .001). Remaining symptoms of ADHD, antisocial personality disorder, alcohol abuse, criminal offending, reading disorders, and low educational level were overrepresented in the ADHD/DCD groups. The combination of ADHD and DCD appeared to carry a particularly gloomy outlook.
Childhood ADHD and DCD appears to be a most important predictor of poor psychosocial functioning in early adulthood. It would seem appropriate to screen for such disorders in schools and clinics so that therapies may be started early.
普通人群注意力障碍领域需要进行对照纵向研究。
在一项基于社区的随访研究中,将61名22岁的受试者中的55名进行比较,这些受试者在7岁初次检查时患有注意力缺陷多动障碍(ADHD),伴有或不伴有共病的发育协调障碍(DCD),与51名年龄匹配的未患此类疾病的受试者中的46名相比,在众多结果变量方面进行比较。所有受试者均未接受过兴奋剂治疗。进行随访研究的精神科医生对原始诊断组状态不知情。
ADHD/DCD组中58%的人预后不良,而对照组为13%(p <.001)。ADHD的残留症状、反社会人格障碍、酒精滥用、犯罪、阅读障碍和低教育水平在ADHD/DCD组中更为常见。ADHD和DCD的合并似乎预示着特别黯淡的前景。
儿童期ADHD和DCD似乎是成年早期心理社会功能不良的最重要预测因素。在学校和诊所筛查此类疾病似乎是合适的,以便可以尽早开始治疗。