Kalff Ariane C, Hendriksen Jos G M, Kroes Marielle, Vles Johan S H, Steyaert Jean, Feron Frans J M, van Zeben Thea M C B, Jolles Jelle
Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.
J Abnorm Child Psychol. 2002 Dec;30(6):589-98. doi: 10.1023/a:1020859629994.
The aim of this prospective study was to examine whether neurocognitive performance of children aged 5-6 years distinguished children who were later diagnosed with attention deficit/hyperactivity disorder(ADHD) or "borderline ADHD" from children without ADHD after adjustment for behavioral measures and to examine the influence of comorbid psychopathology. Out of a general population of 1,317 children, 366 children were selected on the basis of their scores on the Child Behavior Checklist (CBCL). Eighteen months later, the parents were interviewed using a standardized child psychiatric interview: 33 children were classified as ADHD and 75 children as borderline ADHD, and there were 258 children without ADHD. Children with rated ADHD were significantly impaired on measures of visuomotor ability and working memory compared to children without ADHD after adjustment for CBCL results. The performance of borderline ADHD children was in between that of children with and without ADHD. In addition, 4 groups of children were analyzed: 9 ADHD, 24 ADHD with comorbid oppositional defiant disorder/conduct disorder (ODD/CD), 59 ODD/CD, and 274 controls. Children with rated comorbid ADHD and ODD/CD performed significantly worse on these tasks compared to children with rated ODD/CD and control children while they did not differ from ADHD children. Our results imply that neurocognitive measures can contribute to the early identification of ADHD with and without comorbid ODD/CD.
这项前瞻性研究的目的是,在对行为指标进行校正之后,检验5至6岁儿童的神经认知表现能否区分后来被诊断为注意力缺陷/多动障碍(ADHD)或“边缘性ADHD”的儿童与未患ADHD的儿童,并检验共病精神病理学的影响。在1317名儿童的总体人群中,根据儿童行为量表(CBCL)的得分挑选出366名儿童。18个月后,采用标准化儿童精神病学访谈对家长进行访谈:33名儿童被归类为ADHD,75名儿童被归类为边缘性ADHD,258名儿童未患ADHD。在校正CBCL结果后,与未患ADHD的儿童相比,被评定为ADHD的儿童在视运动能力和工作记忆测量方面存在显著受损。边缘性ADHD儿童的表现介于患ADHD和未患ADHD的儿童之间。此外,对4组儿童进行了分析:9名ADHD儿童、24名患有共病对立违抗障碍/品行障碍(ODD/CD)的ADHD儿童、59名ODD/CD儿童和274名对照儿童。与评定为ODD/CD的儿童和对照儿童相比,评定为患有共病ADHD和ODD/CD的儿童在这些任务上的表现明显更差,而他们与ADHD儿童没有差异。我们的结果表明,神经认知测量有助于早期识别患有和未患有共病ODD/CD的ADHD。