Ishii Takashi, Takahashi Osamu, Kawamura Yuuichi, Ohta Tatsuro
Central Hospital Aichi Prefectural Colony, Nagoya University Graduate School of Medicine, Aichi, Japan.
Psychiatry Clin Neurosci. 2003 Oct;57(5):457-63. doi: 10.1046/j.1440-1819.2003.01148.x.
Attention deficit-hyperactivity disorder (ADHD) has been noted for its high rate of comorbidity. The present study is the first report in Japan evaluating the proportion of comorbidity in ADHD cases presenting in the clinical setting, aiming at clarifying the picture of ADHD in Japan. The subjects consisted of 68 child and adolescent cases meeting criteria for ADHD (Diagnostic and Statistical Manual of Mental Disorders, 4th edn) under treatment at a child psychiatry clinic (IQ > 50, mental age >or= 4 years old). Disorders evaluated as comorbid disorders were mood disorders, anxiety disorders, elimination disorders, sleep disorders, tic disorders, oppositional defiant disorder (ODD), conduct disorder (CD), school refusal, and epilepsy. Comorbidity with mood disorders, anxiety disorders, ODD, and CD, were found to be lower than the high rates conventionally reported in North America. The lower age of the present subjects, primarily in infancy and elementary school age with few adolescent cases, and a bias towards milder cases from an outpatient clinic without inpatient facilities are believed to be factors accounting for this disparity. Furthermore, it was a notable fact that mentally delayed cases (IQ: 51-84) amounted to 34% of the cases, indicating the necessity to consider intelligence level when formulating a treatment strategy for ADHD.
注意缺陷多动障碍（ADHD）因其高共病率而受到关注。本研究是日本首份评估临床环境中ADHD病例共病比例的报告，旨在厘清日本ADHD的情况。研究对象包括在一家儿童精神科诊所接受治疗的68例符合ADHD标准（《精神疾病诊断与统计手册》第4版）的儿童和青少年病例（智商>50，心理年龄≥4岁）。被评估为共病的疾病有情绪障碍、焦虑障碍、排泄障碍、睡眠障碍、抽动障碍、对立违抗障碍（ODD）、品行障碍（CD）、学校恐惧症和癫痫。发现与情绪障碍、焦虑障碍、ODD和CD的共病率低于北美传统报告的高比率。本研究对象年龄较小，主要是婴幼儿和小学年龄段，青少年病例较少，且来自一家没有住院设施的门诊诊所的病例偏向病情较轻，这些因素被认为是造成这种差异的原因。此外，一个值得注意的事实是，智力发育迟缓病例（智商：51 - 84）占病例总数的34%，这表明在制定ADHD治疗策略时需要考虑智力水平。
