Faraone Stephen V, Biederman Joseph, Mick Eric
Medical Genetics Research Program and Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Psychol Med. 2006 Feb;36(2):159-65. doi: 10.1017/S003329170500471X.
This study examined the persistence of attention deficit hyperactivity disorder (ADHD) into adulthood.
We analyzed data from published follow-up studies of ADHD. To be included in the analysis, these additional studies had to meet the following criteria: the study included a control group and it was clear from the methods if the diagnosis of ADHD included subjects who did not meet full criteria but showed residual and impairing signs of the disorder. We used a meta-analysis regression model to separately assess the syndromatic and symptomatic persistence of ADHD.
When we define only those meeting full criteria for ADHD as having 'persistent ADHD', the rate of persistence is low, approximately 15% at age 25 years. But when we include cases consistent with DSM-IV's definition of ADHD in partial remission, the rate of persistence is much higher, approximately 65%.
Our results show that estimates of ADHD's persistence rely heavily on how one defines persistence. Yet, regardless of definition, our analyses show that evidence for ADHD lessens with age. More work is needed to determine if this reflects true remission of ADHD symptoms or is due to the developmental insensitivity of diagnostic criteria for the disorder.
本研究调查了注意缺陷多动障碍(ADHD)持续至成年期的情况。
我们分析了已发表的ADHD随访研究数据。要纳入分析,这些额外的研究必须满足以下标准:研究包括一个对照组,并且从方法中可以明确ADHD的诊断是否包括未达到全部标准但表现出该障碍残留及损害性症状的受试者。我们使用荟萃分析回归模型分别评估ADHD的综合征和症状持续情况。
当我们仅将那些符合ADHD全部标准的人定义为患有“持续性ADHD”时,持续率较低,25岁时约为15%。但当我们纳入符合DSM-IV中ADHD部分缓解定义的病例时,持续率要高得多,约为65%。
我们的结果表明,ADHD持续情况的估计在很大程度上取决于对持续性的定义。然而,无论定义如何,我们的分析表明ADHD的证据随年龄增长而减少。需要开展更多工作来确定这是反映了ADHD症状的真正缓解,还是由于该障碍诊断标准对发育不敏感所致。