Volk Heather E, Henderson Cynthia, Neuman Rosalind J, Todd Richard D
Doctoral Program in Public Health Studies, Saint Louis University School of Public Health, Saint Louis, Missouri, USA.
Am J Med Genet B Neuropsychiatr Genet. 2006 Apr 5;141B(3):312-8. doi: 10.1002/ajmg.b.30299.
Statistically based classification methods have successfully refined ADHD into homogenous and heritable subtypes. External validity and impairment of these subtypes was examined using the Child Behavior Checklist (CBCL). We compared mean CBCL syndrome and competency t-scores across ADHD subtypes defined by latent class analysis in a sample of 1,346 individual twins from Missouri. The potential for comorbidity with conduct disorder (CD), oppositional defiant disorder (ODD), or major depression (MD) to increase impairment in specific ADHD subtypes was also examined. CBCL profiles confirm differences in severity, with more severe classes having increased syndrome scale and decreased competency scale CBCL scores. Clinically significant impairment was found for severe inattentive and combined subtypes and the mild combined subtype. Overall, the presence of comorbid CD, ODD, or MD did not result in increased ADHD subtype impairment. CBCL scores distinguish impairment in ADHD subtypes created through LCA. Comorbidity with CD, ODD, or MD does not significantly increase impairment among ADHD subtypes. The mild combined ADHD subtype represents a clinically significant but under-studied form of ADHD.
基于统计学的分类方法已成功地将注意力缺陷多动障碍（ADHD）细化为同质且可遗传的亚型。使用儿童行为检查表（CBCL）对这些亚型的外部效度和损害情况进行了检查。我们比较了来自密苏里州的1346对双胞胎样本中，通过潜在类别分析定义的ADHD各亚型的CBCL综合征和能力t分数均值。还研究了与品行障碍（CD）、对立违抗障碍（ODD）或重度抑郁（MD）共病增加特定ADHD亚型损害的可能性。CBCL概况证实了严重程度的差异，更严重的类别CBCL综合征量表得分增加而能力量表得分降低。在严重注意力不集中型、混合型以及轻度混合型亚型中发现了具有临床意义的损害。总体而言，共病CD、ODD或MD并未导致ADHD亚型损害增加。CBCL分数可区分通过潜在类别分析产生的ADHD亚型中的损害情况。与CD、ODD或MD共病并不会显著增加ADHD亚型之间的损害。轻度混合型ADHD亚型代表了一种具有临床意义但研究不足的ADHD形式。
