Pineda David A, Palacio Luis Guillermo, Puerta Isabel C, Merchán Vilma, Arango Clara P, Galvis Astrid Yuleth, Gómez Mónica, Aguirre Daniel Camilo, Lopera Francisco, Arcos-Burgos Mauricio
Neuropsychology and Conduct Disorder Group, Faculty of Psychology, Master Program of Neuropsychology, University of San Buenaventura, Medellin, Colombia.
Eur Child Adolesc Psychiatry. 2007 Aug;16(5):337-46. doi: 10.1007/s00787-007-0605-4.
Three independent complex segregation analyses found that the cause of Attention Deficit/Hyperactivity Disorder (ADHD) was the presence of major genes interacting with environmental influences. In order to identify potential environmental risk factors for ADHD in the Paisa community--a very well described, genetically isolated group--we randomly selected a sample of 486 children between 6 and 11 years of age. This group included 200 children with ADHD (149 males and 51 females) and 286 healthy controls (135 males and 151 females). The ADHD DSM-IV diagnosis was obtained using the DICA and BASC evaluation instruments, and the children's mothers or grandmothers filled out a questionnaire on each child's exposure to prenatal, neonatal, and early childhood risk factors. The data were analyzed using cross tabulation and stepwise logistic multiple-regression analyses. Cross tabulation associated ADHD with a variety of factors, including miscarriage symptoms, premature delivery symptoms, maternal respiratory viral infection, moderate to severe physical illness in the mother during gestation, prenatal cigarette and alcohol exposure, neonatal seizures, asphyxia or anoxia, severe neonatal illness, mild speech retardation, moderate brain injury, and febrile seizures (odds ratio >or= 2, P < 0.05). Stepwise logistic multiple-regression analysis also uncovered a block of variables, including male gender, maternal illnesses, prenatal alcohol exposure, mild speech retardation, febrile seizures, and moderate brain injury (odds ratio >or= 2.0, P < 0.05). Future studies on the risk of developing ADHD must include these environmental factors as covariates.
三项独立的复杂分离分析发现，注意力缺陷多动障碍（ADHD）的病因是主要基因与环境影响相互作用的结果。为了确定在派萨社区（一个描述详尽、基因隔离的群体）中ADHD的潜在环境风险因素，我们随机抽取了486名6至11岁的儿童作为样本。该样本包括200名患有ADHD的儿童（149名男性和51名女性）以及286名健康对照儿童（135名男性和151名女性）。使用DICA和BASC评估工具进行ADHD的DSM-IV诊断，儿童的母亲或祖母填写了一份关于每个儿童产前、新生儿期和幼儿期风险因素暴露情况的问卷。数据采用交叉列表分析和逐步逻辑多元回归分析。交叉列表分析将ADHD与多种因素相关联，包括流产症状、早产症状、母亲呼吸道病毒感染、孕期母亲中度至重度身体疾病、产前香烟和酒精暴露、新生儿惊厥、窒息或缺氧、严重新生儿疾病、轻度语言发育迟缓、中度脑损伤以及热性惊厥（优势比≥2，P < 0.05）。逐步逻辑多元回归分析还发现了一组变量，包括男性性别、母亲疾病、产前酒精暴露、轻度语言发育迟缓、热性惊厥和中度脑损伤（优势比≥2.0，P < 0.05）。未来关于患ADHD风险的研究必须将这些环境因素作为协变量纳入。
