Miller Torri W, Nigg Joel T, Faraone Stephen V
Department of Psychology, Michigan State University, East Lansing, MI 48824, USA.
J Abnorm Psychol. 2007 Aug;116(3):519-28. doi: 10.1037/0021-843X.116.3.519.
Ongoing debate over the validity of the attention-deficit/hyperactivity disorder (ADHD) construct in adulthood is fueled in part by uncertainty regarding implications of potentially extensive yet incompletely described comorbid Axis I and II psychopathology. Three hundred sixty-three adults ages 18 to 37 completed semistructured clinical interviews; informants were also interviewed, and best estimate diagnoses were obtained. Results were as follows: First, ADHD combined type (ADHD-C) had an excess of externalizing and internalizing Axis I disorders, suggesting a gradient-of-severity relationship between it and ADHD inattentive type (ADHD-I). Second, ADHD-C and ADHD-I did not differ in frequency of Axis II disorders. Third, however, ADHD overall was associated with increased rates of Axis II disorders, compared with rates in non-ADHD control participants, including both Cluster B (primarily borderline personality disorder) and Cluster C disorders. Fourth, ADHD incrementally accounted for clinician-rated global assessment of functioning scores above and beyond comorbid conditions or symptoms on either Axis I or Axis II. Results further inform nosology of ADHD in adults.
成人注意力缺陷多动障碍（ADHD）概念的有效性一直存在争议，部分原因是对于潜在广泛但描述不完整的共病轴I和轴II精神病理学的影响存在不确定性。363名年龄在18至37岁之间的成年人完成了半结构化临床访谈；还对 informant 进行了访谈，并获得了最佳估计诊断。结果如下：第一，ADHD混合型（ADHD-C）的轴I外化和内化障碍过多，表明它与注意力不集中型ADHD（ADHD-I）之间存在严重程度梯度关系。第二，ADHD-C和ADHD-I在轴II障碍的发生率上没有差异。第三，然而，与非ADHD对照参与者相比，总体ADHD与轴II障碍的发生率增加有关，包括B类（主要是边缘性人格障碍）和C类障碍。第四，ADHD在轴I或轴II上的共病状况或症状之外，逐步解释了临床医生评定的整体功能评估得分。研究结果进一步为成人ADHD的分类学提供了信息。
