Purper-Ouakil D, Cortese S, Wohl M, Asch M, Acquaviva E, Falissard B, Michel G, Gorwood P, Mouren M C
AP-HP, Hôpital Robert Debré, Paris, France.
Eur Child Adolesc Psychiatry. 2007 Dec;16(8):505-9. doi: 10.1007/s00787-007-0627-y. Epub 2007 Sep 14.
Early recognition of attention-deficit/hyperactivity disorder (ADHD) may improve the educational and psychosocial outcome of most affected children. To date, factors associated with diagnostic delay of ADHD have not specifically been addressed. Aims of this study were to evaluate the mean diagnostic delay (time between first consultation and definite diagnosis) in a clinical sample of French children with ADHD referred to an outpatient university clinic, and to determine associated factors.
A total of 129 consecutively referred ADHD patients aged 6-16 years. A detailed history of the children was obtained from their parents. The Kiddie-SADS-PL, the ADHD-Rating Scale, and the Clinical Global Impression Scale were used for clinical assessment.
Mean diagnostic delay was 32.89 months. A previous suspicion of ADHD by any health care professional, therapist or teacher was significantly associated with a reduced diagnostic delay. Co-morbidity with anxiety/depressive disorders and previous contact with a mental health professional were associated with a significant delay in diagnosis.
Delay in diagnosis of ADHD in France is among the longest reported. Children with co-morbid anxiety or depressive disorders are particularly at risk of having a significant delay in the diagnosis. Health professionals, therapists and teachers may play a relevant role to accelerate the diagnostic procedure.
早期识别注意力缺陷多动障碍（ADHD）可能会改善大多数患病儿童的教育和心理社会结局。迄今为止，尚未专门探讨与ADHD诊断延迟相关的因素。本研究的目的是评估转诊至大学门诊诊所的法国ADHD儿童临床样本中的平均诊断延迟（首次咨询与明确诊断之间的时间），并确定相关因素。
共纳入129例年龄在6至16岁之间连续转诊的ADHD患者。从他们的父母那里获取了孩子的详细病史。使用儿童版情感障碍和精神分裂症问卷（Kiddie-SADS-PL）、ADHD评定量表和临床总体印象量表进行临床评估。
平均诊断延迟为32.89个月。任何医疗保健专业人员、治疗师或教师先前对ADHD的怀疑与诊断延迟缩短显著相关。合并焦虑/抑郁障碍以及先前与心理健康专业人员接触与诊断显著延迟相关。
法国ADHD的诊断延迟是报告中最长的之一。患有共病焦虑或抑郁障碍的儿童尤其有诊断显著延迟的风险。卫生专业人员、治疗师和教师可能在加速诊断过程中发挥相关作用。
