Sobanski Esther, Brüggemann Daniel, Alm Barbara, Kern Sebastian, Deschner Monika, Schubert Thomas, Philipsen Alexandra, Rietschel Marcella
Department of Psychiatry and Psychotherapy Central Institute of Mental Health, J 5, 68159 Mannheim, Germany.
Eur Arch Psychiatry Clin Neurosci. 2007 Oct;257(7):371-7. doi: 10.1007/s00406-007-0712-8.
This exploratory study aims to compare lifetime psychiatric axis-I-comorbidity and psychosocial functioning in a clinically referred sample of adult patients with attention-deficit/hyperactivity disorder (ADHD) with a population-based healthy control group and to examine whether patients with ADHD and lifetime comorbid diagnoses differ from patients with pure ADHD in their functional impairment.
Seventy adult patients with ADHD according to DSM-IV criteria and a gender- as well as age-matched population based control group underwent diagnostic evaluations with clinical interviews for ADHD, DSM-IV disorders and demographic information.
The prevalence of psychiatric lifetime comorbidity was 77.1% in patients with ADHD and thus exceeded the rate in the control group, which was 45.7%. Significantly more patients suffered from depressive episodes, substance related disorders and eating disorders. Compared to the control group adults with ADHD were significantly impaired in a variety of psychosocial functions (education, occupational training). Patients with ADHD and lifetime diagnosis of comorbid psychiatric disorders differed from patients with pure ADHD in their psychosocial functioning only in the percentage of unemployed individuals, which was higher in patients with psychiatric comorbidity.
Adults with ADHD suffer significantly more often from other psychiatric disorders than individuals of the population-based control group and are impaired in several areas of psychosocial functioning. Poor psychosocial outcome is primarily related to ADHD and not to additional psychiatric disorders. Due to the limited number of assessed patients these results need to be confirmed by studies with larger sample size.
本探索性研究旨在比较临床转诊的成年注意力缺陷多动障碍（ADHD）患者样本与基于人群的健康对照组在终生精神疾病轴I共病情况及心理社会功能方面的差异，并研究患有ADHD且有终生共病诊断的患者与单纯ADHD患者在功能损害方面是否存在不同。
70名符合DSM-IV标准的成年ADHD患者以及一个性别和年龄匹配的基于人群的对照组接受了针对ADHD、DSM-IV障碍及人口统计学信息的临床访谈诊断评估。
ADHD患者中终生精神疾病共病的患病率为77.1%，超过了对照组的45.7%。患有抑郁发作、物质相关障碍和饮食障碍的患者明显更多。与对照组相比，患有ADHD的成年人在多种心理社会功能（教育、职业培训）方面存在明显损害。患有ADHD且有终生共病精神疾病诊断的患者与单纯ADHD患者在心理社会功能方面的差异仅体现在失业个体的比例上，患有精神疾病共病的患者这一比例更高。
患有ADHD的成年人比基于人群的对照组个体更常患有其他精神疾病，并且在心理社会功能的多个领域存在损害。不良的心理社会结果主要与ADHD有关，而非与其他精神疾病有关。由于评估的患者数量有限，这些结果需要通过更大样本量的研究来证实。
