患有对立违抗障碍或品行障碍共病的注意力缺陷多动障碍：是离散性还是非离散性破坏性行为障碍？
ADHD with comorbid oppositional defiant disorder or conduct disorder: discrete or nondistinct disruptive behavior disorders?
作者信息
Connor Daniel F, Doerfler Leonard A
机构信息
University of Connecticut Medical School, Farmington, CT 06030-1410, USA.
出版信息
J Atten Disord. 2008 Sep;12(2):126-34. doi: 10.1177/1087054707308486. Epub 2007 Oct 12.
OBJECTIVE
In children with ADHD who have comorbid disruptive behavior diagnoses distinctions between oppositional defiant disorder (ODD) and conduct disorder (CD) remain unclear. The authors investigate differences between ODD and CD in a large clinical sample of children with ADHD.
METHOD
Consecutively referred and systematically assessed male children and adolescents with either ADHD (n = 65), ADHD with ODD (n = 85), or ADHD with CD (n = 50) were compared using structured diagnostic interviews and parent, teacher, and clinician rating scales.
RESULTS
In children with ADHD, significant differences emerged between ODD and CD in the domains of delinquency, overt aggression, and ADHD symptom severity; ADHD with CD was most severe, followed by ADHD with ODD, and ADHD had the least severe symptoms. Distinctions between ADHD with CD and the other two groups were found for parenting, treatment history, and school variables.
CONCLUSION
Within the limits of a cross-sectional methodology, results support clinically meaningful distinctions between ODD and CD in children with ADHD.
目的
在患有注意力缺陷多动障碍（ADHD）且合并破坏性行为诊断的儿童中，对立违抗性障碍（ODD）和品行障碍（CD）之间的区别仍不明确。作者在一个大型的ADHD儿童临床样本中研究ODD和CD之间的差异。
方法
使用结构化诊断访谈以及家长、教师和临床医生评定量表，对连续转诊并经过系统评估的患有ADHD（n = 65）、ADHD合并ODD（n = 85）或ADHD合并CD（n = 50）的男性儿童和青少年进行比较。
结果
在患有ADHD的儿童中，ODD和CD在犯罪、公开攻击行为以及ADHD症状严重程度等方面存在显著差异；ADHD合并CD最为严重，其次是ADHD合并ODD，而单纯ADHD症状最轻。在养育方式、治疗史和学校相关变量方面，发现ADHD合并CD与其他两组之间存在差异。
结论
在横断面研究方法的局限性范围内，研究结果支持在患有ADHD的儿童中，ODD和CD之间存在具有临床意义的区别。
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