Hurtig Tuula, Ebeling Hanna, Taanila Anja, Miettunen Jouko, Smalley Susan L, McGough James J, Loo Sandra K, Järvelin Marjo-Riitta, Moilanen Irma K
University of Oulu, Finland.
J Am Acad Child Adolesc Psychiatry. 2007 Dec;46(12):1605-13. doi: 10.1097/chi.0b013e318157517a.
To study attention-deficit/hyperactivity disorder (ADHD) symptoms and DSM-IV subtypes in childhood and adolescence.
A total of 457 adolescents ages 16 to 18 years from the Northern Finland Birth Cohort 1986 participated in an epidemiological survey for ADHD. After assessment with a diagnostic interview those with current or childhood ADHD were classified using DSM-IV criteria. Childhood diagnosis of ADHD was set according to retrospective recall. The characteristics and relationships in ADHD symptomatology in childhood and adolescence were studied in relation to behavioral problems and parental history of attentional problems.
ADHD was reported more commonly in childhood than in adolescence and variations in subtype classification occurred. Those with childhood and adolescent diagnosis had endorsed specific inattentive symptoms more commonly, had greater comorbid major depression and/or oppositional defiant disorder, and had fathers with more reported attentional problems than those with only childhood diagnosis. In childhood, ADHD subtypes differed along symptom severity, but by adolescence these differences were no longer significant.
The persistence of ADHD from childhood to adolescence may be common. Specific inattentive symptoms, certain psychiatric comorbidity, and family history of attention problems (fathers specifically) contribute to the risk of persistent ADHD. ADHD subtype differences reflect symptom severity differences in childhood that are negligible by adolescence.
研究儿童期和青少年期的注意力缺陷多动障碍(ADHD)症状及DSM-IV亚型。
来自1986年芬兰北部出生队列的457名16至18岁青少年参与了一项ADHD流行病学调查。在通过诊断访谈进行评估后,根据DSM-IV标准对目前或儿童期患有ADHD的患者进行分类。儿童期ADHD诊断根据回顾性回忆确定。研究了儿童期和青少年期ADHD症状学的特征及与行为问题和父母注意力问题病史的关系。
ADHD在儿童期的报告率高于青少年期,且亚型分类存在差异。儿童期和青少年期均被诊断为ADHD的患者比仅在儿童期被诊断的患者更常出现特定的注意力不集中症状,共病重度抑郁和/或对立违抗障碍的情况更多,且其父亲报告的注意力问题更多。在儿童期,ADHD亚型在症状严重程度上存在差异,但到青少年期这些差异不再显著。
ADHD从儿童期持续到青少年期可能很常见。特定的注意力不集中症状、某些精神共病以及注意力问题家族史(尤其是父亲)会增加ADHD持续存在的风险。ADHD亚型差异反映了儿童期的症状严重程度差异,而到青少年期这些差异可忽略不计。