Miller Carlin J, Flory Janine D, Miller Scott R, Harty Seth C, Newcorn Jeffrey H, Halperin Jeffrey M
Department of Psychology, University of Windsor, 401 Sunset Ave., Windsor, Ontario, Canada N9B 3P4.
J Clin Psychiatry. 2008 Sep;69(9):1477-84. doi: 10.4088/jcp.v69n0916.
Adults with attention-deficit/hyperactivity disorder (ADHD) experience considerable functional impairment. However, the extent to which comorbid Axis II personality disorders contribute to their difficulties and whether such comorbidities are associated with the childhood condition or the persistence of ADHD into adulthood remain unclear.
This study examined the presence of personality disorders in a longitudinal sample of 96 adolescents diagnosed with ADHD when they were 7 through 11 years old, as compared to a matched, never ADHD-diagnosed, control group (N = 85). Participants were between 16 and 26 years old at follow-up. On the basis of a psychiatric interview, the ADHD group was subdivided into those with and without persistent ADHD. Axis II symptoms were assessed by using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Data were analyzed using logistic regression, and odds ratios (ORs) were generated. The study was conducted from 1994 through 1997.
Individuals diagnosed with childhood ADHD are at increased risk for personality disorders in late adolescence, specifically borderline (OR = 13.16), antisocial (OR = 3.03), avoidant (OR = 9.77), and narcissistic (OR = 8.69) personality disorders. Those with persistent ADHD were at higher risk for antisocial (OR = 5.26) and paranoid (OR = 8.47) personality disorders but not the other personality disorders when compared to those in whom ADHD remitted.
Results suggest that ADHD portends risk for adult personality disorders, but the risk is not uniform across disorders, nor is it uniformly related to child or adult diagnostic status.
患有注意力缺陷多动障碍（ADHD）的成年人存在相当程度的功能损害。然而，共病的轴II人格障碍在多大程度上导致了他们的困难，以及这些共病是与儿童期疾病相关，还是与ADHD持续到成年有关，目前尚不清楚。
本研究调查了96名在7至11岁时被诊断为ADHD的青少年的纵向样本中人格障碍的存在情况，并与匹配的、从未被诊断为ADHD的对照组（N = 85）进行比较。随访时参与者年龄在16至26岁之间。根据精神科访谈，ADHD组被细分为患有持续性ADHD和未患有持续性ADHD的两组。使用《精神疾病诊断与统计手册》第四版轴II人格障碍的结构化临床访谈来评估轴II症状。采用逻辑回归分析数据，并生成优势比（OR）。该研究于1994年至1997年进行。
被诊断为儿童期ADHD的个体在青春期后期患人格障碍的风险增加，特别是边缘型（OR = 13.16）、反社会型（OR = 3.03）、回避型（OR = 9.77）和自恋型（OR = 8.69）人格障碍。与ADHD缓解的个体相比，患有持续性ADHD的个体患反社会型（OR = 5.26）和偏执型（OR = 8.47）人格障碍的风险更高，但其他人格障碍的风险并不高。
结果表明，ADHD预示着成年后患人格障碍的风险，但这种风险在不同障碍中并不一致，也与儿童或成人的诊断状态没有统一的关联。
