Gadow Kenneth D, DeVincent Carla J, Schneider Jayne
Department of Psychiatry and Behavioral Science, State University of New York at Stony Brook, Stony Brook, NY 11794-8790, USA.
J Atten Disord. 2009 Mar;12(5):474-85. doi: 10.1177/1087054708320404.
Identification of differences among children with ADHD only, autism spectrum disorder (ASD)+ADHD, and chronic multiple tic disorder (CMTD)+ADHD may lead to better understanding of clinical phenotypes.
Children were evaluated using the parent- and teacher-completed questionnaires.
All three groups were highly similar in severity of oppositional defiant disorder and conduct disorder symptoms; however, the ASD+ADHD group generally exhibited the most severe anxiety, although the CMTD+ADHD group had the most severe generalized anxiety. The two comorbid groups had the most involved medical histories and the greatest likelihood of a family history of psychopathology.
Groups differed in clinically meaningful ways, and the apparent association between tics and anxiety may explain in part the elevated levels of anxiety in both comorbid groups. Collectively, results suggest that ADHD may be better conceptualized as a family of interrelated syndromes defined in part by comorbid conditions and that continued research is clearly warranted.
识别仅患有注意力缺陷多动障碍（ADHD）、自闭症谱系障碍（ASD）合并ADHD以及慢性多发性抽动障碍（CMTD）合并ADHD的儿童之间的差异，可能有助于更好地理解临床表型。
使用家长和教师填写的问卷对儿童进行评估。
在对立违抗障碍和品行障碍症状的严重程度方面，所有三组非常相似；然而，ASD合并ADHD组通常表现出最严重的焦虑，尽管CMTD合并ADHD组的广泛性焦虑最为严重。两个共病组的病史最为复杂，且有精神病理学家族史的可能性最大。
各组在临床上存在有意义的差异，抽动与焦虑之间的明显关联可能部分解释了两个共病组焦虑水平升高的原因。总体而言，结果表明，ADHD可能更好地被概念化为一组相互关联的综合征，部分由共病情况定义，显然有必要继续进行研究。
