注意缺陷多动障碍与品行障碍、抑郁障碍、焦虑障碍及其他障碍的共病情况。
Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders.
作者信息
Biederman J, Newcorn J, Sprich S
机构信息
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114.
出版信息
Am J Psychiatry. 1991 May;148(5):564-77. doi: 10.1176/ajp.148.5.564.
OBJECTIVE
Attention deficit hyperactivity disorder is a heterogeneous disorder of unknown etiology. Little is known about the comorbidity of this disorder with disorders other than conduct. Therefore, the authors made a systematic search of the psychiatric and psychological literature for empirical studies dealing with the comorbidity of attention deficit hyperactivity disorder with other disorders.
DATA COLLECTION
The search terms included hyperactivity, hyperkinesis, attention deficit disorder, and attention deficit hyperactivity disorder, cross-referenced with antisocial disorder (aggression, conduct disorder, antisocial disorder), depression (depression, mania, depressive disorder, bipolar), anxiety (anxiety disorder, anxiety), learning problems (learning, learning disability, academic achievement), substance abuse (alcoholism, drug abuse), mental retardation, and Tourette's disorder.
FINDINGS
The literature supports considerable comorbidity of attention deficit hyperactivity disorder with conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, learning disabilities, and other disorders, such as mental retardation, Tourette's syndrome, and borderline personality disorder.
CONCLUSIONS
Subgroups of children with attention deficit hyperactivity disorder might be delineated on the basis of the disorder's comorbidity with other disorders. These subgroups may have differing risk factors, clinical courses, and pharmacological responses. Thus, their proper identification may lead to refinements in preventive and treatment strategies. Investigation of these issues should help to clarify the etiology, course, and outcome of attention deficit hyperactivity disorder.
目的
注意力缺陷多动障碍是一种病因不明的异质性疾病。对于该疾病与品行障碍以外的其他疾病的共病情况,人们了解甚少。因此,作者对精神病学和心理学文献进行了系统检索,以查找有关注意力缺陷多动障碍与其他疾病共病情况的实证研究。
数据收集
检索词包括多动、运动亢进、注意力缺陷障碍和注意力缺陷多动障碍,并与反社会障碍(攻击、品行障碍、反社会障碍)、抑郁(抑郁、躁狂、抑郁症、双相情感障碍)、焦虑(焦虑症、焦虑)、学习问题(学习、学习障碍、学业成绩)、物质滥用(酗酒、药物滥用)、智力迟钝和抽动秽语障碍进行交叉检索。
研究结果
文献支持注意力缺陷多动障碍与品行障碍、对立违抗障碍、情绪障碍、焦虑障碍、学习障碍以及其他疾病(如智力迟钝、抽动秽语综合征和边缘型人格障碍)存在相当多的共病情况。
结论
可根据注意力缺陷多动障碍与其他疾病的共病情况来划分患有该疾病的儿童亚组。这些亚组可能具有不同的危险因素、临床病程和药物反应。因此,对它们的正确识别可能会改进预防和治疗策略。对这些问题的研究应有助于阐明注意力缺陷多动障碍的病因、病程和结局。