Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, YAW 6A-6900, Boston, MA 02114, USA.
J Psychiatr Res. 2011 Feb;45(2):150-5. doi: 10.1016/j.jpsychires.2010.06.009. Epub 2010 Jul 24.
Despite the existence of several follow-up studies of children with ADHD followed up into adulthood, there is limited information on whether patterns of persistence and remission in ADHD can be predicted over the long term. The main aim of this study was to evaluate predictors of persistence of ADHD in a large sample of boys with and without ADHD followed prospectively for 11 years into young adulthood.
Subjects were Caucasian, non-Hispanic boys with (N = 110) and without (N = 105) ADHD who were 6-17 years old at the baseline assessment (mean age 11 years) and 15 to 31 years old at the follow-up assessment (mean age 22 years). Subjects were comprehensively and blindly assessed with structured diagnostic interviews and assessments of cognitive, social, school, and family functioning.
At the 11-year follow-up, 78% of children with ADHD continued to have a full (35%) or a partial persistence (subsyndromal (22%), impaired functioning (15%), or remitted but treated (6%)). Predictors of persistence were severe impairment of ADHD, psychiatric comorbidity, and exposure to maternal psychopathology at baseline.
These findings prospectively confirm that persistence of ADHD over the long term is predictable from psychosocial adversity and psychiatric comorbidity ascertained 11 years earlier.
尽管存在几项对 ADHD 儿童进行的成年后随访研究,但关于 ADHD 的持续和缓解模式是否可以长期预测的信息有限。本研究的主要目的是评估在一项前瞻性随访 11 年至成年早期的大样本 ADHD 男孩和无 ADHD 男孩中,ADHD 持续存在的预测因素。
研究对象为白种人、非西班牙裔男孩,他们在基线评估时(平均年龄 11 岁)患有(N=110)和不患有(N=105)ADHD,年龄在 6-17 岁之间,在随访评估时(平均年龄 22 岁)年龄在 15-31 岁之间。研究对象通过结构化诊断访谈和认知、社会、学校和家庭功能评估进行全面和盲法评估。
在 11 年的随访中,78%的 ADHD 儿童持续存在完全(35%)或部分(亚综合征(22%)、功能受损(15%)或缓解但治疗(6%))持续存在。持续存在的预测因素包括 ADHD 严重受损、精神病共病和基线时母亲精神病理学的暴露。
这些发现前瞻性地证实,ADHD 的长期持续存在可以从 11 年前确定的社会心理逆境和精神病共病预测。