Department of Health Studies, University of Chicago, Chicago, IL 60637, USA.
J Clin Child Adolesc Psychol. 2010;39(6):761-75. doi: 10.1080/15374416.2010.517173.
Three subtypes of attention-deficit/hyperactivity disorder (ADHD) based on numbers of symptoms of inattention (I) and hyperactivity-impulsivity (HI) were defined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) to reduce heterogeneity of the disorder, but the subtypes proved to be highly unstable over time. A continuous alternative to nominal subtyping is evaluated in a longitudinal study of 129 four- to six-year-old children with ADHD and 130 comparison children. Children who met criteria for all subtypes in Year 1 continued to exhibit greater functional impairment than comparison children during Years 2 to 9. Among children with ADHD in Year 1, I and HI symptoms differentially predicted teacher-rated need for treatment and reading and mathematics achievement scores over the next 8 years in controlled analyses. Consistent with other studies, these findings suggest that the use of diagnostic modifiers specifying the numbers of I and HI symptoms could reduce heterogeneity and facilitate clinical intervention, prognosis, and research.
三种亚型的注意缺陷多动障碍（ADHD）基于注意力不集中（I）和多动冲动（HI）症状的数量在《精神障碍诊断与统计手册》（第四版）中定义，以减少该疾病的异质性，但事实证明，这些亚型在时间上极不稳定。在一项对 129 名 4 至 6 岁患有 ADHD 的儿童和 130 名对照组儿童的纵向研究中，对连续替代名义亚型进行了评估。在第 1 年符合所有亚型标准的儿童在第 2 年至第 9 年期间仍表现出比对照组儿童更大的功能障碍。在第 1 年患有 ADHD 的儿童中，在控制分析中，I 症状和 HI 症状在接下来的 8 年中差异预测了教师评定的治疗需求以及阅读和数学成绩。与其他研究一致，这些发现表明，使用指定 I 和 HI 症状数量的诊断修饰符可以减少异质性并促进临床干预、预后和研究。
