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青少年亚临床 ADHD 和破坏性行为诊断相关的精神问题。

Psychiatric problems associated with subthreshold ADHD and disruptive behaviour diagnoses in teenagers.

机构信息

Child and Adolescent Psychiatric Unit, Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden.

出版信息

Acta Paediatr. 2011 Nov;100(11):1468-75. doi: 10.1111/j.1651-2227.2011.02363.x. Epub 2011 Jun 11.

Abstract

AIM

To study the coexistence of subthreshold diagnoses of both attention deficit hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBD) with other symptoms of child and adolescent psychiatric disorders as well as risk behaviours associated with smoking, alcohol and drug use.

METHODS

A population-based sample of twins including 177 girls and 135 boys was interviewed using the Swedish version of Kiddie-SADS Present and Lifetime Version (K-SADS-PL). Subthreshold diagnoses were compiled based on the ADHD and DBD criteria, where each criterion was assessed as 'possible' or 'certain' according to K-SADS-PL. The odds ratios (OR) between the subthreshold diagnoses and each of the screening questions in K-SADS-PL were calculated.

RESULTS

Subthreshold diagnoses of ADHD and DBD coexisted with the screening questions concerning depression, mania, panic attack, phobias, anorexia nervosa, motor tics and posttraumatic stress disorder (PTSD) in girls. In boys, these subthreshold diagnoses coexisted with symptoms of depression and PTSD. For both boys and girls, smoking and high alcohol consumption contributed to a high OR with regard to ADHD and DBD.

CONCLUSION

Subthreshold diagnoses of ADHD and DBD were risk factors for several other psychiatric symptoms as well as smoking and high alcohol consumption. Thus, a broad clinical assessment is needed for adolescents with such preliminary diagnoses.

摘要

目的

研究阈下诊断注意缺陷多动障碍(ADHD)和破坏性行为障碍(DBD)与儿童和青少年精神障碍的其他症状以及与吸烟、饮酒和药物使用相关的风险行为的共存情况。

方法

使用瑞典版 Kiddie-SADS 现在和终身版本(K-SADS-PL)对包括 177 名女孩和 135 名男孩在内的双胞胎进行了基于人群的抽样调查。根据 K-SADS-PL,根据 ADHD 和 DBD 标准编制了阈下诊断,每个标准均根据 K-SADS-PL 评估为“可能”或“确定”。计算了阈下诊断与 K-SADS-PL 中每个筛查问题之间的优势比(OR)。

结果

在女孩中,ADHD 和 DBD 的阈下诊断与抑郁、躁狂、惊恐发作、恐惧症、神经性厌食症、运动性抽搐和创伤后应激障碍(PTSD)的筛查问题并存。在男孩中,这些阈下诊断与抑郁和 PTSD 症状并存。对于男孩和女孩,吸烟和大量饮酒与 ADHD 和 DBD 的高 OR 有关。

结论

ADHD 和 DBD 的阈下诊断是其他几种精神症状以及吸烟和大量饮酒的危险因素。因此,对于有此类初步诊断的青少年,需要进行广泛的临床评估。

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