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生物和心理社会环境风险因素影响 ADHD 儿童的症状严重程度和精神共病。

Biological and psychosocial environmental risk factors influence symptom severity and psychiatric comorbidity in children with ADHD.

机构信息

Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, JW Goethe University, Deutschordenstraße 50, 60528 Frankfurt am Main, Germany.

出版信息

J Neural Transm (Vienna). 2012 Jan;119(1):81-94. doi: 10.1007/s00702-011-0659-9. Epub 2011 May 31.


DOI:10.1007/s00702-011-0659-9
PMID:21626412
Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a genetically as well as environmentally determined disorder with a high rate of psychiatric comorbidity. In this study, non-genetic biological and psychosocial risk factors for ADHD symptom severity and comorbid disorders were assessed in 275 children with ADHD, aged 5-13 years, mean age 9.7 (SD 1.9). Pre-/perinatal biological and lifetime psychosocial risk factors as well as data on parental ADHD were obtained. A different pattern of risk factors emerged for inattentive and hyperactive-impulsive ADHD symptoms. Inattentive symptoms were strongly influenced by psychosocial risk factors, whereas for hyperactive-impulsive symptoms, predominantly biological risk factors emerged. Hyperactive-impulsive symptoms also were a strong risk factor for comorbid oppositional defiant (ODD) and conduct disorder (CD). Smoking during pregnancy was a risk factor for comorbid CD but not ODD and further differential risk factors were observed for ODD and CD. Comorbid anxiety disorder (AnxD) was not related to ADHD symptoms and additional biological and psychosocial risk factors were observed. This study adds to the body of evidence that non-genetic biological and psychosocial risk factors have an impact on ADHD symptom severity and differentially influence comorbid disorders in ADHD. The findings are relevant to the prevention and treatment of ADHD with or without comorbid disorders.

摘要

注意缺陷多动障碍(ADHD)是一种具有高精神共病率的遗传和环境决定的疾病。在这项研究中,我们评估了 275 名年龄在 5-13 岁之间(平均年龄 9.7±1.9 岁)的 ADHD 儿童的非遗传生物和心理社会风险因素与 ADHD 症状严重程度和共病障碍的关系。我们获得了产前/围产期的生物和终生心理社会风险因素以及父母 ADHD 的数据。注意力不集中和多动冲动型 ADHD 症状的风险因素呈现出不同的模式。注意力不集中症状受心理社会风险因素的强烈影响,而多动冲动症状则主要由生物风险因素引起。多动冲动症状也是共患对立违抗性障碍(ODD)和品行障碍(CD)的强烈危险因素。怀孕期间吸烟是共患 CD 的危险因素,但不是 ODD 的危险因素,并且在 ODD 和 CD 中观察到了进一步的差异风险因素。共患焦虑障碍(AnxD)与 ADHD 症状无关,并且还观察到了其他的生物和心理社会风险因素。本研究进一步证实了非遗传生物和心理社会风险因素对 ADHD 症状严重程度有影响,并对 ADHD 的共病障碍有不同的影响。这些发现与 ADHD 伴或不伴共病障碍的预防和治疗有关。

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Biological and psychosocial environmental risk factors influence symptom severity and psychiatric comorbidity in children with ADHD.

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[5]
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[6]
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[7]
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[8]
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[10]
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本文引用的文献

[1]
Phenotypic and measurement influences on heritability estimates in childhood ADHD.

Eur Child Adolesc Psychiatry. 2010-3-7

[2]
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