School of Psychology, University College Dublin, Dublin, Republic of Ireland.
Psychol Med. 2012 Oct;42(10):2225-34. doi: 10.1017/S0033291712000219. Epub 2012 Feb 28.
The outcomes of attention deficit hyperactivity disorder (ADHD) have been studied extensively in the first decades of life, but less is known about ADHD in adulthood. Hence we investigated cross-sectional age-related differences in behavioural symptoms, neuropsychological function and severity of co-morbid disorders within a clinically referred adult ADHD population.
We subdivided 439 referrals of individuals with ADHD (aged 16-50 years) into four groups based on decade of life and matched for childhood ADHD severity. We compared the groups on measures of self- and informant-rated current behavioural ADHD symptoms, neuropsychological performance, and self-rated co-morbid mood and anxiety symptoms.
There was a significant age-related reduction in the severity of all ADHD symptoms based on informant-ratings. In contrast, according to self-ratings, inattentive symptoms increased with age. Neuropsychological function improved across age groups on measures of selective attention and response inhibition. There was a mild correlation between the severity of depression symptoms and increasing age.
This observational study suggests that, in adulthood, ADHD symptoms as measured using informant-ratings and neuropsychological measures continue to improve with increasing age. However the subjective experience of people with ADHD is that their symptoms worsen. This dichotomy may be partially explained by the presence of co-morbid affective symptoms. The main limitation of the study is that it is cross-sectional rather than longitudinal, and the latter design would provide more conclusive evidence regarding age-related changes in an adult ADHD population.
在生命的最初几十年里，人们对注意缺陷多动障碍（ADHD）的结局进行了广泛的研究，但对成年期的 ADHD 知之甚少。因此，我们调查了在一个临床确诊的成年 ADHD 人群中，行为症状、神经心理学功能和共患疾病严重程度随年龄的横断面差异。
我们根据生活的十年将 439 名 ADHD 患者（年龄在 16-50 岁之间）的转诊患者分为四组，并根据儿童期 ADHD 的严重程度进行匹配。我们比较了各组在自我和知情者评定的当前行为 ADHD 症状、神经心理学表现以及自我评定的共患情绪和焦虑症状方面的差异。
根据知情者评定，所有 ADHD 症状的严重程度都随年龄的增长而显著降低。相比之下，根据自我评定，注意力不集中的症状随着年龄的增长而增加。在注意力选择和反应抑制方面，神经心理学功能在各个年龄组都有所提高。抑郁症状的严重程度与年龄的增长呈轻度相关。
这项观察性研究表明，在成年期，使用知情者评定和神经心理学测量的 ADHD 症状随着年龄的增长继续改善。然而，ADHD 患者的主观体验是他们的症状恶化了。这种二分法可能部分归因于共患情感症状的存在。该研究的主要局限性在于它是横断面的，而不是纵向的，后者的设计将为成年 ADHD 人群中与年龄相关的变化提供更具结论性的证据。
