Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD of the Psychiatry Department, Massachusetts General Hospital, Boston, MA 02114, USA.
J Clin Psychiatry. 2012 Jul;73(7):941-50. doi: 10.4088/JCP.11m07529.
To estimate the risks for psychopathology and functional impairments in adulthood among a longitudinal sample of youth with and without attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood.
This was a case-controlled, 16-year (15-19 years) prospective follow-up study of ADHD. 140 boys with and 120 without DSM-III-R ADHD were recruited from pediatric and psychiatric settings. The main outcome measures were structured diagnostic interviews and measures of psychosocial, educational, and neuropsychological functioning. Data were collected from 1988 to 2006.
At the 16-year follow-up, subjects with ADHD continued to significantly differ from controls in lifetime rates of antisocial, mood, anxiety, and addictive disorders, but with the exception of a higher interval prevalence of anxiety disorders (20% vs 8%; z = 2.32, P = .02) and smoking dependence (27% vs 11%; z = 2.30, P = .02), the incidence of individual disorders in the 6-year interval between the current and prior follow-up did not differ significantly from controls. At follow-up, the ADHD subjects compared with controls were significantly (P < .05) more impaired in psychosocial, educational, and neuropsychological functioning, differences that could not be accounted for by other active psychopathology.
These long-term prospective findings provide further evidence for the high morbidity associated with ADHD across the life cycle, stressing the importance of early recognition of this disorder for prevention and early intervention strategies. These findings also indicate that, in adulthood, ADHD confers significant risks for impairment that cannot be accounted for by other psychopathology.
在童年被诊断患有注意缺陷多动障碍（ADHD）的纵向青少年样本中，评估成年后出现精神病理学和功能障碍的风险。
这是一项针对 ADHD 的病例对照、16 年（15-19 岁）前瞻性随访研究。从儿科和精神病科环境中招募了 140 名患有 DSM-III-R ADHD 的男孩和 120 名无 ADHD 的男孩作为对照组。主要结局测量是结构性诊断访谈以及心理社会、教育和神经心理学功能的测量。数据收集于 1988 年至 2006 年。
在 16 年的随访中，患有 ADHD 的受试者在终身发生反社会、情绪、焦虑和成瘾障碍的比率上仍显著不同于对照组，但除了焦虑障碍的间隔患病率较高（20%对 8%；z = 2.32，P =.02）和吸烟依赖（27%对 11%；z = 2.30，P =.02）外，当前和前一次随访之间的 6 年间隔内，个别疾病的发病率与对照组相比无显著差异。在随访时，与对照组相比，ADHD 受试者在心理社会、教育和神经心理学功能方面的受损程度显著（P <.05），这些差异不能用其他活跃的精神病理学来解释。
这些长期前瞻性研究结果提供了 ADHD 在整个生命周期中高发病率的进一步证据，强调了早期识别这种疾病对于预防和早期干预策略的重要性。这些发现还表明，在成年期，ADHD 会导致显著的功能障碍风险，而这些风险不能用其他精神病理学来解释。
