Barkley R A, Fischer M, Edelbrock C S, Smallish L
Department of Psychiatry, University of Massachusetts Medical Center, Worcester 01655.
J Am Acad Child Adolesc Psychiatry. 1990 Jul;29(4):546-57. doi: 10.1097/00004583-199007000-00007.
The psychiatric outcome is reported for a large sample of hyperactive children (N = 123), meeting research diagnostic criteria, and normal control children (N = 66) followed prospectively over an 8-year period into adolescence. Over 80% of the hyperactives were attention deficit hyperactivity disorder (ADHD) and 60% had either oppositional defiant disorder and/or conduct disorder at outcome. Rates of antisocial acts were considerably higher among hyperactives than normals, as were cigarette and marijuana use and negative academic outcomes. The presence of conduct disorder accounted for much though not all of these outcomes. Family status of hyperactives was much less stable over time than in the normal subjects. The use of research criteria for diagnosing children as hyperactive identifies a pattern of behavioral symptoms that is highly stable over time and associated with considerably greater risk for family disturbance and negative academic and social outcomes in adolescence than has been previously reported.
报告了一大群符合研究诊断标准的多动儿童(N = 123)和正常对照儿童(N = 66)的精神科转归情况,这些儿童在8年的时间里被前瞻性地随访至青春期。超过80%的多动儿童患有注意力缺陷多动障碍(ADHD),60%在随访结束时患有对立违抗障碍和/或品行障碍。多动儿童的反社会行为发生率、吸烟和使用大麻的比例以及学业不良率均显著高于正常儿童。品行障碍的存在虽然不能完全解释所有这些转归,但能解释其中大部分。随着时间的推移,多动儿童的家庭状况比正常儿童的家庭状况要不稳定得多。使用研究标准将儿童诊断为多动,发现了一种行为症状模式,这种模式随着时间的推移高度稳定,并且与青春期家庭困扰、学业和社会不良转归的风险显著增加有关,比之前报道的情况更为严重。