Groß-Lesch Silke, Dempfle Astrid, Reichert Susanne, Jans Thomas, Geissler Julia, Kittel-Schneider Sarah, Nguyen Thuy Trang, Reif Andreas, Lesch Klaus-Peter, Jacob Christian Peter
University of Würzburg, Germany.
Philipps-University Marburg, Marburg, Germany.
J Atten Disord. 2016 Oct;20(10):855-66. doi: 10.1177/1087054713510353. Epub 2013 Nov 6.
Comorbidity in adult ADHD (aADHD) has been investigated in a large number of studies using varying research approaches with divergent results. In contrast, there is limited information about sex- or subtype-related differences from studies with small sample size.
A large sample of 910 individuals (458 males, 452 females) affected with aADHD was recruited at a tertiary referral center. All probands underwent a four-step procedure for diagnosing aADHD, including the Structured Clinical Interview of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) Axis I disorders to assess comorbidity. This study will provide additional information regarding the co-morbidity of Axis I disorders in the currently largest clinical referral sample. However, the main objective of this study is to gain information about sex- or subtype-related differences.
Affected females show higher rates of mood (61% vs. 49%), anxiety (32% vs. 22%), and eating disorders (16% vs. 1%) than affected males, while substance use disorders were more frequent in affected males (45% vs. 29%), which mirrors sex differences in prevalence in the general population. There were hardly any relevant differences in comorbidities between subtypes, with the exception of the inattentive subtype having an especially low prevalence of panic disorder. Comorbidity in general and substance use disorders in particular, but not sex or subtype, were highly predictive of lower psychosocial status.
Sex-related differences in the comorbidity of aADHD are more pronounced than subtype-related differences.
在大量研究中，采用了不同的研究方法对成人注意力缺陷多动障碍（aADHD）的共病情况进行了调查，结果各异。相比之下，关于小样本研究中性别或亚型相关差异的信息有限。
在一家三级转诊中心招募了910名患有aADHD的个体（458名男性，452名女性）的大样本。所有先证者都接受了诊断aADHD的四步程序，包括使用《精神疾病诊断与统计手册》（第4版；DSM-IV）轴I障碍的结构化临床访谈来评估共病情况。本研究将提供关于目前最大临床转诊样本中轴I障碍共病情况的更多信息。然而，本研究的主要目的是获取关于性别或亚型相关差异的信息。
与患病男性相比，患病女性出现情绪障碍（61%对49%）、焦虑障碍（32%对22%）和饮食障碍（16%对1%）的比例更高，而物质使用障碍在患病男性中更为常见（45%对29%），这反映了一般人群中患病率的性别差异。除注意力不集中亚型惊恐障碍患病率特别低外，各亚型之间在共病情况上几乎没有相关差异。总体共病情况，尤其是物质使用障碍，但不是性别或亚型，对较低的心理社会状态具有高度预测性。
aADHD共病情况中的性别相关差异比亚型相关差异更为明显。
