共患抑郁障碍的注意缺陷多动障碍:注意缺陷多动障碍严重程度、亚型和家族性精神障碍的作用。

Comorbid Depressive Disorders in ADHD: The Role of ADHD Severity, Subtypes and Familial Psychiatric Disorders.

机构信息

Department of Dynamic and Clinical Psychology, University of Rome Sapienza, Rome, Italy.

U.O.N.P.I. Avezzano, L'Aquila, Italy.

出版信息

Psychiatry Investig. 2014 Apr;11(2):137-42. doi: 10.4306/pi.2014.11.2.137. Epub 2014 Apr 11.

Abstract

OBJECTIVE

To evaluate the presence of Major Depressive Disorder (MDD) and Dysthymic Disorder (DD) in a sample of Italian children with Attention Deficit Hyperactivity Disorder (ADHD) and to explore specific features of comorbid depressive disorders in ADHD.

METHODS

Three hundred and sixty-six consecutive, drug-naïve Caucasian Italian outpatients with ADHD were recruited and comorbid disorders were evaluated using DSM-IV-TR criteria. To evaluate ADHD severity, parents of all children filled out the ADHD Rating Scale. Thirty-seven children with comorbid MDD or DD were compared with 118 children with comorbid conduct disorder and 122 without comorbidity for age, sex, IQ level, family psychiatric history, and ADHD subtypes and severity.

RESULTS

42 of the ADHD children displayed comorbid depressive disorders: 16 exhibited MDD, 21 DD, and 5 both MDD and DD. The frequency of hyperactive-impulsive subtypes was significantly lower in ADHD children with depressive disorders, than in those without any comorbidity. ADHD children with depressive disorders showed a higher number of familial psychiatric disorders and higher score in the Inattentive scale of the ADHD Rating Scale, than children without any comorbidity. No differences were found for age, sex and IQ level between the three groups.

CONCLUSION

Consistent with previous studies in other countries, depressive disorders affect a significant proportion of ADHD children in Italy. Patient assessment and subsequent treatment should take into consideration the possible presence of this comorbidity, which could specifically increase the severity of ADHD attention problems.

摘要

目的

评估意大利注意缺陷多动障碍(ADHD)患儿样本中重度抑郁症(MDD)和心境恶劣障碍(DD)的存在,并探讨 ADHD 共病抑郁障碍的特定特征。

方法

招募了 366 名连续的、未经药物治疗的高加索裔意大利 ADHD 门诊患者,并使用 DSM-IV-TR 标准评估共病障碍。为了评估 ADHD 的严重程度,所有儿童的家长均填写了 ADHD 评定量表。将 37 名患有共病 MDD 或 DD 的儿童与 118 名患有共病品行障碍的儿童和 122 名无共病的儿童进行比较,比较的因素包括年龄、性别、智商水平、家族精神病史以及 ADHD 亚型和严重程度。

结果

42 名 ADHD 儿童存在共病抑郁障碍:16 名患有 MDD,21 名患有 DD,5 名患有 MDD 和 DD。与无任何共病的 ADHD 儿童相比,患有抑郁障碍的 ADHD 儿童中多动冲动亚型的发生率显著降低。患有抑郁障碍的 ADHD 儿童的家族精神疾病发生率更高,ADHD 评定量表的注意力不集中分量表的得分也更高,而与无任何共病的儿童相比,他们的年龄、性别和智商水平没有差异。

结论

与其他国家的先前研究一致,抑郁障碍在意大利的 ADHD 儿童中影响着相当大的比例。患者评估和后续治疗应考虑到这种共病的存在,因为这可能会特异性地增加 ADHD 注意力问题的严重程度。

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