Vidal Raquel, Barrau Víctor, Casas Miguel, Caballero-Correa María, Martínez-Jiménez Pedro, Ramos-Quiroga Josep Antoni
Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, España; Departament de Psiquiatria i Medicina Legal, Facultat de Medicina, Universitat Autònoma de Barcelona, España.
Servicio de Psiquiatría, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, España.
Rev Psiquiatr Salud Ment. 2014 Jul-Sep;7(3):104-12. doi: 10.1016/j.rpsm.2014.03.003. Epub 2014 Jun 13.
The aim of the current study was to assess the prevalence of symptoms of attention deficit/hyperactivity disorder (ADHD) in adolescents and young adults diagnosed with other primary psychiatric disorders, who had not responded to previous treatments.
A total of 795 outpatients aged 15 to 24 years were included. The presence of ADHD was studied using DSM-IV criteria and the frequency of symptoms using the 18 item DuPaul ADHD Rating Scale.
ADHD (DSM-IV criteria) was present in 48 patients (6%), none of whom had previously received the diagnosis. A total of 260 patients (32.7%) met the criteria for moderate ADHD and between them, severity of primary psychiatric disorder was higher according to the CGI-S (P=.007). Risk factors for moderate ADHD symptoms were the presence of substance use disorders (SUD) (odds ratio=1.543, P=.01) and borderline personality disorders (odds ratio =2.173, p=.0001).
Unrecognized ADHD was present in 6% of patients; moreover 32.7% of the sample also presented moderate symptoms of the disorder. Screening for ADHD in young patients with refractory response to primary disorder treatment, mainly those with substance use disorders, conduct and personality disorders is highly advisable, due to the high frequency of ADHD comorbidity in these psychiatric disorders.
本研究旨在评估被诊断患有其他原发性精神障碍且对先前治疗无反应的青少年和青年成人中注意力缺陷/多动障碍(ADHD)症状的患病率。
共纳入795名年龄在15至24岁的门诊患者。使用《精神疾病诊断与统计手册》第四版(DSM-IV)标准研究ADHD的存在情况,并使用18项杜保罗ADHD评定量表研究症状频率。
48名患者(6%)存在ADHD(DSM-IV标准),其中无一例先前被诊断出患有该病。共有260名患者(32.7%)符合中度ADHD标准,根据临床总体印象量表严重程度(CGI-S),他们的原发性精神障碍严重程度更高(P = 0.007)。中度ADHD症状的危险因素是存在物质使用障碍(SUD)(优势比 = 1.543,P = 0.01)和边缘性人格障碍(优势比 = 2.173,P = 0.0001)。
6%的患者存在未被识别的ADHD;此外,32.7%的样本也表现出该障碍的中度症状。鉴于这些精神障碍中ADHD共病的高频率,强烈建议对原发性疾病治疗反应不佳的年轻患者,主要是那些患有物质使用障碍、品行障碍和人格障碍的患者进行ADHD筛查。