Department of Psychiatry, Psychosomatics and Psychotherapy in Childhood and Adolescence, Medical Faculty, University of Cologne, Robert-Koch-Str. 10, 50931, Cologne, Germany,
Eur Child Adolesc Psychiatry. 2015 Jun;24(6):665-73. doi: 10.1007/s00787-014-0634-8. Epub 2014 Nov 14.
Comparatively little information is available from population-based studies on subgroup trajectories of attention-deficit/hyperactivity disorder (ADHD) core symptoms of inattention and hyperactivity-impulsivity (particularly as defined by DSM-IV and ICD-10). Recent report of a subgroup with high and increasing inattention symptoms across development requires replication. To identify the different trajectory subgroups for inattention, hyperactivity-impulsivity and total symptoms of ADHD in children and adolescents aged 7-19 years. Eleven birth cohorts from 2,593 families with children and adolescents who had parent ratings for the outcome measures of inattention, hyperactivity-impulsivity or total symptoms were considered. Data were analysed using an accelerated longitudinal design and growth mixture modelling was applied to detect subgroups. For all three outcome measures, three trajectories with low (78.3-83.3 %), moderate (13.4-18.8 %) and high (2.8-3.2 %) symptom levels were detected. Course within these subgroups was largely comparable across outcome domains. In general, a decrease in symptoms with age was observed in all severity subgroups, although the developmental course was stable for the high subgroups of inattention and total symptoms. About 3 % of children in a community-based sample follow a course with a high level of ADHD symptoms. In this high trajectory group, hyperactivity-impulsivity symptoms decrease with age from 7 to 19 years, whilst inattention and total symptoms are stable. There was no evidence for an increase in symptoms across childhood/adolescence in any of the severity groups.
基于人群的研究中，关于注意力缺陷/多动障碍（ADHD）核心症状的亚组轨迹（尤其是根据 DSM-IV 和 ICD-10 定义的注意力不集中和多动冲动）的信息相对较少。最近有报告称，在整个发育过程中，存在一个亚组的注意力不集中症状较高且呈上升趋势，这需要进一步证实。本研究旨在确定儿童和青少年（7-19 岁）中注意缺陷、多动冲动和 ADHD 总症状的不同轨迹亚组。共纳入了来自 11 个出生队列的 2593 个家庭的儿童和青少年，这些家庭的儿童和青少年均有家长对注意缺陷、多动冲动或总症状进行评定。使用加速纵向设计进行数据分析，并应用增长混合模型来检测亚组。对于所有三个结局指标，均检测到低（78.3-83.3%）、中（13.4-18.8%）和高（2.8-3.2%）症状水平的三个轨迹亚组。在这些亚组内，各个结局领域的轨迹基本相似。一般来说，在所有严重程度亚组中，随着年龄的增长，症状都有所下降，尽管高严重程度亚组的注意缺陷和总症状的发育过程是稳定的。在一个基于社区的样本中，约 3%的儿童存在 ADHD 症状水平较高的情况。在这个高轨迹组中，7 至 19 岁时，多动冲动症状随年龄增长而下降，而注意力不集中和总症状则保持稳定。在任何严重程度组中，均没有证据表明症状在整个儿童期/青春期内会增加。
