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不良生活事件在患有注意力缺陷多动障碍的老年人抑郁症中的作用。

The role of adverse life events on depression in older adults with ADHD.

作者信息

Semeijn E J, Comijs H C, Kooij J J S, Michielsen M, Beekman A T F, Deeg D J H

机构信息

The Netherlands EMGO Institute for Health and Care Research, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands; Expertise Centre Adult ADHD, PsyQ, The Hague, The Netherlands.

The Netherlands EMGO Institute for Health and Care Research, Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

J Affect Disord. 2015 Mar 15;174:574-9. doi: 10.1016/j.jad.2014.11.048. Epub 2014 Nov 29.

Abstract

BACKGROUND

Comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and depression is high, also in older adults. Thus far it is not well understood why ADHD and depression are so strongly interrelated. One factor that may play a role in older adults with ADHD is an increased risk of experiencing adverse life events.

METHODS

Six year follow-up data were used from the Longitudinal Aging Study Amsterdam (LASA). To diagnose ADHD, the DIVA 2.0, a diagnostic interview was administered among a subsample (N=230, age 60-94). In addition to the ADHD diagnosis, the associations between the number of ADHD symptoms, depressive symptoms and adverse life events were examined. Data were analyzed by means of logistic and linear regression analyses.

RESULTS

Compared to older adults without ADHD, those with ADHD reported more serious conflicts. The risk of depression in older adults with ADHD was partly explained by serious conflicts. Furthermore, the association between ADHD severity and depression was stronger in those who experienced serious conflicts and those who experienced more adverse life events.

LIMITATIONS

The ADHD diagnosis was based on the DSM-IV criteria, which were developed for children, and have not yet been validated in (older) adults.

CONCLUSIONS

Having conflicts with others and accumulation of adverse life events over time partly explained the association between ADHD and depression. Better and earlier treatment of ADHD may prevent the development of depression in the presence of life events associated with ADHD.

摘要

背景

注意缺陷多动障碍(ADHD)与抑郁症之间的共病现象很常见,在老年人中也是如此。到目前为止,ADHD与抑郁症为何如此紧密相关尚不清楚。在患有ADHD的老年人中,一个可能起作用的因素是经历不良生活事件的风险增加。

方法

使用了来自阿姆斯特丹纵向衰老研究(LASA)的六年随访数据。为了诊断ADHD,对一个子样本(N = 230,年龄60 - 94岁)进行了DIVA 2.0诊断访谈。除了ADHD诊断外,还研究了ADHD症状数量、抑郁症状与不良生活事件之间的关联。通过逻辑回归和线性回归分析对数据进行了分析。

结果

与没有ADHD的老年人相比,患有ADHD的老年人报告的冲突更严重。患有ADHD的老年人患抑郁症的风险部分可由严重冲突来解释。此外,在经历严重冲突和经历更多不良生活事件的人群中,ADHD严重程度与抑郁症之间的关联更强。

局限性

ADHD诊断基于为儿童制定的DSM-IV标准,该标准尚未在(老年)成年人中得到验证。

结论

与他人发生冲突以及随着时间推移不良生活事件的积累部分解释了ADHD与抑郁症之间的关联。在存在与ADHD相关的生活事件时,更好、更早地治疗ADHD可能预防抑郁症的发生。

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