Lin Yu-Ju, Lo Kuan-Wu, Yang Li-Kuang, Gau Susan Shur-Fen
Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; Department of Psychiatry, Far Eastern Memorial Hospital, No. 21, Section 2, Nanya South Road, New Taipei City 220, Taiwan; Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan.
Department of Psychiatry, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan; School of Medicine, College of Medicine, National Taiwan University, No. 1, Jen-Ai Road Section 1, Taipei 100, Taiwan.
Res Dev Disabil. 2015 Dec;47:48-60. doi: 10.1016/j.ridd.2015.07.026. Epub 2015 Aug 27.
The newly published Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) elevates the threshold of the ADHD age-of-onset criterion from 7 to 12 years. This study evaluated the quality of life and functional impairment of adults with ADHD who had symptoms onset by or after 7 years and examined the mediation effect of family function and anxiety/depression symptoms between ADHD diagnosis and quality of life and functional impairment. We assessed 189 adults with ADHD and 153 non-ADHD controls by psychiatric interview and self-administered reports on the Adult ADHD Quality of Life Scale, Weiss Functional Impairment Rating Scale, Family APGAR, and Adult Self Report Inventory-4. The ADHD group was divided into early-onset ADHD (onset <7 years, n=147) and late-onset ADHD (onset between 7 and 12 years, n=42). The mediation analysis was conducted to verify the mediating factors from ADHD to functional impairment and quality of life. The late-onset ADHD had more severe functional impairment at work and poorer family support than early-onset ADHD while they had comparable impairment at other domains. Less perceived family support and current anxiety/depressive symptoms partially mediated the link between ADHD diagnosis and quality of life/functional impairment both in early- and late-onset ADHD. Our data support decreased quality of life and increased functional impairment in adult ADHD, regardless of age of onset, and these adverse outcomes may be mediated by family support and anxiety/depression at adulthood. Our findings also imply that the new DSM-5 ADHD criteria do not over-include individuals without impairment.
新出版的《精神疾病诊断与统计手册》第5版（DSM - 5）将注意力缺陷多动障碍（ADHD）发病年龄标准的阈值从7岁提高到了12岁。本研究评估了7岁及之后出现症状的成人ADHD患者的生活质量和功能损害情况，并检验了家庭功能以及焦虑/抑郁症状在ADHD诊断与生活质量和功能损害之间的中介作用。我们通过精神科访谈以及成人ADHD生活质量量表、韦斯功能损害评定量表、家庭APGAR量表和成人自我报告量表 - 4的自评报告，对189名成人ADHD患者和153名非ADHD对照者进行了评估。ADHD组被分为早发型ADHD（发病年龄<7岁，n = 147）和晚发型ADHD（发病年龄在7至12岁之间，n = 42）。进行中介分析以验证从ADHD到功能损害和生活质量的中介因素。与早发型ADHD相比，晚发型ADHD在工作方面的功能损害更严重，家庭支持更少，而在其他领域的损害相当。无论是早发型还是晚发型ADHD，较少的家庭支持感和当前的焦虑/抑郁症状在一定程度上介导了ADHD诊断与生活质量/功能损害之间的联系。我们的数据支持成人ADHD患者生活质量下降和功能损害增加，无论发病年龄如何，而这些不良后果可能由成年期的家庭支持和焦虑/抑郁介导。我们的研究结果还表明，新的DSM - 5 ADHD标准并没有过度纳入无损害的个体。
