Anixt Julia S, Vaughn Aaron J, Powe Neil R, Lipkin Paul H
*Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; †Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; ‡Department of Medicine, University of California, San Francisco, San Francisco, CA; §Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD; ‖Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
J Dev Behav Pediatr. 2016 Apr;37(3):196-204. doi: 10.1097/DBP.0000000000000279.
Parental and self-perceptions about outgrowing attention-deficit hyperactivity disorder (ADHD) likely impact treatment decisions; however, little is known about these perceptions. The aim of this study was to assess adolescent and parent perceptions of outgrowing childhood ADHD and evaluate how these perceptions relate to ADHD symptoms and quality of life (QoL).
Cross-sectional survey of adolescents (13-18 years) with a childhood diagnosis of ADHD and their parents. Participants were contacted by mail and completed questionnaires about: perceptions of outgrowing ADHD, current ADHD symptoms (the Conners' Scales), and QoL (PedsQL). ANCOVAs were conducted to assess the relationship between the perception of outgrowing ADHD and: (1) current ADHD symptoms and (2) QoL, controlling for co-morbidities and medication use.
115 adolescent-parent dyads were enrolled. Mean age was 15.5 ± 1.7 years, 73% were male, and 63% were taking ADHD medication. Only 16% of adolescents and 9% of parents reported outgrowing ADHD, with little correlation between parent and adolescent responses (kappa 0.3). Adolescents who reported Yes or Don't Know to outgrowing ADHD, compared to those who reported No, had lower scores on the inattention (IA) and hyperactivity (H) scales of both parent report and adolescent self-report Conners' scales and higher scores on the adolescent self-report PedsQL.
A majority of adolescents do not endorse outgrowing their ADHD diagnosis, but those that do demonstrate fewer ADHD symptoms and better QoL than those who don't, suggesting that adolescents have insight about their level of impairment and should have a valued role in making treatment decisions.
父母及自身对于注意力缺陷多动障碍（ADHD）自愈的认知可能会影响治疗决策；然而，人们对这些认知了解甚少。本研究的目的是评估青少年及父母对儿童ADHD自愈的认知，并评估这些认知与ADHD症状及生活质量（QoL）之间的关系。
对童年期被诊断为ADHD的青少年（13 - 18岁）及其父母进行横断面调查。通过邮件联系参与者，他们完成了关于ADHD自愈认知、当前ADHD症状（康纳斯量表）和生活质量（儿童生活质量量表）的问卷。进行协方差分析以评估ADHD自愈认知与以下两方面的关系：（1）当前ADHD症状；（2）生活质量，并对共病和药物使用进行控制。
共纳入115对青少年 - 父母二元组。平均年龄为15.5±1.7岁，73%为男性，63%正在服用ADHD药物。只有16%的青少年和9%的父母报告ADHD已自愈，父母与青少年的回答之间相关性很小（kappa值为0.3）。与回答“未自愈”的青少年相比，回答“已自愈”或“不确定”的青少年在父母报告和青少年自我报告的康纳斯量表的注意力不集中（IA）和多动（H）量表上得分较低，而在青少年自我报告的儿童生活质量量表上得分较高。
大多数青少年不认可自己的ADHD诊断已自愈，但那些认为已自愈的青少年比未自愈的青少年表现出更少的ADHD症状和更好的生活质量，这表明青少年对自己的受损程度有洞察力，在治疗决策中应发挥重要作用。
