Xia Weiping, Shen Lixiao, Zhang Jinsong
Department of Clinical Psychology, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Adolescent Health Care, Xin Hua Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Arch Psychiatry. 2015 Dec 25;27(6):356-67. doi: 10.11919/j.issn.1002-0829.215115.
Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in children that can extend into adulthood and that is often associated with a variety of comorbid psychiatric disorders.
Assess the comorbidity of ADHD with anxiety disorders and depressive disorders in school-aged children, and the relationship of the severity of ADHD, anxiety, and depressive symptoms in children who have ADHD with the severity of the corresponding symptoms in their parents.
A two-stage screening process identified children 7-10 years of age with and without ADHD treated at the Xin Hua Hospital in Shanghai. ADHD and other DSM-IV diagnoses were determined by a senior clinician using the Schedule for Affective Disorder and Schizophrenia for School-Aged Children (K-SADS-PL). One parent for each enrolled child completed three self-report scales: the ADHD Adult Self Report Scale (ASRS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In total 135 children with ADHD and 65 control group children without ADHD were enrolled; parents for 94 of the children with ADHD and 63 of the children without ADHD completed the parental assessment scales.
Among the 135 children with ADHD, 27% had a comorbid anxiety disorder, 18% had a comorbid depressive disorder, and another 15% had both comorbid anxiety and depressive disorders. Parents of children with ADHD self-reported more severe ADHD inattention symptoms than parents of children without ADHD and were more likely to meet criteria for adult ADHD. Mothers (but not fathers) of children with ADHD had significantly more severe trait anxiety and depressive symptoms than mothers of children without ADHD. Among children with ADHD, the severity of ADHD symptoms was not significantly correlated with the severity of ADHD symptoms in parents, but depressive symptoms and anxiety symptoms in the children were significantly correlated with the corresponding symptoms in the parents.
School-aged children with ADHD commonly suffer from comorbid anxiety and depressive disorders, and the severity of these symptoms parallels the level of anxiety and depressive symptoms in their parents. Self-reported symptoms of ADHD are significantly more common in parents of children with ADHD than in parents of children without ADHD. Longitudinal studies are needed to disentangle the genetic, biological, and social factors responsible for these complex inter-relationships.
注意缺陷多动障碍（ADHD）是儿童常见的精神障碍，可持续至成年期，且常与多种共病精神障碍相关。
评估学龄儿童ADHD与焦虑症和抑郁症的共病情况，以及ADHD儿童的ADHD、焦虑和抑郁症状严重程度与父母相应症状严重程度之间的关系。
采用两阶段筛查程序，确定在上海新华医院接受治疗的7至10岁患与未患ADHD的儿童。由一名资深临床医生使用儿童情感障碍和精神分裂症量表（K-SADS-PL）确定ADHD及其他DSM-IV诊断。每名入选儿童的一位家长完成三份自我报告量表：ADHD成人自我报告量表（ASRS）、状态-特质焦虑量表（STAI）和贝克抑郁量表（BDI）。共纳入135名ADHD儿童和65名非ADHD对照组儿童；94名ADHD儿童的家长和63名非ADHD儿童的家长完成了家长评估量表。
在135名ADHD儿童中，27%患有共病焦虑症，18%患有共病抑郁症，另有15%同时患有共病焦虑症和抑郁症。ADHD儿童的家长自我报告的ADHD注意力不集中症状比非ADHD儿童的家长更严重，且更有可能符合成人ADHD的标准。ADHD儿童的母亲（而非父亲）的特质焦虑和抑郁症状比非ADHD儿童的母亲明显更严重。在ADHD儿童中，ADHD症状的严重程度与父母的ADHD症状严重程度无显著相关性，但儿童的抑郁症状和焦虑症状与父母的相应症状显著相关。
患有ADHD的学龄儿童常伴有焦虑症和抑郁症共病，这些症状的严重程度与父母的焦虑和抑郁症状水平相当。ADHD儿童的家长自我报告的ADHD症状明显比非ADHD儿童的家长更常见。需要进行纵向研究以理清导致这些复杂相互关系的遗传、生物学和社会因素。
