Korsgaard Hans Ole, Torgersen Svenn, Wentzel-Larsen Tore, Ulberg Randi
Department for Child and Adolescent Mental Health (The Nic Waal Institute), Lovisenberg Diakonale Hospital, P.O. Box 4970, Nydalen, N-0440, Oslo, Norway.
Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway.
BMC Psychiatry. 2016 Jun 1;16:175. doi: 10.1186/s12888-016-0871-0.
Attention deficit hyperactivity disorder (ADHD) is a lifelong condition which carries great cost to society and has an extensive comorbidity. It has been assumed that ADHD is 2 to 5 times more frequent in boys than in girls. Several studies have suggested developmental trajectories that link ADHD and certain personality disorders. The present study investigated the prevalence of ADHD, common Axis I disorders, and their gender differences in a sample of adolescent outpatients. We also wanted to investigate the relationship between ADHD and personality disorders (PDs), as well as how this relationship was influenced by adjustment for Axis I disorders, age and gender.
We used a sample consisting of 153 adolescents, aged 14 to 17 years, who were referred to a non-specialized mental health outpatient clinic with a defined catchment area. ADHD, conduct disorder (CD) and other Axis I conditions were assessed using the Mini International Neuropsychiatric Interview (MINI). PDs were assessed using the Structured Interview for DSM-IV Personality (SIDP-IV).
13.7 % of the adolescents met diagnostic criteria for ADHD, with no significant gender difference. 21.6 % had at least one PD, 17.6 % had CD, and 4.6 % had both ADHD and a PD. There was a significantly elevated number of PD symptoms in adolescents with an ADHD diagnosis (p = 0.001), and this relationship was not significantly weakened when adjusted for age, gender and other Axis I disorders (p = 0.026). Antisocial (χ (2) = 21.18, p = 0.002) and borderline (χ (2) = 6.15, p = 0.042) PDs were significantly more frequent in girls than in boys with ADHD.
We found no significant gender difference in the prevalence of ADHD in a sample of adolescents referred to a general mental health outpatient clinic. Adolescent girls with ADHD had more PDs than boys, with antisocial and borderline PDs significantly different. The present study suggests that ADHD in girls in a general outpatient population may be more prevalent than previously assumed. It especially highlights the importance of assessing antisocial and borderline personality pathology in adolescent girls presenting with ADHD symptoms.
注意缺陷多动障碍（ADHD）是一种终身性疾病，给社会带来巨大代价且存在广泛的共病情况。一般认为，ADHD在男孩中的发病率是女孩的2至5倍。多项研究提出了将ADHD与某些人格障碍联系起来的发展轨迹。本研究调查了青少年门诊样本中ADHD、常见的轴I障碍及其性别差异。我们还想研究ADHD与人格障碍（PDs）之间的关系，以及这种关系如何受到轴I障碍、年龄和性别的调整影响。
我们使用了一个由153名年龄在14至17岁的青少年组成的样本，这些青少年被转介到一个有明确服务区域的非专科心理健康门诊。使用迷你国际神经精神访谈（MINI）评估ADHD、品行障碍（CD）和其他轴I疾病。使用DSM-IV人格结构化访谈（SIDP-IV）评估PDs。
13.7%的青少年符合ADHD诊断标准，无显著性别差异。21.6%的青少年至少患有一种PD，17.6%的青少年患有CD，4.6%的青少年同时患有ADHD和PD。ADHD诊断的青少年中PD症状数量显著增加（p = 0.001），在对年龄、性别和其他轴I障碍进行调整后，这种关系并未显著减弱（p = 0.026）。患有ADHD的女孩中反社会（χ(2)=21.18，p = 0.002）和边缘型（χ(2)=6.15，p = 0.042）PDs的发生率显著高于男孩。
在转介到普通心理健康门诊的青少年样本中，我们发现ADHD患病率无显著性别差异。患有ADHD的青少年女孩比男孩患更多的PDs，反社会和边缘型PDs存在显著差异。本研究表明，普通门诊人群中女孩的ADHD可能比之前认为的更普遍。它特别强调了在出现ADHD症状的青少年女孩中评估反社会和边缘型人格病理的重要性。
