Pliszka S R
J Am Acad Child Adolesc Psychiatry. 1989 Nov;28(6):882-7. doi: 10.1097/00004583-198911000-00012.
The effect of the comorbidity of overanxious disorder (ANX) in attention deficit hyperactivity disorder (ADHD) on laboratory measures of behavior, cognition, and stimulant response was examined. Seventy-nine children who met DSM-III-R criteria for ADHD were tested further for an oppositional defiant disorder (ODD), conduct disorder (CD), or ANX. Subjects with comorbid ANX showed less impulsiveness on a laboratory measure of behavior and had longer, sluggish reaction times on the Memory Scanning Test than those without ANX. ADHD subjects with comorbid ANX were less frequently diagnosed as CD. Forty-three of the subjects completed a double-blind trial of methylphenidate; subjects with comorbid anxiety had a significantly poorer response to the stimulant than those without anxiety, while the comorbidity of ODD or CD did not affect stimulant response. The results suggest that ADHD with comorbid ANX may represent children with primary anxiety who develop secondary inattentiveness, or they may represent a different subtype of ADHD, perhaps similar to the condition of attention deficit disorder without hyperactivity under DSM-III.
研究了注意缺陷多动障碍（ADHD）合并过度焦虑障碍（ANX）对行为、认知及兴奋剂反应实验室指标的影响。对79名符合DSM-III-R标准的ADHD儿童进一步检测对立违抗障碍（ODD）、品行障碍（CD）或ANX。合并ANX的受试者在行为实验室指标上表现出较少的冲动性，且在记忆扫描测试中反应时间更长、更迟缓，相比无ANX的受试者。合并ANX的ADHD受试者被诊断为CD的频率更低。43名受试者完成了哌甲酯双盲试验；合并焦虑的受试者对兴奋剂的反应明显比无焦虑者差，而合并ODD或CD并不影响兴奋剂反应。结果表明，合并ANX的ADHD可能代表原发性焦虑且继发注意力不集中的儿童，或者可能代表ADHD的一种不同亚型，也许类似于DSM-III下的注意力缺陷障碍无多动型。
