Unit of Child and Adolescent Psychiatry (MPEA1), CHU Montpellier-Saint Eloi Hospital, Montpellier, France.
Unit of Child Neurology and Psychiatry of "Tor Vergata", University of Rome, Italy.
Psychiatry Res. 2017 Mar;249:244-251. doi: 10.1016/j.psychres.2016.12.055. Epub 2017 Jan 6.
This study aims to establish if adult patients with major depressive disorder (MDD) and childhood Attention Deficit/Hyperactivity disorder (ADHD) symptoms would be more frequently within the bipolar spectrum than depressed patients without childhood ADHD.
This study was carried out in outpatients recruited by psychiatrists in private practice, with 3963 participants being included in the final sample. Clinicians filled out questionnaires about current depressive symptoms in their patients, lifetime bipolar symptoms, global assessment of functioning and parental history of both major depression and bipolar disorder. Patients assessed current level of anxiety and depressive symptoms and antecedents of childhood ADHD symptoms.
Depressed adults with significant childhood ADHD symptoms had a specific pattern of their major depressive episode compared to depressed patients without such symptoms. Subjects with childhood ADHD symptoms were more likely to report lifetime symptoms of mania/hypomania and to have a parent with type I or II bipolar disorder. The developmental trajectories of familial risk for lifetime bipolar symptoms showed that parental bipolar disorder influenced lifetime bipolar symptoms both through a direct pathway and an indirect pathway involving childhood ADHD symptoms. Childhood ADHD and number of depressive symptoms both made direct contributions to lifetime bipolar symptoms.
本研究旨在确定患有重性抑郁障碍（MDD）和儿童注意缺陷/多动障碍（ADHD）症状的成年患者是否比没有儿童 ADHD 的抑郁患者更频繁地存在于双相谱中。
这项研究是在私人执业的精神科医生招募的门诊患者中进行的，共有 3963 名参与者被纳入最终样本。临床医生填写了关于患者当前抑郁症状、终生双相症状、总体功能评估以及父母的重性抑郁障碍和双相障碍病史的问卷。患者评估了当前的焦虑和抑郁症状以及儿童 ADHD 症状的前因。
与没有此类症状的抑郁患者相比，有明显儿童 ADHD 症状的成年抑郁患者其重性抑郁发作具有特定模式。有儿童 ADHD 症状的患者更有可能报告有躁狂/轻躁狂的终生症状，并且有父母患有 I 型或 II 型双相障碍。终生双相症状的家族风险发展轨迹表明，父母的双相障碍通过直接途径和间接途径（涉及儿童 ADHD 症状）影响终生双相症状。儿童 ADHD 和抑郁症状的数量都对终生双相症状有直接影响。
