Roy Arunima, Hechtman Lily, Arnold L Eugene, Swanson James M, Molina Brooke S G, Sibley Margaret H, Howard Andrea L
Division of Molecular Psychiatry, University Hospital Würzburg, Germany.
Division of Child Psychiatry, McGill University, Montreal, Quebec, Canada.
J Am Acad Child Adolesc Psychiatry. 2017 Aug;56(8):687-695.e7. doi: 10.1016/j.jaac.2017.05.020. Epub 2017 Jun 8.
Recent results from the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (ADHD; MTA) have demonstrated impairments in several functioning domains in adults with childhood ADHD. The childhood predictors of these adult functional outcomes are not adequately understood. The objective of the present study was to determine the effects of childhood demographic, clinical, and family factors on adult functional outcomes in individuals with and without childhood ADHD from the MTA cohort.
Regressions were used to determine associations of childhood factors (age range 7-10 years) of family income, IQ, comorbidity (internalizing, externalizing, and total number of non-ADHD diagnoses), parenting styles, parental education, number of household members, parental marital problems, parent-child relationships, and ADHD symptom severity with adult outcomes (mean age 25 years) of occupational functioning, educational attainment, emotional functioning, sexual behavior, and justice involvement in participants with (n = 579) and without (n = 258) ADHD.
Predictors of adult functional outcomes in ADHD included clinical factors such as baseline ADHD severity, IQ, and comorbidity; demographic factors such as family income, number of household members and parental education; and family factors such as parental monitoring and parental marital problems. Predictors of adult outcomes were generally comparable for children with and without ADHD.
Childhood ADHD symptoms, IQ, and household income levels are important predictors of adult functional outcomes. Management of these areas early on, through timely treatments for ADHD symptoms, and providing additional support to children with lower IQ and from households with low incomes, could assist in improving adult functioning.
注意缺陷多动障碍（ADHD）多模式治疗研究（MTA）的最新结果表明，患有儿童期ADHD的成年人在多个功能领域存在损害。这些成人功能结局的儿童期预测因素尚未得到充分理解。本研究的目的是确定儿童期人口统计学、临床和家庭因素对MTA队列中有或无儿童期ADHD个体的成人功能结局的影响。
采用回归分析来确定儿童期因素（年龄范围7 - 10岁），包括家庭收入、智商、共病情况（内化性、外化性以及非ADHD诊断总数）、养育方式、父母教育程度、家庭成员数量、父母婚姻问题、亲子关系以及ADHD症状严重程度与成人结局（平均年龄25岁）之间的关联，这些成人结局包括职业功能、教育程度、情绪功能、性行为以及司法参与情况，研究对象为患有ADHD（n = 579）和未患有ADHD（n = 258）的参与者。
ADHD成人功能结局的预测因素包括临床因素，如基线ADHD严重程度、智商和共病情况；人口统计学因素，如家庭收入、家庭成员数量和父母教育程度；以及家庭因素，如父母监督和父母婚姻问题。患有和未患有ADHD的儿童的成人结局预测因素通常具有可比性。
儿童期ADHD症状、智商和家庭收入水平是成人功能结局的重要预测因素。早期对这些方面进行管理，通过及时治疗ADHD症状，并为智商较低和来自低收入家庭的儿童提供额外支持，可能有助于改善成人功能。
