Stickley A, Koyanagi A, Takahashi H, Ruchkin V, Inoue Y, Kamio Y
Department of Child and Adolescent Mental Health, National Institute of Mental Health, National Centre of Neurology and Psychiatry (NCNP), 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8553, Japan; The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, Huddinge 141 89, Sweden; Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.
Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain.
Eur Psychiatry. 2017 Sep;45:227-234. doi: 10.1016/j.eurpsy.2017.07.010. Epub 2017 Aug 4.
There has been little research on the association of attention-deficit/hyperactivity disorder (ADHD) with co-occurring physical diseases. The aim of this study was to examine the association between possible ADHD and physical multimorbidity (i.e.≥2 physical diseases) among adults in the English general population.
Data were analyzed from 7274 individuals aged≥18 years that came from the Adult Psychiatric Morbidity Survey 2007. ADHD symptoms were assessed with the Adult Self-Report Scale (ASRS) Screener. Information was also obtained on 20 self-reported doctor/other health professional diagnosed physical health conditions present in the past 12 months. Multivariable logistic regression and mediation analyses were conducted to assess the associations.
There was a monotonic relation between the number of physical diseases and possible ADHD (ASRS score≥14). Compared to those with no diseases, individuals with≥5 diseases had over 3 times higher odds for possible ADHD (odds ratio [OR]: 3.30, 95% confidence interval [CI]: 2.48-4.37). This association was observed in all age groups. Stressful life events (% mediated 10.3-24.3%), disordered eating (6.8%), depression (12.8%), and anxiety (24.8%) were significant mediators in the association between possible ADHD and physical multimorbidity.
Adults that screen positive for ADHD are at an increased risk for multimorbidity and several factors are important in this association. As many adults with ADHD remain undiagnosed, the results of this study highlight the importance of detecting adult ADHD as it may confer an increased risk for poorer health outcomes, including physical multimorbidity.
关于注意力缺陷多动障碍(ADHD)与共病身体疾病之间的关联研究较少。本研究旨在探讨英国普通人群中成年人可能患有的ADHD与身体多种疾病(即≥2种身体疾病)之间的关联。
对来自2007年成人精神病发病率调查的7274名18岁及以上个体的数据进行分析。使用成人自陈量表(ASRS)筛查工具评估ADHD症状。还获取了过去12个月内20种自我报告的经医生/其他健康专业人员诊断的身体健康状况信息。进行多变量逻辑回归和中介分析以评估关联。
身体疾病数量与可能患有的ADHD(ASRS评分≥14)之间存在单调关系。与无疾病者相比,患有≥5种疾病的个体患可能的ADHD的几率高出3倍多(优势比[OR]:3.30,95%置信区间[CI]:2.48 - 4.37)。在所有年龄组中均观察到这种关联。压力性生活事件(中介效应占比10.3 - 24.3%)、饮食失调(6.8%)、抑郁(12.8%)和焦虑(24.8%)是可能的ADHD与身体多种疾病之间关联的重要中介因素。
ADHD筛查呈阳性的成年人患多种疾病的风险增加,且多种因素在这种关联中起重要作用。由于许多患有ADHD的成年人仍未被诊断出来,本研究结果凸显了检测成人ADHD的重要性,因为它可能会增加包括身体多种疾病在内的较差健康结局的风险。