Stern Adi, Agnew-Blais Jessica C, Danese Andrea, Fisher Helen L, Matthews Timothy, Polanczyk Guilherme V, Wertz Jasmin, Arseneault Louise
Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Occupational Therapy, University of Haifa, Haifa, Israel.
J Child Psychol Psychiatry. 2020 Nov;61(11):1234-1242. doi: 10.1111/jcpp.13217. Epub 2020 Feb 29.
Attention deficit/hyperactivity disorder (ADHD) is associated with emotional problems, and their co-occurrence often leads to worse outcomes. We investigated the developmental associations between ADHD and emotional problems from childhood to early adolescence and examined the genetic and environmental contributions to their developmental link. We further tested whether this developmental association remained across the transition to young adulthood.
We used data from the Environmental Risk (E-Risk) Longitudinal Twin Study, a cohort of 2,232 British twins. In childhood, ADHD and emotional problems were assessed at ages 5, 7, 10 and 12 with mothers' and teachers' reports. At age 18, we used self-reported symptoms according to DSM-5 criteria for ADHD, and DSM-IV for anxiety and depression.
Longitudinal analyses showed that earlier ADHD was associated with later emotional problems consistently across childhood. However, earlier emotional problems were not associated with later ADHD symptoms. The developmental association between ADHD and later emotional problems in childhood was entirely explained by common genetic factors. Consistent with results in childhood, earlier symptoms of ADHD were associated with later emotional problems during the transition to young adulthood.
Our findings demonstrate that ADHD symptoms are predictors of the development of emotional problems, from childhood up to young adulthood, through shared genetic influences. Interventions targeting ADHD symptoms might prevent the development of emotional problems. Clinicians treating youth with ADHD must be aware of their risk for developing emotional problems and ought to assess, monitor and treat emotional problems alongside ADHD symptoms from childhood to adulthood.
注意力缺陷多动障碍（ADHD）与情绪问题相关，二者同时出现往往会导致更糟糕的结果。我们研究了从童年到青春期早期ADHD与情绪问题之间的发展关联，并探讨了基因和环境因素对它们发展联系的影响。我们还进一步测试了这种发展关联在向青年期过渡的过程中是否依然存在。
我们使用了来自环境风险（E-Risk）纵向双生子研究的数据，该研究队列包括2232名英国双生子。在童年时期，通过母亲和教师的报告，在5岁、7岁、10岁和12岁时对ADHD和情绪问题进行评估。在18岁时，我们根据DSM-5标准对ADHD进行自我报告症状评估，根据DSM-IV对焦虑和抑郁进行评估。
纵向分析表明，在整个童年时期，较早出现的ADHD始终与较晚出现的情绪问题相关。然而，较早出现的情绪问题与较晚出现的ADHD症状无关。童年时期ADHD与较晚出现的情绪问题之间的发展关联完全由共同的基因因素解释。与童年时期的结果一致，在向青年期过渡期间，较早出现的ADHD症状与较晚出现的情绪问题相关。
我们的研究结果表明，从童年到青年期，通过共同的基因影响，ADHD症状是情绪问题发展的预测因素。针对ADHD症状的干预措施可能会预防情绪问题的发展。治疗患有ADHD的青少年的临床医生必须意识到他们出现情绪问题的风险，并且应该从童年到成年期，在评估、监测和治疗ADHD症状的同时，对情绪问题进行评估、监测和治疗。
