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一项具有广泛人群代表性的纵向研究中注意缺陷多动障碍症状的发展轨迹

Developmental trajectories of ADHD symptoms in a large population-representative longitudinal study.

作者信息

Murray Aja Louise, Hall Hildigunnur Anna, Speyer Lydia Gabriela, Carter Lara, Mirman Daniel, Caye Arthur, Rohde Luis

机构信息

Department of Psychology, University of Edinburgh, UK.

Department of Psychiatry, Federal University of Rio Grande do Sul, Brazil.

出版信息

Psychol Med. 2021 Mar 26:1-7. doi: 10.1017/S0033291721000349.

Abstract

BACKGROUND

Previous research has suggested that there is substantial heterogeneity in the developmental trajectories of attention-deficit/hyperactivity disorder (ADHD) symptoms. Sometimes, qualitative distinctions between trajectories with different ages of onset and/or patterns of remission are made; however, little is known about the predictors and broader clinical meaningfulness of these candidate 'developmental subtypes' of ADHD symptoms.

METHODS

We applied latent class growth analysis to data from the UK Millennium Cohort Study (MCS; N = 11 316; ages 3, 5, 7, 11 and 14) to evaluate whether developmental trajectories of ADHD symptoms differing in early life predictors could be identified. Our optimal model included six trajectory groups, labelled unaffected (34.9% of the sample), mildly affected (24.1%), subclinical remitting (12.8%), pre-school onset partially remitting (14.1%), developmentally increasing (7.6%) and pre-school onset persistent (6.4%).

RESULTS

Factors such as gender, conduct problems, cognitive ability, maternal education, premature birth, peer problems and school readiness scores differentiated between specific ADHD symptom trajectories.

CONCLUSIONS

Taken together, our findings provide preliminary evidence that distinguishing different trajectories of ADHD symptoms could be clinically informative.

摘要

背景

先前的研究表明,注意力缺陷多动障碍(ADHD)症状的发展轨迹存在显著异质性。有时,会对不同起病年龄和/或缓解模式的轨迹进行质性区分;然而,对于这些ADHD症状的候选“发育亚型”的预测因素和更广泛的临床意义知之甚少。

方法

我们对英国千禧队列研究(MCS;N = 11316;年龄为3岁、5岁、7岁、11岁和14岁)的数据应用了潜在类别增长分析,以评估是否可以识别出在早期生活预测因素方面不同的ADHD症状发展轨迹。我们的最佳模型包括六个轨迹组,分别标记为未受影响(占样本的34.9%)、轻度受影响(24.1%)、亚临床缓解(12.8%)、学前起病部分缓解(14.1%)、发育性增加(7.6%)和学前起病持续(6.4%)。

结果

性别、品行问题、认知能力、母亲教育程度、早产、同伴问题和入学准备分数等因素在特定的ADHD症状轨迹之间存在差异。

结论

综合来看,我们的研究结果提供了初步证据,表明区分ADHD症状的不同轨迹可能具有临床指导意义。

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