Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Aichi, Japan.
Hidamari kokoro clinic, Aichi, Japan.
Psychiatry Res. 2021 Jun;300:113893. doi: 10.1016/j.psychres.2021.113893. Epub 2021 Mar 22.
Subjective attention deficit/hyperactivity disorder (ADHD) symptoms seen in adult depressive patients have often become a pathophysiological topic in recent years. Screening questionnaires are widely used for detecting ADHD; however, the risk of misdiagnosis exists. The present study examined whether self-perceptions of ADHD-related characteristics were consistent regardless of changes in the severity of depressive symptoms. Between April to October 2018, newly diagnosed depressed outpatients aged 24-59 years with good social functioning and without a history of ADHD were asked to fill out the Adult ADHD Self-Report Scale version 1.1 (ASRS) and the Beck Depression Inventory (BDI) at baseline (n = 726) and 12-week follow-up (n = 202). A statistically significant correlation was found between a change in BDI and ASRS scores (score at baseline minus score at the endpoint; r = .57). In addition, the higher the rate of improvement in BDI, the lower the frequency of positive screening for ADHD by ASRS. This study showed that subjective ADHD symptoms were correlated with depressive states. Diagnostic evaluation of comorbid ADHD using self-report scales in a primary care setting should be made with caution.
主观注意缺陷/多动障碍(ADHD)症状在成年抑郁患者中较为常见,近年来已成为病理生理学研究的课题。筛查问卷广泛用于检测 ADHD,但存在误诊的风险。本研究旨在探讨无论抑郁症状严重程度如何变化,ADHD 相关特征的自我认知是否一致。2018 年 4 月至 10 月,对 726 例新诊断的、年龄在 24-59 岁之间、社会功能良好且无 ADHD 病史的门诊抑郁患者进行调查,要求他们在基线(n=726)和 12 周随访(n=202)时填写成人 ADHD 自评量表第 1.1 版(ASRS)和贝克抑郁量表(BDI)。BDI 和 ASRS 评分的变化之间存在统计学显著相关性(基线评分减去终点评分;r=0.57)。此外,BDI 改善率越高,ASRS 对 ADHD 的阳性筛查频率越低。本研究表明,主观 ADHD 症状与抑郁状态相关。在基层医疗机构使用自我报告量表对共病 ADHD 进行诊断评估时应谨慎。