De Rossi Pietro, D'Aiello Barbara, Pretelli Italo, Menghini Deny, Di Vara Silvia, Vicari Stefano
Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy.
Department of Human Sciences, Libera Università Maria Santissima Assunta University, Rome, Italy.
Front Psychiatry. 2023 Jan 27;14:1069934. doi: 10.3389/fpsyt.2023.1069934. eCollection 2023.
Attention deficit hyperactivity disorder (ADHD) has been associated with difficulties in regulating aversion states, high functional impairment, and a high risk of psychopathology across the lifespan. ADHD is clinically heterogeneous, with a wide spectrum of severity and associated symptoms. Clinical characteristics need to be carefully defined in different periods of life as ADHD course, symptoms, and comorbidities may fluctuate and change over time. Adolescence usually represents the transition from primary to secondary education, with a qualitative and quantitative change in environmental and functional demands, thus driving symptoms' change.
In order to characterize age-related clinical features of children (<11 years) and adolescents (≥11 years) with ADHD, we conducted a naturalistic study on 750 children and adolescents assessed for ADHD at our Neuropsychiatry Unit over the course of 3 years (2018-2020).
We found that ADHD symptoms were significantly higher in children than adolescents. More importantly, we found worse global functioning, lower adaptive skills, higher levels of anxiety and depressive symptoms, somatic complaints, emotional dysregulation, social problems, and aggression in adolescents, despite a lower severity of ADHD-specific symptoms.
These results should be confirmed in longitudinal observational studies of adequate sample size in order to reliably describe a potential course characterized by worsening of functioning, reduction in ADHD-specific symptoms and increase in general psychopathology during the transition from childhood to adolescence.
注意缺陷多动障碍（ADHD）与调节厌恶状态困难、高功能损害以及终生患精神病理学疾病的高风险有关。ADHD在临床上具有异质性，严重程度和相关症状范围广泛。由于ADHD的病程、症状和共病可能随时间波动和变化，因此需要在生命的不同阶段仔细界定临床特征。青春期通常代表着从小学到中学教育的过渡，环境和功能需求在质和量上都发生了变化，从而导致症状改变。
为了描述患有ADHD的儿童（<11岁）和青少年（≥11岁）与年龄相关的临床特征，我们对750名儿童和青少年进行了一项自然主义研究，这些儿童和青少年在3年（2018 - 2020年）期间在我们的神经精神病科接受了ADHD评估。
我们发现儿童的ADHD症状明显高于青少年。更重要的是，我们发现尽管青少年ADHD特定症状的严重程度较低，但他们的整体功能更差、适应技能更低、焦虑和抑郁症状水平更高、躯体不适、情绪失调、社会问题及攻击性更强。
这些结果应在足够样本量的纵向观察研究中得到证实，以便可靠地描述从童年到青春期过渡期间以功能恶化、ADHD特定症状减少和一般精神病理学增加为特征的潜在病程。
