儿童和青少年注意力缺陷多动障碍、对立违抗障碍及品行障碍相关环境与心理社会风险因素的系统评价
Systematic Review of Environmental and Psychosocial Risk Factors associated with Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder, and Conduct Disorder in Children and Adolescents.
作者信息
Elbagir Rasha, Faisal Mohd, O'Hanharan Susan
机构信息
Department of Child and Adolescent Psychiatry, Mid West, University Hospital Limerick, Health Service Executive, Limerick, Republic of Ireland.
出版信息
Scand J Child Adolesc Psychiatr Psychol. 2023 Aug 25;11(1):108-119. doi: 10.2478/sjcapp-2023-0011. eCollection 2023 Jan.
BACKGROUND
In the majority of cases, attention deficit hyperactivity disorder (ADHD) is accompanied by one or more comorbid disorders, with the oppositional defiant disorder (ODD) being one of the most frequently diagnosed comorbid disorders. There is a lack of systematic reviews addressing the evidence for an association between the independent environmental and psychosocial risk factors associated with ADHD, ODD, and Conduct Disorder (CD).
OBJECTIVE
This study aims to determine the link between ADHD and ODD/CD, specifically in terms of the most up-to-date environmental and psychosocial risk factors in the development of these illnesses.
RESULTS
Eleven studies were included in this systematic review. Among these, ten studies involved environmental risk factors, and only one involved socioeconomic risk factors as exposure. Of the ten studies highlighting the environmental risk factors, six studies reported perinatal risk factors, three reported Atopic diseases as exposure measures, and one involved exposure to energy and coffee drinks. We have found that the most common risk factors associated with ADHD, ODD and CD in Europe and North America were Perinatal risk factors. In contrast, the risk factors of Atopic diseases were more common in Asia.
CONCLUSIONS
Most of the studies included in our systematic review fall within the scope of environmental risk factors were perinatal risk factors and atopic diseases are the most common risk factors. However, only one article highlighted the association of socioeconomic risk factors as an exposure. Our review results suggest the need for more research focused on psychosocial risk factors for ADHD and comorbid ODD/CD. Further research is required with the primary objective of investigating this association in greater depth and examining the possible mechanisms at varying levels is needed.
背景
在大多数情况下，注意力缺陷多动障碍（ADHD）伴有一种或多种共病，对立违抗障碍（ODD）是最常被诊断出的共病之一。目前缺乏系统评价来探讨与ADHD、ODD和品行障碍（CD）相关的独立环境和心理社会风险因素之间关联的证据。
目的
本研究旨在确定ADHD与ODD/CD之间的联系，特别是在这些疾病发展过程中最新的环境和心理社会风险因素方面。
结果
本系统评价纳入了11项研究。其中，10项研究涉及环境风险因素，仅有1项研究涉及社会经济风险因素作为暴露因素。在突出环境风险因素的10项研究中，6项研究报告了围产期风险因素，3项研究报告了特应性疾病作为暴露指标，1项研究涉及能量饮料和咖啡饮料的暴露。我们发现，在欧洲和北美，与ADHD、ODD和CD相关的最常见风险因素是围产期风险因素。相比之下，特应性疾病的风险因素在亚洲更为常见。
结论
我们系统评价中纳入的大多数研究属于环境风险因素范畴，围产期风险因素和特应性疾病是最常见的风险因素。然而，仅有一篇文章强调了社会经济风险因素作为暴露因素的关联。我们的综述结果表明，需要更多关注ADHD及共病ODD/CD心理社会风险因素的研究。需要进一步开展研究，其主要目的是更深入地调查这种关联，并研究不同层面的可能机制。
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