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注意缺陷多动障碍成年患者童年/青少年期转诊至专科护理或治疗的病史:与临床表现、精神共病和情绪失调的相互关系

History of Childhood/Adolescence Referral to Speciality Care or Treatment in Adult Patients with Attention-Deficit/Hyperactivity Disorder: Mutual Relations with Clinical Presentation, Psychiatric Comorbidity and Emotional Dysregulation.

作者信息

Brancati Giulio Emilio, De Rosa Ugo, De Dominicis Francesco, Petrucci Alessandra, Nannini Alessandro, Medda Pierpaolo, Schiavi Elisa, Perugi Giulio

机构信息

Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy.

Mental Health Centre, Local Health Unit 2, Via San Carlo 2, 06049 Spoleto, Italy.

出版信息

Brain Sci. 2023 Aug 27;13(9):1251. doi: 10.3390/brainsci13091251.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that only rarely remits in adulthood. While several studies underlined differences between child and adult ADHD, the relationship between adult clinical presentation and early referral/treatment has been rarely investigated. In our study, 100 adults with ADHD were recruited and subdivided according to a history of referral to speciality care or treatment with methylphenidate (MPH) during childhood/adolescence. The early referral was associated with a history of disruptive behaviors during childhood/adolescence. Current ADHD symptoms were more pronounced in patients first referred during childhood/adolescence but never treated with MPH. Early MPH treatment was associated with lower rates of mood disorders and lower severity of emotional dysregulation at the time of assessment. Negative emotionality mediated the relationship between MPH treatment and mood disorders comorbidity. ADHD patients first referred during childhood/adolescence are characterized by more externalizing features than those first referred in adulthood. MPH treatment during the developmental age may have a role in preventing mood disorders in patients with ADHD, possibly by reducing emotional dysregulation.

摘要

注意力缺陷多动障碍(ADHD)是一种神经发育疾病,在成年期很少缓解。虽然多项研究强调了儿童和成人ADHD之间的差异,但成人临床表现与早期转诊/治疗之间的关系却鲜有研究。在我们的研究中,招募了100名患有ADHD的成年人,并根据童年/青少年时期转诊至专科护理或使用哌甲酯(MPH)治疗的病史进行了细分。早期转诊与童年/青少年时期的破坏性行为史有关。在童年/青少年时期首次转诊但从未接受过MPH治疗的患者中,当前的ADHD症状更为明显。早期MPH治疗与评估时较低的情绪障碍发生率和较低的情绪调节障碍严重程度相关。消极情绪介导了MPH治疗与情绪障碍共病之间的关系。与成年期首次转诊的患者相比,童年/青少年时期首次转诊的ADHD患者具有更多的外化特征。发育年龄期间的MPH治疗可能在预防ADHD患者的情绪障碍方面发挥作用,可能是通过减少情绪调节障碍来实现的。

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