Tang Yajing, Qiu Sunwei, Li Haimei, Si Feifei, Zhao Mengjie, Dong Min, Pan Meirong, Yue Xinxin, Liu Lu, Qian Qiujin, Wang Yufeng
Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China.
NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
Psychiatry Investig. 2023 Sep;20(9):789-798. doi: 10.30773/pi.2023.0070. Epub 2023 Sep 19.
Subthreshold attention-deficit/hyperactivity disorder (ADHD) has been suggested to be a "morbid condition" which also needs medical attention.
The present study recruited 89 children with subthreshold ADHD (sADHD), 115 children with diagnosed ADHD (cADHD), and 79 healthy controls (HC) to explore the clinical manifestation, executive functions (EFs) of sADHD, and the caregiver strain. The clinical manifestation was evaluated through clinical interviews and parent-reports. Executive functions were assessed both experimentally and ecologically. Caregiver strain was measured by a parent-reported questionnaire.
For the clinical manifestation, both sADHD and cADHD indicated impairments when compared with HC. The comorbidities and the scaled symptoms indicated that the externalizing behaviors were relatively less serious in sADHD than cADHD, whereas the internalizing behaviors between two groups were comparable. For ecological EFs, sADHD scored between cADHD and HC in inhibition and working memory. For experimental EFs, sADHD was comparable to cADHD in inhibition, shifting, and was worse than cADHD in verbal working memory. For the caregiver strain, all scores of sADHD were between that in cADHD and that in HC.
Our present findings supported the suggestion of subthreshold ADHD as "morbid condition," which should be treated with caution in clinical practice, especially for the internalizing behaviors and some key components of EFs.
阈下注意缺陷多动障碍（ADHD）被认为是一种“病态状况”，也需要医学关注。
本研究招募了89名阈下ADHD儿童（sADHD）、115名已确诊ADHD儿童（cADHD）和79名健康对照儿童（HC），以探究sADHD的临床表现、执行功能（EFs）以及照料者压力。通过临床访谈和家长报告评估临床表现。从实验和生态学角度评估执行功能。通过家长报告的问卷测量照料者压力。
在临床表现方面，与HC相比，sADHD和cADHD均显示出损害。共病情况和量表症状表明，sADHD的外化行为比cADHD相对不那么严重，而两组的内化行为相当。在生态学EFs方面，sADHD在抑制和工作记忆方面的得分介于cADHD和HC之间。在实验性EFs方面，sADHD在抑制、转换方面与cADHD相当，在言语工作记忆方面比cADHD差。在照料者压力方面，sADHD的所有得分均介于cADHD和HC之间。
我们目前的研究结果支持将阈下ADHD视为“病态状况”的观点，在临床实践中应谨慎对待，尤其是对于内化行为和EFs的一些关键组成部分。
