Jensen P S, Shervette R E, Xenakis S N, Richters J
Department of Psychiatry and Neurology, Eisenhower Army Medical Center, Fort Gordon, Ga.
Am J Psychiatry. 1993 Aug;150(8):1203-9. doi: 10.1176/ajp.150.8.1203.
The authors examined the discriminant validity of the diagnosis of attention deficit disorder with hyperactivity.
They used standardized rating scales of life stresses and child and family functioning to assess psychosocial and family risk factors in 47 children who had the diagnosis of attention deficit disorder with hyperactivity, a matched group of 47 children in the community, and a matched group of 47 children seen in a psychiatric clinic.
Children who had the diagnosis of attention deficit disorder and children in the psychiatric clinic reported significantly more depression and anxiety than did the children in the community; furthermore, children diagnosed as having attention deficit disorder with hyperactivity had more externalizing symptoms than did children in the psychiatric clinic. Children diagnosed as having attention deficit disorder with hyperactivity plus a comorbid anxiety or depressive disorder had higher levels of coexisting life stresses and parental symptoms than did children who had the single diagnosis of attention deficit disorder with hyperactivity.
These results underscore the need for future studies to carefully assess children diagnosed as having attention deficit disorder with hyperactivity for concurrent psychiatric disorders as well as family and psychosocial stressors that may contribute to childhood symptoms. Such information is essential because different subtypes of attention deficit disorder with comorbid disorders may arise from different etiologic pathways, may require varying treatment options, and may foreshadow different eventual outcomes.
作者研究了多动性注意缺陷障碍诊断的区分效度。
他们使用生活压力以及儿童和家庭功能的标准化评定量表,对47名被诊断为多动性注意缺陷障碍的儿童、47名相匹配的社区儿童以及47名在精神科诊所就诊的相匹配儿童的心理社会和家庭风险因素进行评估。
被诊断为注意缺陷障碍的儿童以及在精神科诊所就诊的儿童比社区儿童报告了更多的抑郁和焦虑;此外,被诊断为多动性注意缺陷障碍的儿童比在精神科诊所就诊的儿童有更多的外化症状。被诊断为多动性注意缺陷障碍合并共病焦虑或抑郁障碍的儿童比仅被诊断为多动性注意缺陷障碍的儿童有更高水平的并存生活压力和父母症状。
这些结果强调未来研究需要仔细评估被诊断为多动性注意缺陷障碍的儿童是否存在并发精神障碍以及可能导致儿童期症状的家庭和心理社会应激源。此类信息至关重要,因为合并障碍的不同亚型的多动性注意缺陷障碍可能源于不同的病因途径,可能需要不同的治疗选择,并且可能预示不同的最终结局。