围产期并发症与注意力缺陷障碍（ADD）的表现有关吗？共病和家族性问题。
Are perinatal complications relevant to the manifestation of ADD? Issues of comorbidity and familiality.
作者信息
Sprich-Buckminster S, Biederman J, Milberger S, Faraone S V, Lehman B K
机构信息
Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114.
出版信息
J Am Acad Child Adolesc Psychiatry. 1993 Sep;32(5):1032-7. doi: 10.1097/00004583-199309000-00023.
OBJECTIVE
We evaluated the role of pregnancy, delivery, and infancy complications (PDICs) in the etiology of attention deficit disorder (ADD) addressing issues of comorbidity and familiarity by formulating and testing multiple hypotheses.
METHOD
Subjects were six to 17-year-old boys with DSM-III attention deficit disorder (ADD, N = 73), psychiatric (N = 26), and normal (N = 26) controls and their relatives. Information on PDICs was obtained from the mothers in a standardized manner blind to the proband's clinical status.
RESULTS
Using odds ratio analyses, an association was found between ADD and PDICs that was strongest for the comorbid and nonfamilial subtypes. In contrast, noncomorbid and familial ADD subgroups differed less from normal controls in the risk for PDICs.
CONCLUSIONS
The increased risk for PDICs in nonfamilial ADD children and the lack of evidence for increased risk among familial ADD patients suggests that PDICs may be part of nongenetic etiologic mechanisms in this disorder, especially for children who have comorbid disorders.
目的
我们通过提出并检验多个假设，评估了妊娠、分娩及婴儿期并发症（PDICs）在注意缺陷障碍（ADD）病因学中的作用，并探讨了共病和家族性问题。
方法
研究对象为6至17岁患有精神疾病诊断与统计手册第三版（DSM-III）注意缺陷障碍（ADD，n = 73）的男孩、患有精神疾病的对照组（n = 26）以及正常对照组（n = 26）及其亲属。通过对先证者临床状况不知情的母亲以标准化方式获取有关PDICs的信息。
结果
采用优势比分析，发现ADD与PDICs之间存在关联，这种关联在共病和非家族性亚型中最为显著。相比之下，非共病和家族性ADD亚组在PDICs风险方面与正常对照组的差异较小。
结论
非家族性ADD儿童中PDICs风险增加，而家族性ADD患者中无风险增加的证据，这表明PDICs可能是该疾病非遗传病因机制的一部分，尤其是对于患有共病的儿童。
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