Alpert J E, Maddocks A, Nierenberg A A, O'Sullivan R, Pava J A, Worthington J J, Biederman J, Rosenbaum J F, Fava M
Department of Psychiatry, Massachusetts General Hospital, Boston 02114, USA.
Psychiatry Res. 1996 Jun 1;62(3):213-9. doi: 10.1016/0165-1781(96)02912-5.
The prevalence of attention deficit hyperactivity disorder (ADHD) with childhood onset and its relationship to course and treatment outcome of major depressive disorder (MDD) in adults was studied in 116 patients (ages 18-65) consecutively enrolled for treatment of MDD. Sixteen percent of the patient were found to meet full or subthreshold criteria for the DSM-III-R diagnosis of childhood ADHD. Twelve percent endorsed persistence of ADHD symptoms into adulthood. Depressed adults meeting criteria for childhood ADHD did not differ significantly from other depressed adults on any measures related to the chronicity or severity of the mood disorder, Axis I comorbidity, or response to acute antidepressant treatment. Our results are clinically important as they suggest that clinicians need to be aware of the possibility that a substantial proportion of patients with MDD may suffer from comorbid ADHD and that treatments need to include the targeting of possible residual ADHD symptoms in addition to those of depression.
对116名(年龄在18 - 65岁之间)连续入组接受重度抑郁症(MDD)治疗的患者,研究了儿童期起病的注意力缺陷多动障碍(ADHD)的患病率及其与成人重度抑郁症病程和治疗结果的关系。发现16%的患者符合DSM-III-R中儿童ADHD的全部或亚阈值诊断标准。12%的患者认可ADHD症状持续到成年期。符合儿童ADHD标准的成年抑郁症患者在与情绪障碍的慢性或严重程度、轴I共病或急性抗抑郁治疗反应相关的任何指标上,与其他成年抑郁症患者没有显著差异。我们的结果具有临床重要性,因为它们表明临床医生需要意识到相当比例的MDD患者可能患有共病ADHD,并且治疗除了针对抑郁症症状外,还需要针对可能残留的ADHD症状。