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注意缺陷多动障碍成人患者:共病与适应性损害

Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments.

作者信息

Murphy K, Barkley R A

机构信息

Department of Psychiatry, University of Massachusetts Medical Center, Worcester 01655, USA.

出版信息

Compr Psychiatry. 1996 Nov-Dec;37(6):393-401. doi: 10.1016/s0010-440x(96)90022-x.

Abstract

Attention deficit hyperactivity disorder (ADHD) is increasingly recognized as a legitimate adult diagnostic category. Yet the nature of and comorbidities and adaptive impairments associated with adult ADHD have received little scientific investigation. The present study, therefore, compared 172 adults diagnosed with ADHD with 30 adults referred to the same adult ADHD clinic who were not so diagnosed. The ADHD group showed a significantly greater prevalence of oppositional, conduct, and substance abuse disorders, and greater illegal substance use than control adults. Moreover, adults with ADHD displayed greater self-reported psychological maladjustment, more driving risks (speeding violations), and more frequent changes in employment. Significantly more ADHD adults had experienced a suspension of their driver license, had performed poorly, quit, or been fired from their job, and had a history of poorer educational performance and more frequent school disciplinary actions against them than adults without ADHD. Multiple marriages were more likely in the ADHD group as well. Contrary to previous studies, anxiety and mood disorders were not found to be more prevalent in the ADHD than in the control group. Results suggest that ADHD in adults is associated with relatively specific risks for disruptive behavior disorders, school and job performance problems, and driving risks.

摘要

注意力缺陷多动障碍(ADHD)越来越被视为一种合理的成人诊断类别。然而,与成人ADHD相关的本质、共病情况及适应性损害却很少得到科学研究。因此,本研究将172名被诊断为ADHD的成年人与30名转至同一成人ADHD诊所但未被诊断为此病的成年人进行了比较。ADHD组对立违抗障碍、品行障碍和物质滥用障碍的患病率显著更高,非法物质使用情况也比对照组成年人更严重。此外,患有ADHD的成年人自我报告的心理适应不良情况更严重,驾驶风险(超速违规)更高,就业变动更频繁。与没有ADHD的成年人相比,显著更多的ADHD成年人经历过驾照吊销、工作表现不佳、辞职或被解雇,并且有学业成绩较差及学校对其采取纪律处分更频繁的历史。ADHD组中多次结婚的情况也更常见。与之前的研究相反,未发现ADHD组的焦虑和情绪障碍比对照组更普遍。结果表明,成人ADHD与破坏性行为障碍、学业和工作表现问题以及驾驶风险等相对特定的风险相关。

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