Faraone S V, Biederman J, Mennin D, Gershon J, Tsuang M T
Child Psychiatry Service, Massachusetts General Hospital, Boston 02114, USA.
J Am Acad Child Adolesc Psychiatry. 1996 Nov;35(11):1449-59. doi: 10.1097/00004583-199611000-00013.
Attention-deficit hyperactivity disorder (ADHD) is a familial disorder that places the siblings of ADHD children at high risk for ADHD, conduct, mood, and anxiety disorders. Although the pattern of psychiatric risk has been well documented by prior family studies, neither the short- nor long-term outcome of these high-risk siblings has been prospectively examined.
To document the 4-year psychiatric, psychosocial, and neuropsychological outcome of the siblings of children with ADHD.
DSM-III-R structured diagnostic interviews and blind raters were used to conduct a 4-year follow-up of siblings from ADHD and control families. The siblings were also evaluated for cognitive, achievement, social, school, and family functioning.
At follow-up, significant elevations of behavioral, mood, and anxiety disorders were found among the siblings of ADHD children. The high-risk siblings had high rates of school failure and showed evidence of neuropsychological and psychosocial dysfunction. These impairments aggregated among the siblings who had ADHD.
The siblings of ADHD children are at high risk for clinically meaningful levels of psychopathology and functional impairment. In addition to supporting hypotheses about the familial transmission of ADHD, the results suggest that the high-risk siblings might be appropriate targets for primary preventive interventions.
注意力缺陷多动障碍（ADHD）是一种家族性疾病，ADHD儿童的兄弟姐妹患ADHD、品行、情绪和焦虑症的风险很高。尽管先前的家族研究已充分记录了精神疾病风险模式，但这些高危兄弟姐妹的短期和长期结局均未得到前瞻性研究。
记录ADHD儿童兄弟姐妹4年的精神、心理社会和神经心理结局。
采用DSM-III-R结构化诊断访谈和盲法评估者对ADHD家庭和对照家庭的兄弟姐妹进行4年随访。还对这些兄弟姐妹的认知、学业成绩、社交、学校和家庭功能进行了评估。
随访时，发现ADHD儿童的兄弟姐妹中行为、情绪和焦虑症显著增加。高危兄弟姐妹的学业失败率很高，并有神经心理和心理社会功能障碍的证据。这些损害在患有ADHD的兄弟姐妹中更为集中。
ADHD儿童的兄弟姐妹有临床意义的精神病理学和功能损害的高风险。这些结果除了支持有关ADHD家族遗传的假设外，还表明高危兄弟姐妹可能是初级预防干预的合适目标。
