Sherman D K, McGue M K, Iacono W G
Department of Psychology, University of Minnesota, Minneapolis 55455-0344, USA.
Am J Psychiatry. 1997 Apr;154(4):532-5. doi: 10.1176/ajp.154.4.532.
The present study examined probandwise concordance rates for attention deficit hyperactivity disorder (ADHD) in a community sample of 194 monozygotic and 94 dizygotic male twins, ages 11-12 years.
DSM-III and DSM-III-R diagnoses of ADHD were based on rating scale reports from the twins' teachers and structured interview reports obtained from their mothers. Model-fitting analyses were used to estimate genetic and environmental effects on ADHD.
Concordance rates for ADHD were greater for monozygotic than dizygotic twins according to both mothers' and teachers' reports; this finding indicates the importance of genetic factors in the etiology of this syndrome. Fifteen percent of subjects received an ADHD diagnosis by teachers' ratings, compared with 6% by mothers' reports. Three percent of subjects met criteria for ADHD in both school and home settings. Teachers' ratings yielded moderate monozygotic and dizygotic concordance rates, in contrast to mothers' reports, which indicated a high monozygotic and a zero dizygotic concordance for ADHD. A model that included additive genetic and nonshared environmental factors provided the best fit to these ADHD data.
ADHD, as defined by DSM criteria, appears to be a genetically influenced disorder whether diagnoses are based on teachers' or mothers' reports. However, the extent of this genetic influence seems to vary by informant source. These findings suggest that obtaining diagnostic data from either teachers' or mothers' reports alone may provide an incomplete characterization of ADHD.
本研究在一个包含194对同卵男性双胞胎和94对异卵男性双胞胎的社区样本中，调查了11至12岁儿童注意力缺陷多动障碍（ADHD）的先证者一致率。
基于双胞胎教师的评定量表报告以及从他们母亲那里获得的结构化访谈报告，对ADHD进行DSM-III和DSM-III-R诊断。采用模型拟合分析来估计基因和环境对ADHD的影响。
根据母亲和教师的报告，同卵双胞胎的ADHD一致率高于异卵双胞胎；这一发现表明基因因素在该综合征病因中的重要性。15%的受试者根据教师评定被诊断为ADHD，相比之下，母亲报告的比例为6%。3%的受试者在学校和家庭环境中均符合ADHD标准。与母亲的报告不同，教师评定得出的同卵和异卵双胞胎一致率为中等水平，母亲报告显示ADHD的同卵双胞胎一致率高而异卵双胞胎一致率为零。一个包含加性基因和非共享环境因素的模型最符合这些ADHD数据。
无论诊断是基于教师还是母亲的报告，DSM标准定义的ADHD似乎是一种受基因影响的疾病。然而，这种基因影响的程度似乎因报告来源而异。这些发现表明，仅从教师或母亲的报告中获取诊断数据可能无法全面描述ADHD。
