Mannuzza S, Klein R G, Bessler A, Malloy P, LaPadula M
Child and Adolescent Behavior Center, Long Island Jewish Medical Center, New Hyde Park, N.Y., USA.
Am J Psychiatry. 1998 Apr;155(4):493-8. doi: 10.1176/ajp.155.4.493.
Numerous studies have examined the adolescent and young adult fate of children with attention deficit hyperactivity disorder (ADHD). In marked contrast, relatively little is known about the adult outcome of these children. There have been only two controlled, prospective studies of psychiatric status into adulthood. The present study was conducted to gain further understanding of the natural course of this common childhood condition.
This was a prospective follow-up of clinically diagnosed, white boys of average intelligence who were referred by teachers to a child psychiatric research clinic at an average age of 7.3 years. At a mean age of 24.1 years, 85 probands (82% of the childhood cohort) and 73 comparison subjects (94% of adolescent comparison subjects) were directly interviewed by trained clinicians who were blind to group status.
Evaluations of the probands and comparison subjects indicated significantly higher prevalences of antisocial personality disorder (12% versus 3%) and nonalcohol substance abuse (12% versus 4%) in the probands, whereas mood disorders (4% versus 4%) and anxiety disorders (2% versus 7%) were not significantly different. At adult follow-up, ADHD was rare, occurring in only 4% of the probands (no comparison subjects).
The results of the present study are consistent with the authors' previously reported major findings. They strongly suggest that children with ADHD are at significantly higher risk for a specific negative course marked by antisocial and substance-related disorders.
众多研究探讨了患有注意力缺陷多动障碍(ADHD)儿童在青少年期及青年期的情况。相比之下,对于这些儿童成年后的结局了解相对较少。仅有两项关于成年后精神状态的对照前瞻性研究。开展本研究是为了进一步了解这种常见儿童疾病的自然病程。
这是一项对临床诊断为智力正常的白人男孩的前瞻性随访研究,这些男孩由教师转介至一家儿童精神科研究诊所,平均年龄为7.3岁。在平均年龄24.1岁时,85名先证者(占儿童队列的82%)和73名对照对象(占青少年对照对象的94%)接受了对分组情况不知情的训练有素的临床医生的直接访谈。
对先证者和对照对象的评估显示,先证者中反社会人格障碍(12%对3%)和非酒精物质滥用(12%对4%)的患病率显著更高,而情绪障碍(4%对4%)和焦虑障碍(2%对7%)无显著差异。在成人随访中,ADHD很罕见,仅在先证者中出现4%(对照对象中未出现)。
本研究结果与作者先前报告的主要发现一致。它们强烈表明,患有ADHD的儿童出现以反社会和物质相关障碍为特征的特定负面病程的风险显著更高。