Faraone S V, Biederman J, Mennin D, Russell R, Tsuang M T
Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
J Child Psychol Psychiatry. 1998 Oct;39(7):1045-53.
ADHD is a familial disorder with high rates of comorbidity with conduct disorder in childhood and antisocial personality and substance use disorders in adulthood. A growing literature suggests that ADHD with antisocial comorbidity may be nosologically distinct from other forms of ADHD. Previously, we proposed a family-based stratification that defined Antisocial families as those with either conduct disorder or antisocial personality disorder in the probands or relatives. To provide predictive validity for that stratification, we assessed psychopathology in these families 4 years after their initial assessment. Results show that the probands and siblings from Antisocial families had higher rates of psychopathology during the 4-year follow-up period compared with siblings from Non-antisocial and control families. They also had more deviant ratings on the Child Behavior Checklist (especially for anxious/depressed, delinquent, and aggressive behavior). We found fewer group differences in the academic, psychosocial, and intellectual correlates of ADHD. These results confirm and extend previous work indicating that Antisocial ADHD may be a nosologically and clinically meaningful subform of ADHD.
注意力缺陷多动障碍（ADHD）是一种家族性疾病，在儿童期与品行障碍、成年期与反社会人格障碍及物质使用障碍共病率很高。越来越多的文献表明，伴有反社会共病的ADHD在疾病分类学上可能与其他形式的ADHD不同。此前，我们提出了一种基于家族的分层方法，将反社会家族定义为先证者或亲属中患有品行障碍或反社会人格障碍的家族。为了验证该分层方法的预测效度，我们在首次评估4年后对这些家族的精神病理学情况进行了评估。结果显示，与来自非反社会家族和对照家族的兄弟姐妹相比，反社会家族的先证者和兄弟姐妹在4年随访期内精神病理学发生率更高。他们在儿童行为量表上的评分也更偏离正常（尤其是在焦虑/抑郁、违纪和攻击性行为方面）。我们发现，在ADHD的学业、心理社会和智力相关因素方面，组间差异较少。这些结果证实并扩展了先前的研究工作，表明反社会型ADHD可能是ADHD在疾病分类学和临床上具有意义的一个亚型。
