A systematic evaluation of ADHD and comorbid psychopathology in a population-based twin sample.
A systematic evaluation of ADHD and comorbid psychopathology in a population-based twin sample.
复制标题
对基于人群的双胞胎样本中的多动症和共病精神病理学进行系统评估。
DOI：
10.1097/01.chi.0000166173.72815.83
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发表时间：
2005
影响因子：
13.3
通讯作者：
Todd,RichardD
中科院分区：
文献类型：
--
作者：
Volk,HeatherE;Neuman,RosalindJ;Todd,RichardD
临床和人群样本表明，注意力缺陷/多动障碍（ADHD）与其他疾病一起发生。ADHD亚型内的共病性障碍聚类尚未得到很好的研究.METHODLatent class analysis（LCA）在一个双生子样本中研究了DSM-IV ADHD、对立违抗性障碍（ODD）、品行障碍（CD）和抑郁症状的共病性。作者为ADHD和共病障碍症状拟合了不同的模型。双胞胎一致性比率（同卵与异卵）进行了比较，检查遗传对类memberity. ESTSLCA的ADHD症状的影响，导致七类，包括注意力不集中，组合，和多动亚型在1,616名受试者。少数ADHD症状（53.4%）和严重上课不专心（12.3%）最为常见。在1,587名受试者中，ODD、CD和抑郁症状的LCA显示了五个类别，包括ODD（19.4%）、抑郁（14.5%）和两个复合类别：ODD/CD（6.9%）和ODD/CD/抑郁（7.2%）。所有ADHD亚型均存在内化和外化共病障碍。双胞胎一致性的比值比（OR）表明遗传对严重注意力不集中的影响（OR = 4.18; 95%置信区间[CI]，1.52-11.53）和合并（OR = 5.25; 95%CI，1.32-20.78）ADHD类别和ODD（OR = 1.49; 95%CI，0.70-3.17），ODD/CD（OR = 3.32; 95%CI，0.57-19.28），ODD/CD/抑郁（OR = 1.20; 95%CI，0.30-4.77）类。结论：在ADHD亚型中，内化障碍和外化障碍没有差异性聚集。LCA可以提供更精确的ADHD共病特征。
OBJECTIVEClinical and population samples demonstrate that attention-deficit/hyperactivity disorder (ADHD) occurs with other disorders. Comorbid disorder clustering within ADHD subtypes is not well studied.METHODLatent class analysis (LCA) examined the co-occurrence of DSM-IV ADHD, oppositional defiant disorder (ODD), conduct disorder (CD), and depression symptoms in a population twin sample. The authors fit separate models for ADHD and comorbid disorder symptoms. Twin concordance ratios (monozygotic versus dizygotic) were compared examining genetic influence on class membership.RESULTSLCA of ADHD symptoms resulted in seven classes including inattentive, combined, and hyperactive subtypes in 1,616 subjects. The few ADHD symptoms (53.4%) and severe inattentive (12.3%) classes were most frequent. LCA of ODD, CD, and depression symptoms in 1,587 subjects revealed five classes including ODD (19.4%), depression (14.5%), and two composite classes: ODD/CD (6.9%) and ODD/CD/depression (7.2%). Internalizing and externalizing comorbid disorders were present across all ADHD subtypes. Odds ratios (ORs) for twin concordance indicate genetic influence on severe inattentive (OR = 4.18; 95% confidence interval [CI], 1.52-11.53) and combined (OR = 5.25; 95% CI, 1.32-20.78) ADHD classes and ODD (OR = 1.49; 95% CI, 0.70-3.17), ODD/CD (OR = 3.32; 95% CI, 0.57-19.28), and ODD/CD/depression (OR = 1.20; 95% CI, 0.30-4.77) classes.CONCLUSIONSInternalizing and externalizing disorders did not cluster differentially within ADHD subtypes. LCA may provide a more precise characterization of comorbidity with ADHD.