Sex and Age Differences in Attention-Deficit/Hyperactivity Disorder Symptoms and Diagnoses: Implications for DSM-V and ICD-11
Sex and Age Differences in Attention-Deficit/Hyperactivity Disorder Symptoms and Diagnoses: Implications for DSM-V and ICD-11
复制标题
DOI：
10.1016/j.jaac.2009.11.011
复制
发表时间：
2010-03-01
影响因子：
13.3
通讯作者：
Todd, Richard D.
中科院分区：
文献类型：
--
作者：
Ramtekkar, Ujjwal P.;Reiersen, Angela M.;Todd, Richard D.
目的：在大型社区样本中检查注意力缺陷/多动障碍 (ADHD) 症状认可的性别和年龄差异。方法：根据密苏里州出生记录确定有四个或更多同父异母兄弟姐妹的家庭完成了有关终生 DSM-IV ADHD 症状的电话访谈，以及针对当前 ADHD 症状的 ADHD 症状和正常行为 (SWAN) 调查问卷的优点和缺点。 9,380 名 7 岁至 29 岁受试者的完整数据可用。终生和当前 DSM-IV 类似 ADHD 诊断是根据 DSM-IV 症状标准分配的。使用线性回归来检查性别和年龄对 SWAN ADHD 症状评分的影响。使用逻辑回归来检查性别和年龄对特定 AbHD 诊断的影响。分数多项式图用于检查 ADHD 症状计数随年龄的变化。结果：目前 DSM-IV 类 ADHD 的总体患病率为 9.2%，男女比例为 2.28:1。儿童中 DSM-IV 样 ADHD 的患病率最高。 DSM-IV 样 ADHD 亚型患病率的性别差异在青少年中最高。平均而言，终生患有 DSM-IV 类 ADHD 诊断的个体即使在青少年或成人时期，当前的 ADHD 症状也会加重。结论：男女比例低于一些基于临床的研究报告的比例，表明社区中女性的诊断不足。尽管他们可能不再符合全部症状标准，但与一般人群相比，有终生 DSM-IV 类 ADHD 病史的年轻人仍保持较高水平的 ADHD 症状。 DSM-V 和 ICD-11 应考虑使用特定年龄的诊断标准。 J. Am.阿卡德。儿童青少年。精神病学，2010；49(3)：217-228。
Objective: To examine gender and age differences in attention-deficit/hyperactivity disorder (ADHD) symptom endorsement in a large community-based sample. Method: Families with four or more full siblings ascertained from Missouri birth records completed telephone interviews regarding lifetime DSM-IV ADHD symptoms and the Strengths and Weaknesses of ADHD-Symptoms and Normal-behavior (SWAN) questionnaire for current ADHD symptoms. Complete data were available for 9,380 subjects aged 7 through 29 years. Lifetime and current DSM-IV-Iike ADHD diagnoses were assigned by the DSM-IV symptom criteria. Linear regression was used to examine sex and age effects on SWAN ADHD symptom scores. Logistic regression was used to examine sex and age effects on specific AbHD diagnoses. Fractional polynomial graphs were used to examine ADHD symptom count variations across age. Results: Overall prevalence of current DSM-IV-Iike ADHD was 9.2% with a male:female ratio of 2.28:1. The prevalence of DSM-IV-like ADHD was highest in children. Gender differences in DSM-IV-like ADHD subtype prevalences were highest in adolescents. On average, individuals with lifetime DSM-IV-Iike ADHD diagnoses had elevated current ADHD symptoms even as adolescents or adults. Conclusions: Lower male:female ratios than reported in some clinic-based studies suggest that females are underdiagnosed in the community. Although they may no longer meet the full symptom criteria, young adults with a history of lifetime DSM-IV-Iike ADHD maintain higher levels of ADHD symptoms compared with the general population. The use of age-specific diagnostic criteria should be considered for DSM-V and ICD-11. J. Am. Acad. Child Adolesc. Psychiatry, 2010;49(3):217-228.