Comorbid Symptom Severity in Attention-Deficit/Hyperactivity Disorder: A Clinical Study
Comorbid Symptom Severity in Attention-Deficit/Hyperactivity Disorder: A Clinical Study
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DOI：
10.4088/jcp.11m07099
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发表时间：
2012-05-01
影响因子：
5.3
通讯作者：
Ford, Julian D.
中科院分区：
文献类型：
--
作者：
Connor, Daniel F.;Ford, Julian D.
目的：虽然目前注意力缺陷多动障碍（ADHD）的诊断标准不包括情绪症状，外化行为问题，或侵略，执业临床医生往往面临着这些症状的评估和管理时，评估和治疗ADHD患者。虽然很多研究都集中在ADHD的共病障碍，但很少关注可能符合或不符合综合征标准但影响ADHD治疗计划和结果的共病症状。本研究的目的是描述ADHD儿童和青少年的情绪和行为症状，并将其与非ADHD对照组进行比较。从1995年到2005年，经主治医生诊断为ADHD合并亚型（n = 175）或ADHD注意力不集中亚型（n = 70）的临床转诊儿童和青少年（使用DSM-IV标准）与非ADHD精神对照组（n = 65）和非ADHD社区对照组（n = 72）进行比较，评估情绪症状，外化行为问题和攻击性;比较控制了年龄，性别和家庭收入。两个ADHD组的抑郁症状严重程度与非ADHD精神病对照组相同，高于社区对照组。与其他组相比，ADHD合并亚型组的外化行为问题和攻击性更严重。随着ADHD症状严重程度的增加，外化行为问题和攻击性，而不是内在症状，也增加了严重程度。家庭收入有一个独立的关系，外化disorders.Conclusions：高利率的内化情绪症状，外化的问题行为，侵略被发现在临床ADHD样本。外化行为问题和攻击似乎与多动-冲动型ADHD症状域和总体ADHD症状严重程度相关。对于多动症核心症状的有效治疗是否也会减少相关情绪和行为症状的存在并改善多动症儿童和青少年的日常功能，仍然是一个经验问题。J Clin Psychiatry 2012;73（5）：711-717（c）版权所有2012 Physicians Postgraduate Press，Inc.
Objective: Although current attention-deficit/hyperactivity disorder (ADHD) diagnostic criteria do not include emotional symptoms, externalizing behavior problems, or aggression, the practicing clinician is often faced with the evaluation and management of these symptoms when assessing and treating patients with ADHD. While much research has focused on comorbid disorders in ADHD, less attention has been directed to comorbid symptoms that may or may not meet syndrome criteria but that influence ADHD treatment planning and outcome. The aim of this study is to describe emotional and behavioral symptoms in children and adolescents with ADHD and compare them with non-ADHD control groups.Method: From 1995 to 2005, clinically referred children and adolescents with the combined subtype of ADHD (n = 175) or the inattentive subtype of ADHD (n = 70) as diagnosed by the primary physician (using DSM-IV criteria) were compared with a non-ADHD psychiatric control group (n = 65) and a non-ADHD community control group (n = 72) on measures that assessed emotional symptoms, externalizing behavior problems, and aggression; comparisons were controlled for age, sex, and family income.Results: Both ADHD groups had depressive symptom severity equal to a non-ADHD psychiatric control group and greater than community control groups. Externalizing behavior problems and aggression were more severe in the ADHD combined subtype group compared with other groups. As ADHD symptom severity increased, externalizing behavior problems and aggression, but not internalizing symptoms, also increased in severity. Family income had an independent relationship with externalizing disorders.Conclusions: High rates of internalizing emotional symptoms, externalizing problem behaviors, and aggression were found in a clinical ADHD sample. Externalizing behavior problems and aggression appeared to be related to the hyperactive-impulsive ADHD symptom domain and to overall ADHD symptom severity. It remains an empirical question as to whether effective treatment of the core symptoms of ADHD will also reduce the presence of associated emotional and behavioral symptoms and improve daily functioning in children and adolescents with ADHD. J Clin Psychiatry 2012;73(5):711-717 (c) Copyright 2012 Physicians Postgraduate Press, Inc.