Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample.
Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample.
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DOI：
10.1016/j.jaac.2010.03.006
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发表时间：
2010-06
影响因子：
13.3
通讯作者：
Garvan C
中科院分区：
文献类型：
--
作者：
Bussing R;Mason DM;Bell L;Porter P;Garvan C
描述不同社区样本中儿童注意力缺陷/多动障碍 (ADHD) 的青少年结局。对学区 1,615 名 5 至 11 岁学生样本进行 ADHD 筛查，8 年后进行了病例对照研究。满足完全 (n=94) 和亚阈值 (n=75) DSM-IV ADHD 标准的高风险青少年与人口统计学上相似的低风险同龄人 (n=163) 进行匹配。结果领域包括症状；功能障碍；生活质量；物质使用；教育成果；和少年司法的参与。 44% 患有儿童多动症的青少年尚未得到缓解。与未受影响的同龄人相比，患有儿童多动症的青少年更有可能表现出对立违抗性障碍（OR=12.9；95% CI 5.6-30.0）、焦虑/抑郁（OR=10.3；95% CI 2.7-39.3）、明显的功能障碍（OR=3.4；95% CI 1.7-6.9）、生活质量下降（OR=2.5， 95% CI 1.3-4.7），并参与少年司法（OR=3.1；95% CI 1.0-9.1）。阈下注意力缺陷多动症（而非完全注意力缺陷多动症）会增加保留成绩的风险，而这两种情况都会增加毕业失败的风险。对立违抗性障碍（ODD）会增加吸食大麻和饮酒的风险，但儿童多动症则不会。儿童多动症的青少年结局不受性别、种族或贫困的影响。 ADHD 预示着 ADHD 和合并症症状将持续到青春期，以及功能障碍和青少年司法介入的重大风险。阈下多动症症状通常不符合受影响学生接受特殊教育干预的资格，但却增加了不良教育结果的风险。研究结果强调了早期 ADHD 识别，尤其是其与 ODD 的共病表现，对于预防和干预策略的重要性。
To describe adolescent outcomes of childhood attention deficit-/ hyperactivity disorder (ADHD) in a diverse community sample. ADHD screening of a school district sample of 1,615 students ages 5 to 11 years was followed by a case-control study 8 years later. High risk youths meeting full (n=94) and subthreshold (n=75) DSM-IV ADHD criteria were matched with demographically similar low risk peers (n=163). Outcomes domains included symptoms; functional impairment; quality of life; substance use; educational outcomes; and juvenile justice involvement. 44% of youths with childhood ADHD had not experienced remission. Compared to unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (OR=12.9; 95% CI 5.6-30.0), anxiety/depression (OR=10.3; 95% CI 2.7-39.3), significant functional impairment (OR=3.4; 95% CI 1.7-6.9), reduced quality of life (OR=2.5, 95% CI 1.3-4.7), and to have been involved with juvenile justice (OR=3.1; 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty. ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions, yet increase the risk for adverse educational outcomes. Findings stress the importance of early ADHD recognition, especially its comorbid presentation with ODD, for prevention and intervention strategies.
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DOI：
10.1097/01.chi.0000219831.16226.f8
发表时间：
2006-07-01
影响因子：
13.3
作者：
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通讯作者：
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DOI：
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发表时间：
2006-02-01
影响因子：
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作者：
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