ADHD latent class clusters: DSM-IV subtypes and comorbidity.
ADHD latent class clusters: DSM-IV subtypes and comorbidity.
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DOI：
10.1016/j.psychres.2008.10.008
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发表时间：
2009-12-30
影响因子：
11.3
通讯作者：
Muenke M
中科院分区：
文献类型：
--
作者：
Elia J;Arcos-Burgos M;Bolton KL;Ambrosini PJ;Berrettini W;Muenke M
ADHD（注意缺陷多动障碍）具有复杂的异质性表型，仅部分被精神疾病诊断与统计手册（DSM-IV）标准所捕获。在本报告中，使用K-SADS-IVR（学龄儿童情感障碍和精神分裂症时间表- iv -修订版）症状和症状严重程度数据的潜类分析（LCA）来识别ADHD表型，这些数据来自500名6-18岁的ADHD受试者的临床样本，参与了ADHD基因研究。结果表明，LCA识别出6个独立的ADHD集群，其中一些对应于特定的DSM-IV亚型，而另一些则包含多个亚型。DSM-IV共病焦虑和情绪障碍在所有聚类中大致相似，没有共病的受试者没有聚集在任何一个聚类中。年龄和性别构成也各不相同。这些结果支持基于人群的LCA研究结果。这六个集群提供了额外的同质组，可用于在遗传关联研究中定义ADHD表型。有限的年龄范围聚集在不同的集群中可能被证明是遗传研究中的一个特别优势，因为候选基因的表达可能在发育阶段发生变化。DSM-IV共病心境和焦虑障碍似乎也没有增加集群异质性；然而，需要对风险期进行纵向研究来支持这一发现。
ADHD (Attention Deficit Hyperactivity Disorder) has a complex, heterogeneous phenotype only partially captured by Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. In this report, latent class analyses (LCA) are used to identify ADHD phenotypes using K-SADS-IVR (Schedule for Affective Disorders & Schizophrenia for School Age Children-IV-Revised) symptoms and symptom severity data from a clinical sample of 500 ADHD subjects, ages 6–18, participating in an ADHD genetic study. Results show that LCA identified six separate ADHD clusters, some corresponding to specific DSM-IV subtypes while others included several subtypes. DSM-IV comorbid anxiety and mood disorders were generally similar across all clusters, and subjects without comorbidity did not aggregate within any one cluster. Age and gender composition also varied. These results support findings from population-based LCA studies. The six clusters provide additional homogenous groups that can be used to define ADHD phenotypes in genetic association studies. The limited age ranges aggregating in the different clusters may prove to be a particular advantage in genetic studies where candidate gene expression may vary during developmental phases. DSM-IV comorbid mood and anxiety disorders also do not appear to increase cluster heterogeneity; however, longitudinal studies that cover period of risk are needed to support this finding.
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