Severe psychosocial stress and heavy cigarette smoking during pregnancy: an examination of the pre- and perinatal risk factors associated with ADHD and Tourette syndrome.
Severe psychosocial stress and heavy cigarette smoking during pregnancy: an examination of the pre- and perinatal risk factors associated with ADHD and Tourette syndrome.
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DOI：
10.1007/s00787-010-0115-7
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发表时间：
2010-10
影响因子：
6.4
通讯作者：
Leckman, James F.
中科院分区：
文献类型：
--
作者：
Motlagh, Maria G.;Katsovich, Liliya;Thompson, Nancy;Lin, Haiqun;Kim, Young-Shin;Scahill, Lawrence;Lombroso, Paul J.;King, Robert A.;Peterson, Bradley S.;Leckman, James F.
关键词：
注意力缺陷/多动障碍（ADHD）经常在患有抽动秽语综合症（TS）的儿童中被诊断出来。这种共同发生的基础是不确定的。本研究旨在确定特定的产前和围产期风险因素，包括孕妇重度吸烟和怀孕期间严重的心理社会压力，是否与一种或两种疾病相关，或者两者都不相关。我们比较了222名7至18岁儿童的产前和围产期危险因素的母亲报告数据，其中包括45名单独患有TS的儿童，52名单独患有ADHD的儿童，60名患有TS + ADHD共病的儿童，以及65名未受影响的对照儿童。产前和围产期的历史，以及精神病的评估进行了标准化的问卷调查和半结构化的采访与母亲和儿童。Logistic回归用于确定每个感兴趣变量的比值比。与未受影响的对照组儿童的母亲相比，单独患有ADHD的儿童的母亲在怀孕期间报告了更高的重度吸烟率（>10支/天）和更高的严重心理社会压力水平（OR = 13.5，p < 0.01和OR = 6.8，p < 0.002）。与对照组儿童相比，TS + ADHD和单纯TS患者的母亲重度吸烟和高水平的心理社会压力的发生率也较高，但这些差异未达到统计学意义（重度吸烟：OR = 8.5，p < 0.052，OR = 4.6，p < 0.19;重度心理社会应激：OR = 3.1，p < 0.07，OR = 2.6，p < 0.11）。母亲在怀孕期间大量吸烟和严重的心理社会压力与ADHD的诊断独立相关。TS患者的这些风险因素发生率也较高，但OR未能达到统计学显著性。需要努力减少高危人群中这些风险因素的发生频率。未来的研究，使用遗传敏感的设计，也需要整理出因果关系的途径。
Attention-deficit/hyperactivity disorder (ADHD) is frequently diagnosed in children with Tourette syndrome (TS). The basis for this co-occurrence is uncertain. This study aimed to determine if specific pre- and perinatal risk factors, including heavy maternal smoking and severe psychosocial stress during pregnancy, were associated with one or both disorders, or neither. We compared maternal report data on pre- and perinatal risk factors on 222 children between the ages of 7 and 18 years including 45 individuals with TS alone, 52 individuals with ADHD alone, 60 individuals with condition of comorbid TS + ADHD, and 65 unaffected control children. Pre- and perinatal histories as well as psychiatric assessments were performed using standardized questionnaires and semi-structured interviews with the mothers and children. Logistic regression was used to determine the odds ratio for each variable of interest. Compared to the mothers of unaffected control children, the mothers of children with ADHD alone reported higher rates of heavy smoking (>10 cigarettes per day) during pregnancy and higher levels of severe psychosocial stress during pregnancy (OR = 13.5, p < 0.01 and OR = 6.8, p < 0.002, respectively). The TS + ADHD and the TS alone patients also had higher rates heavy maternal smoking and high levels of psychosocial stress compared to the control children, but these differences failed to reach statistical significance (heavy smoking: OR = 8.5, p < 0.052, OR = 4.6, p < 0.19, respectively; severe psychosocial stress: OR = 3.1, p < 0.07, OR = 2.6, p < 0.11, respectively). Heavy maternal smoking and severe levels psychosocial stress during pregnancy were independently associated with a diagnosis of ADHD. TS patients also had higher rates of these risk factors, but the ORs failed to reach statistical significance. Efforts are needed to reduce the frequency of these risk factors in high-risk populations. Future studies, using genetically sensitive designs, are also needed to sort out the causal pathways.
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影响因子：
2.9
作者：
Gatzke-Kopp, Lisa M.;Beauchaine, Theodore P.
通讯作者：
Beauchaine, Theodore P.
影响因子：
6.9
作者：
Knopik, Valerie S.;Heath, Andrew C.;Martin, Nicholas G.
通讯作者：
Martin, Nicholas G.
影响因子：
3.7
作者：
Corbett, B. A.;Mendoza, S. P.;Levine, S.
通讯作者：
Levine, S.
DOI：
10.1207/s15374424jccp2003_3
发表时间：
1991-09-01
期刊：
JOURNAL OF CLINICAL CHILD PSYCHOLOGY
影响因子：
--
作者：
DUPAUL, GJ
通讯作者：
DUPAUL, GJ
影响因子：
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作者：
Costello, EJ;Mustillo, S;Angold, A
通讯作者：
Angold, A