Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status.
Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status.
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DOI：
10.1001/archpsyc.1993.01820190067007
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发表时间：
1993-07
影响因子：
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通讯作者：
S. Mannuzza;R. Klein;Abrah Bessler;P. Malloy;Maria C Lapadula
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文献类型：
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作者：
S. Mannuzza;R. Klein;Abrah Bessler;P. Malloy;Maria C Lapadula
目的 由于缺乏有关注意力缺陷多动障碍（ADHD）（一种常见的儿童精神疾病）长期自然史的数据，促使开展一项纵向研究来调查这种儿童疾病的成人后遗症。设计 前瞻性研究，随访间隔为 13 至 19 年（平均 16 年），采用盲法系统临床评估。对象 91 名白人男性（平均年龄 26 岁），占被系统诊断为儿童期多动症的队列的 88%，以及 95 名（95%）相似种族、性别、年龄的对照案例，其老师对他们童年时在学校的行为没有表示任何抱怨。结果 先证者的 ADHD 症状（11% vs 1%）、反社会人格障碍（18% vs 2%）和药物滥用障碍（16% vs 4%）的比率显着更高。反社会障碍和药物障碍之间存在显着的合并症。先证者的教育和职业成就显着受损。这些缺点与精神状况无关。我们没有发现先证者情感或焦虑障碍的发生率增加。结论 儿童多动症可预测特定的成人精神疾病，即反社会和药物滥用疾病。在该队列的青少年结局中，我们发现这些干扰取决于多动症症状的持续。相比之下，在成年期，反社会和药物障碍似乎在一定程度上与持续的多动症无关。此外，无论精神状况如何，多动症都会使儿童面临教育和职业不利的相对风险。结果并不支持儿童多动症与成人情绪或焦虑症之间的关系。
OBJECTIVE The paucity of data concerning the long-term natural history of attention-deficit hyperactivity disorder (ADHD), a common childhood psychiatric disorder, prompted a longitudinal study to investigate the adult sequelae of the childhood disorder. DESIGN Prospective study, follow-up intervals ranging from 13 to 19 years (mean, 16 years), with blind systematic clinical assessments. SUBJECTS Ninety-one white males (mean age, 26 years), representing 88% of a cohort systematically diagnosed as hyperactive in childhood, and 95 (95%) of comparison cases of similar race, gender, age, whose teachers had voiced no complaints about their school behavior in childhood. RESULTS Probands had significantly higher rates than comparisons of ADHD symptoms (11% vs 1%), antisocial personality disorders (18% vs 2%), and drug abuse disorders (16% vs 4%). Significant comorbidity occurred between antisocial and drug disorders. Educational and occupational achievements were significantly compromised in the probands. These disadvantages were independent of psychiatric status. We did not find increased rates of affective or anxiety disorders in the probands. CONCLUSIONS Childhood ADHD predicts specific adult psychiatric disorders, namely antisocial and drug abuse disorders. In the adolescent outcome of this cohort, we found that these disturbances were dependent on the continuation of ADHD symptoms. In contrast, in adulthood, antisocial and drug disorders appeared, in part, independent of sustained ADHD. In addition, regardless of psychiatric status, ADHD placed children at relative risk for educational and vocational disadvantage. The results do not support a relationship between childhood ADHD and adult mood or anxiety disorders.