The comorbidity of ADHD in the general population of Swedish school-age children
The comorbidity of ADHD in the general population of Swedish school-age children
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DOI：
10.1017/s0021963001007090
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发表时间：
2001-05-01
影响因子：
7.6
通讯作者：
Gillberg, C
中科院分区：
文献类型：
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作者：
Kadesjö, B;Gillberg, C
本研究检查了患有和不患有DSM-III-R型注意缺陷多动障碍（ADHD）的儿童人群样本中共病/相关诊断和相关问题的模式。对瑞典主流学校人口中一半（N = 409）的7岁儿童进行临床检查，并对家长和教师进行访谈并完成问卷调查。这些孩子在2-4年后接受了随访。87%符合ADHD全部标准的儿童（N = 15）有一种或多种共病诊断，67%至少有两种共病诊断。最常见的合并症是对立违抗性障碍和发育协调障碍。阈下ADHD患儿（N = 42）的共病诊断率也很高（71%和36%），而非ADHD患儿（N = 352）的共病诊断率要低得多（17%和3%）。在随访中，ADHD组中相关学校适应、学习和行为问题的发生率非常高。我们的结论是，即使在一般人群样本中，纯粹的多动症也是罕见的。因此，报告无合并症的ADHD病例的研究可能指的是高度非典型的样本。总的来说，这些研究不能为理性的临床决策提供信息。
This study examined patterns of comorbid/associated diagnoses and associated problems in a population sample of children with and without DSM-III-R attention-deficit hyperactivity disorder (ADHD). Half(N = 409) of a mainstream school population of Swedish 7-year-olds were clinically examined, and parents and teachers were interviewed and completed questionnaires. The children were followed up 2-4 years later. Eighty-seven per cent of children meeting full criteria for ADHD (N = 15) had one or more - and 67% at least two - comorbid diagnoses. The most common comorbidities were oppositional defiant disorder and developmental coordination disorder. Children with subthreshold ADHD (N = 42) also had very high rates of comorbid diagnoses (71% and 36%), whereas those without ADHD (N = 352) had much lower rates (17% and 3%). The rate of associated school adjustment, learning, and behaviour problems at follow-up was very high in the ADHD groups. We concluded that pure ADHD is rare even in a general population sample. Thus, studies reporting on ADHD cases without comorbidity probably refer to highly atypical samples. By and large, such studies cannot inform rational clinical decisions.