Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD.
Childhood and persistent ADHD symptoms associated with educational failure and long-term occupational disability in adult ADHD.
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DOI：
10.1007/s12402-014-0126-1
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发表时间：
2014-06
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影响因子：
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通讯作者：
Peleikis, Dawn E
中科院分区：
文献类型：
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作者：
Fredriksen, Mats;Dahl, Alv A;Martinsen, Egil W;Klungsoyr, Ole;Faraone, Stephen V;Peleikis, Dawn E
很少有研究探讨儿童注意缺陷多动障碍（ADHD）症状对成人ADHD功能结果的影响。为了解决这个问题的维度，ADHD症状在儿童和成年期及其与教育赤字和工作能力的关系进行了研究，在临床样本的成人患者与以前未经治疗的ADHD。前瞻性招募了约250名根据DSM-IV系统诊断为ADHD的成年人。主要结果是高中辍学和去年失业。儿童多动症症状，性别差异，其他精神障碍的合并症，和成人多动症症状进行了检查的历史数据，临床医生访谈，问卷调查。儿童时期ADHD症状严重程度高与高中辍学有关[比值比（OR）= 3.0]，儿童时期多动-冲动症状的数量也较高。值得注意的是，长期工作残疾的女性多于男性（OR = 2.0）。在调整年龄和性别后，成年后持续高水平的ADHD注意力不集中症状（OR = 2.5），共病障碍的数量，特别是焦虑障碍与长期工作能力障碍显著相关。儿童期多动-冲动症状和儿童期ADHD症状的总体严重程度与高中辍学率相关;然而，成年后持续的ADHD注意力不集中症状和共病精神障碍与职业损害更相关。这些发现强调了对ADHD和精神共病的早期识别和干预研究的建议。他们进一步建议，注意力不集中的症状是成人ADHD治疗的重点，并考虑工作场所的干预措施，以防止长期的工作障碍。
Few studies have examined the impact of childhood attention deficit hyperactivity disorder (ADHD) symptoms on adult ADHD functional outcomes. To address this issue dimensionally, ADHD symptoms in childhood and adulthood and their relation to educational deficits and work disability are studied in a clinical sample of adult patients with previously untreated ADHD. About 250 adults diagnosed systematically with ADHD according to DSM-IV were prospectively recruited. Primary outcomes were high school dropout and being out of the work last year. Childhood ADHD symptoms, sex differences, comorbidities of other mental disorders, and adult ADHD symptoms were examined by historical data, clinician interviews, and questionnaires. High levels of ADHD symptom severity in childhood were related to dropping out of high school [odds ratio (OR) = 3.0], as were higher numbers of hyperactive–impulsive symptoms in childhood. Significantly, more women than men were long-term work disabled (OR = 2.0). After adjusting for age and gender, persisting high levels of ADHD inattention symptoms in adulthood (OR = 2.5), number of comorbid disorders, and particularly anxiety disorders were significantly related to long-term work disability. Childhood hyperactive–impulsive symptoms and overall severity of childhood ADHD symptoms were associated with high school dropout rates; however, persisting ADHD inattention symptoms and comorbid mental disorders in adulthood were more correlated to occupational impairment. These findings underline proposals for studies on early recognition and interventions for ADHD and psychiatric comorbidity. They further suggest that inattentive symptoms be a focus of adult ADHD treatment and that workplace interventions be considered to prevent long-term work disability.