Structure and diagnosis of adult attention-deficit/hyperactivity disorder: analysis of expanded symptom criteria from the Adult ADHD Clinical Diagnostic Scale.
Structure and diagnosis of adult attention-deficit/hyperactivity disorder: analysis of expanded symptom criteria from the Adult ADHD Clinical Diagnostic Scale.
复制标题
DOI：
10.1001/archgenpsychiatry.2010.146
复制
发表时间：
2010-11
影响因子：
--
通讯作者：
Van Brunt, David L.
中科院分区：
文献类型：
--
作者：
Kessler, Ronald C.;Green, Jennifer Greif;Adler, Lenard A.;Barkley, Russell A.;Chatterji, Somnath;Faraone, Stephen V.;Finkelman, Matthew;Greenhill, Laurence L.;Gruber, Michael J.;Jewell, Mark;Russo, Leo J.;Sampson, Nancy A.;Van Brunt, David L.
关于成人注意力缺陷多动障碍（ADHD）诊断的适当标准存在争议。为了检查DSM-IV成人ADHD最具预测性的结构和症状。数据来自全国科摩罗调查复制（NCS-R）（n = 131）和大型管理医疗保健计划（n = 214）的调查的丰富子样本的临床访谈。使用临床医生管理的成人ADHD临床诊断量表（ACDS）评估儿童ADHD和当前成人ADHD的扩展症状。分析检查了从儿童到成年的症状的稳定性，成人ADHD的结构，以及最能预测当前临床诊断的成人症状。ACDS由在成人ADHD诊断和治疗方面具有丰富经验的临床研究访谈者通过电话进行。一个丰富的样本社区受访者DSM-IV/ACDS诊断成人多动症几乎一半（45.7%）的受访者谁有儿童多动症继续符合完整的DSM-IV标准，目前成人多动症，其中94.9%的病例有目前的注意力缺陷障碍和34.6%的目前多动症。成年人的持久性更大的注意力不集中比多动冲动。其他受访者符合目前成人ADHD的全部标准，尽管没有达到完整的儿童标准。成人症状的三因素结构包括执行功能，注意力不集中，多动和冲动。逐步逻辑回归发现，执行功能问题是成人DSM-IV/ACDS ADHD最一致和最有区别的预测因子。这些研究结果证明，注意力不集中的持续性比多动症的多动/冲动的儿童症状在成年后更大，但也表明注意力不集中并不是多动症特有的，因为它与其他成人精神障碍密切相关。相比之下，尽管不在DSM-IV中，但执行功能问题是DSM-IV成人ADHD的更具体和一致的重要预测因素，这表明DSM-V/ICD-11中执行功能症状的数量应该增加。
Controversy exists about the appropriate criteria for a diagnosis of adult attention-deficit/hyperactivity disorder (ADHD) To examine the structure and symptoms most predictive of DSM-IV adult ADHD. Data come from clinical interviews in enriched sub-samples of the National Comorbidity Survey Replication (NCS-R) (n = 131) and a survey of a large managed healthcare plan (n = 214). The clinician-administered Adult ADHD Clinical Diagnostic Scale (ACDS) was used to assess childhood ADHD and expanded symptoms of current adult ADHD. Analyses examined stability of symptoms from childhood to adulthood, the structure of adult ADHD, and the adult symptoms most predictive of current clinical diagnoses. The ACDS was administered telephonically by clinical research interviewers with extensive experience in diagnosis and treatment of adult ADHD. An enriched sample of community respondents DSM-IV/ACDS diagnoses of adult ADHD Almost half (45.7%) of respondents who had childhood ADHD continued to meet full DSM-IV criteria for current adult ADHD, with 94.9% of these cases having current attention-deficit disorder and 34.6% current hyperactivity disorder. Adult persistence was much greater for inattention than hyperactivity-impulsivity. Additional respondents met full criteria for current adult ADHD despite not having met full childhood criteria. A three-factor structure of adult symptoms included executive functioning, inattention-hyperactivity, and impulsivity. Stepwise logistic regression found executive functioning problems to be the most consistent and discriminating predictors of adult DSM-IV/ACDS ADHD. These findings document the greater persistence of inattentive than hyperactive/impulsive childhood symptoms of ADHD in adulthood, but also show that inattention in not specific to ADHD, as it is strongly associated with other adult mental disorders. Executive functioning problems, in comparison, are more specific and consistently important predictors of DSM-IV adult ADHD despite not being in DSM-IV, suggesting that the number of executive functioning symptoms should be increased in DSM-V/ICD-11.
登录
查看更多内容
DOI：
10.1097/00004583-199808000-00015
发表时间：
1998-08-01
影响因子：
13.3
作者：
Hudziak, JJ;Heath, AC;Todd, RD
通讯作者：
Todd, RD
影响因子：
4.9
作者：
de Graaf, R.;Kessler, R. C.;Posada-Villa, J.
通讯作者：
Posada-Villa, J.
影响因子：
1.7
作者：
Adler, L;Cohen, J
通讯作者：
Cohen, J
影响因子：
2.3
作者：
Amador-Campos, JA;Forns-Santacana, M;Peró-Cebollero, M
通讯作者：
Peró-Cebollero, M
影响因子：
3.1
作者：
Kessler, RC;Merikangas, KR
通讯作者：
Merikangas, KR