Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood:: Results from the national comorbidity survey replication
Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood:: Results from the national comorbidity survey replication
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DOI：
10.1016/j.biopsych.2005.04.001
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发表时间：
2005-06-01
影响因子：
10.6
通讯作者：
Zaslavsky, AM
中科院分区：
文献类型：
--
作者：
Kessler, RC;Adler, LA;Zaslavsky, AM
背景：尽管人们对成人注意力缺陷/多动障碍（ADHD）越来越感兴趣，但对儿童期病例持续到成年期的预测因素知之甚少。方法：在全国合并症调查复制（NCS-R）中，对3197名18-44岁的受访者进行了儿童多动症、儿童危险因素和成人多动症筛查的回顾性评估。盲法成人ADHD临床再评估访谈对一个子样本的回答者进行。多重归算（Multiple imputation， MI）用于评估儿童ADHD的成人持续性。Logistic回归用于研究回顾性报告的儿童期持久性预测因子。潜在的预测因素包括社会人口统计学、儿童ADHD严重程度、童年逆境、创伤性生活经历和DSM-IV儿童青少年障碍共病（焦虑、情绪、冲动控制和物质障碍）。结果：盲法临床访谈将36.3%回顾性评估儿童ADHD的应答者归类为符合DSM-IV当前ADHD标准。儿童ADHD严重程度和儿童治疗显著预测持久性。控制严重程度和排除治疗，没有其他变量显著预测持久性，即使它们与儿童多动症显著相关。结论：没有发现成人ADHD持续存在的可改变的危险因素，需要进一步的研究，最好是基于前瞻性的一般人群样本，来寻找成人ADHD持续存在的可改变的决定因素。
Background: Despite growing interest in adult attention-deficit/hyperactivity disorder (ADHD), little is known about predictors of persistence of childhood cases into adulthood.Methods: A retrospective assessment of childhood ADHD, childhood risk factors, and a screen for adult ADHD were included in a sample of 3197 18-44 year old respondents in the National Comorbidity Survey Replication (NCS-R). Blinded adult ADHD clinical reappraisal interviews were administered to a sub-sample of respondents. Multiple imputation (MI) was used to estimate adult persistence of childhood ADHD. Logistic regression was used to study retrospectively reported childhood predictors of persistence. Potential predictors included socio-demographics, childhood ADHD severity, childhood adversity, traumatic life experiences, and comorbid DSM-IV child-adolescent disorders (anxiety, mood, impulse-control, and substance disorders).Results: Blinded clinical interviews classified 36.3% of respondents with retrospectively assessed childhood ADHD as meeting DSM-IV criteria for current ADHD. Childhood ADHD severity and childhood treatment significantly predicted persistence. Controlling for severity and excluding treatment, none of the other variables significantly predicted persistence even though they were significantly associated with childhood ADHD.Conclusions: No modifiable risk factors were found for adult persistence of ADHD, Further research, ideally based on prospective general population samples, is needed to search for modifiable determinants of adult persistence of ADHD.