The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study
The long-term longitudinal course of oppositional defiant disorder and conduct disorder in ADHD boys: findings from a controlled 10-year prospective longitudinal follow-up study
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DOI：
10.1017/s0033291707002668
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发表时间：
2008-07-01
影响因子：
6.9
通讯作者：
Faraone, S. V.
中科院分区：
文献类型：
--
作者：
Biederman, J.;Petty, C. R.;Faraone, S. V.
背景更好地了解注意缺陷多动障碍（ADHD）青少年中对立违抗性障碍（ODD）和品行障碍（CD）共病的长期范围和影响具有重要的临床和公共卫生意义。在基线（平均年龄= 10.7岁）、1年（平均年龄= 11.9岁）、4年（平均年龄= 14.7岁）和10年随访（平均年龄= 21.7岁）时对受试者进行盲态评估。受试者在4年随访时ADHD、ODD和CD的终生诊断状态被用于定义四组（对照组、ADHD、ADHD + ODD和ADHD + ODD + CD）。如果在4年评估（间隔诊断）后的任何时间满足全部标准，则10年随访时的诊断结果被认为是阳性的。使用Kaplan-Meier生存函数（ODD的持续性）、logistic回归（二元结果）和负二项回归（计数结果）控制年龄来检查结果。在10年随访时，绝大多数受试者的ODD持续存在。独立于共病CD，在4年和10年随访期间，ODD与重度抑郁症相关。虽然ODD显著增加了CD和反社会人格障碍的风险，但CD对这些结果的风险更大。此外，只有CD与精神活性物质使用障碍、吸烟和双相情感障碍的风险显著增加相关。这些纵向研究结果支持并扩展了先前报告的4年随访结果，表明ODD和CD遵循不同的过程。他们还支持以前的研究结果，即ODD预示着ADHD青少年独立于CD的共病而长大的结果会受到影响。
Background. A better understanding of the long-term scope and impact of the co-morbidity with oppositional defiant disorder (ODD) and conduct disorder (CD) in attention deficit hyperactivity disorder (ADHD) youth has important clinical and public health implications.Method. Subjects were assessed blindly at baseline (mean age = 10.7 years), 1-year (mean age = 11.9 years), 4-year (mean age = 14.7 years) and 10-year follow-up (mean age = 21.7 years). The subjects' lifetime diagnostic status of ADHD, ODD and CD by the 4-year follow-up were used to define four groups (Controls, ADHD, ADHD plus ODD, and ADHD plus ODD and CD). Diagnostic outcomes at the 10-year follow-up were considered positive if full criteria were met any time after the 4-year assessment (interval diagnosis). Outcomes were examined using a Kaplan-Meier survival function (persistence of ODD), logistic regression (for binary outcomes) and negative binomial regression (for count outcomes) controlling for age.Results. ODD persisted in a substantial minority of subjects at the 10-year follow-up. Independent of co-morbid CD, ODD was associated with major depression in the interval between the 4-year and the 10-year follow-up. Although ODD significantly increased the risk for CD and antisocial personality disorder, CD conferred a much larger risk for these outcomes. Furthermore, only CD was associated with significantly increased risk for psychoactive substance use disorders, smoking, and bipolar disorder.Conclusions. These longitudinal findings support and extend previously reported findings from this sample at the 4-year follow-up indicating that ODD and CD follow a divergent course. They also support previous findings that ODD heralds a compromised outcome for ADHD youth grown up independently of the co-morbidity with CD.