Mortality, ADHD, and Psychosocial Adversity in Adults With Childhood ADHD: A Prospective Study
Mortality, ADHD, and Psychosocial Adversity in Adults With Childhood ADHD: A Prospective Study
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DOI：
10.1542/peds.2012-2354
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发表时间：
2013-04-01
期刊：
影响因子：
8
通讯作者：
Katusic, Slavica K.
中科院分区：
文献类型：
--
作者：
Barbaresi, William J.;Colligan, Robert C.;Katusic, Slavica K.
目的：我们研究了注意缺陷多动障碍（ADHD）的儿童ADHD病例和对照人群为基础的样本，前瞻性评估为adultes.METHODS：成人与儿童ADHD和非ADHD对照组从同一出生队列（N = 5718）被邀请参加一项前瞻性结果研究。确定出生队列成员的生命状态。标准化死亡率（SMR）被用来比较儿童ADHD病例和对照组的总体死亡率和病因特异性死亡率。儿童ADHD病例的监禁状态被确定。进行了标准化的神经精神访谈。结果：确定了367例儿童多动症病例的生命状态：7例（1.9%）死亡，10例（2.7%）目前被监禁。儿童ADHD病例与对照组的总生存率SMR为1.88（95%置信区间[CI]，0.83-4.26; P = 0.13），仅事故为1.70（95% CI，0.49-5.97; P = 0.41）。然而，ADHD病例中仅自杀的原因特异性死亡率显著较高（SMR，4.83; 95%CI，1.14-20.46; P = 0.032）。在参与前瞻性评估的儿童ADHD病例中（N = 232;平均年龄，27.0岁），29.3%（95%CI，23.5-35.2）的ADHD持续到成年期。参与儿童ADHD病例比对照组更可能（N = 335;平均年龄，28.6岁）有≥ 1种其他精神疾病（56.9% vs 34.9%;比值比，2.6; 95% CI，1.8-3.8; P <0.01）。儿童ADHD是一种慢性健康问题，具有显著的死亡风险，ADHD的持续性和成年后的长期发病率。
OBJECTIVE: We examined long-term outcomes of attention-deficit/hyperactivity disorder (ADHD) in a population-based sample of childhood ADHD cases and controls, prospectively assessed as adults.METHODS: Adults with childhood ADHD and non-ADHD controls from the same birth cohort (N = 5718) were invited to participate in a prospective outcome study. Vital status was determined for birth cohort members. Standardized mortality ratios (SMRs) were constructed to compare overall and cause-specific mortality between childhood ADHD cases and controls. Incarceration status was determined for childhood ADHD cases. A standardized neuropsychiatric interview was administered.RESULTS: Vital status for 367 childhood ADHD cases was determined: 7 (1.9%) were deceased, and 10 (2.7%) were currently incarcerated. The SMR for overall survival of childhood ADHD cases versus controls was 1.88 (95% confidence interval [CI], 0.83-4.26; P = .13) and for accidents only was 1.70 (95% CI, 0.49-5.97; P = .41). However, the cause-specific mortality for suicide only was significantly higher among ADHD cases (SMR, 4.83; 95% CI, 1.14-20.46; P = .032). Among the childhood ADHD cases participating in the prospective assessment (N = 232; mean age, 27.0 years), ADHD persisted into adulthood for 29.3% (95% CI, 23.5-35.2). Participating childhood ADHD cases were more likely than controls (N = 335; mean age, 28.6 years) to have >= 1 other psychiatric disorder (56.9% vs 34.9%; odds ratio, 2.6; 95% CI, 1.8-3.8; P < .01).CONCLUSIONS: Childhood ADHD is a chronic health problem, with significant risk for mortality, persistence of ADHD, and long-term morbidity in adulthood.