Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later.
Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later.
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DOI：
10.1001/archgenpsychiatry.2012.271
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发表时间：
2012-12
影响因子：
--
通讯作者：
Castellanos, F. Xavier
中科院分区：
文献类型：
--
作者：
Klein, Rachel G.;Mannuzza, Salvatore;Olazagasti, Maria A. Ramos;Roizen, Erica;Hutchison, Jesse A.;Lashua, Erin C.;Castellanos, F. Xavier
对儿童注意力缺陷/多动障碍(ADHD)的前瞻性研究并没有延伸到成年早期。为了测试平均年龄为8岁时被诊断为ADHD的儿童(先证者)的教育、职业、经济、社会和婚姻状况是否更差；持续ADHD、反社会人格障碍(ASPD)、物质障碍(SD)的发病率更高；在平均年龄41岁时，成人起病精神障碍、精神住院和监禁的比例是否高于非ADHD对照。测试：先证者正在进行的ADHD和ASPD与SD之间的正相关性；以及没有持续精神障碍的先证者的社会和职业功能较差的相关性，而不是比较。前瞻性，33年随访研究，临床盲法评估。研究诊所。135名患有儿童期ADHD的高加索男性，没有品行障碍，136名对照的男性没有儿童期ADHD(分别为原始队列的65%和76%)。职业、经济和教育程度；婚姻史；职业和社会功能；持续的和终生的精神障碍；精神住院和监禁。有先证者的教育、职业、经济、社会结果明显比对照差，离婚率更高；持续的ADHD(22%比5%，p<；.001)、ASPD(16%比0%，p<；.001)和SD(14%比5%，p<；.01)更高，但没有更多的情绪或焦虑障碍(p‘s=.36和.33)。进展性ADHD与进展期SD(Phi=0.19，p=0.04)和ASPD+SD(Phi=0.20，p=0.04)关系较弱。一生中，先证者的ASPD和SD显著多于对照组，但没有情绪或焦虑障碍，以及更多的精神科住院和监禁。与比较相比，发病年龄在21岁或以上的精神障碍在先证者中并未显著增加。没有持续精神障碍的先证者的社会功能较差，但职业功能并不差。从青春期开始，儿童ADHD一直到成年都预示着多种不利因素，20岁以后新疾病的发病率没有增加。这一发现突显了延长对ADHD儿童的监测和治疗的重要性。
Prospective studies of childhood attention deficit/hyperactivity disorder (ADHD) have not extended beyond early adulthood. To test whether children diagnosed with ADHD at mean age 8 (probands) have worse educational, occupational, economic, social, marital outcomes; higher rates of ongoing ADHD, antisocial personality disorder (ASPD), substance disorders (SD); adult onset psychiatric disorders, psychiatric hospitalizations and incarcerations, than non-ADHD comparisons, at mean age 41. To test for: positive associations between probands’ ongoing ADHD and ASPD, and SD’s; and for worse social and occupational functioning in probands without ongoing psychiatric disorders, than comparisons. Prospective, 33 year follow-up study, with blind clinical assessments. Research clinic. 135 Caucasian males with ADHD in childhood, free of conduct disorder, and 136 male comparisons without childhood ADHD (65% and 76% of original cohort, respectively). Occupational, economic, and educational attainment; marital history; occupational and social functioning; ongoing and lifetime psychiatric disorders; psychiatric hospitalizations, and incarcerations. Probands had significantly worse educational, occupational, economic, social outcomes, and more divorces than comparisons; higher rates of ongoing ADHD (22% vs 5%, p<.001), ASPD (16% vs 0%, p<.001)and SD (14% vs 5%, p<.01), but not more mood or anxiety disorders (p’s=.36 and .33). Ongoing ADHD was weakly related to ongoing SD (phi=.19, p=.04), and ASPD+SD (phi=.20, p=.04). Lifetime, probands had significantly more ASPD and SD’s, but not mood or anxiety disorders, and more psychiatric hospitalizations and incarcerations than comparisons. Relative to comparisons, psychiatric disorders with onsets at age 21 or beyond were not significantly elevated in probands. Probands without ongoing psychiatric disorders had worse social, but not occupational, functioning. The multiple disadvantages predicted by childhood ADHD well into adulthood began in adolescence, without increased onsets of new disorders after age 20. Findings highlight the importance of extended monitoring and treatment of children with ADHD.
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影响因子：
3.6
作者：
Mannuzza, S;Klein, RG;Moulton, JL
通讯作者：
Moulton, JL
DOI：
10.1097/01.chi.0000219831.16226.f8
发表时间：
2006-07-01
影响因子：
13.3
作者：
August, Gerald J.;Winters, Ken C.;Lee, Susanne
通讯作者：
Lee, Susanne
DOI：
10.1111/j.1469-7610.2004.00214.x
发表时间：
2004-02-01
影响因子：
7.6
作者：
Barkley, RA;Fischer, M;Fletcher, K
通讯作者：
Fletcher, K
影响因子：
6.9
作者：
Biederman, J;Monuteaux, MC;Faraone, SV
通讯作者：
Faraone, SV
DOI：
10.1177/10634266060140030501
发表时间：
2006-09-01
影响因子：
1.9
作者：
Bagwell, Catherine L.;Molina, Brooke S. G.;Hoza, Betsy
通讯作者：
Hoza, Betsy