Comorbidity in attention deficit-hyperactivity disorder
Comorbidity in attention deficit-hyperactivity disorder
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DOI：
10.1046/j.1440-1819.2003.01148.x
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发表时间：
2003-10-01
影响因子：
11.9
通讯作者：
Ohta, T
中科院分区：
文献类型：
--
作者：
Ishii, T;Takahashi, O;Ohta, T
注意力缺陷多动障碍（ADHD）因其高并发症发生率而闻名。本研究是日本第一份评估临床环境中 ADHD 病例中合并症比例的报告，旨在澄清日本 ADHD 的情况。受试者包括 68 名符合 ADHD 标准的儿童和青少年（《精神疾病诊断与统计手册》第 4 版），正在儿童精神病学诊所接受治疗（智商 > 50，心智年龄大于或等于 4 岁）。被评估为共病的疾病有情绪障碍、焦虑障碍、消除障碍、睡眠障碍、抽动障碍、对立违抗障碍（ODD）、品行障碍（CD）、拒绝上学和癫痫。研究发现，情绪障碍、焦虑症、ODD 和 CD 的合并症低于北美传统报告的高发病率。目前受试者的年龄较低，主要是婴儿期和小学年龄，青少年病例很少，以及对没有住院设施的门诊诊所的较轻病例的偏向被认为是造成这种差异的因素。此外，值得注意的是，智力迟缓病例（智商：51-84）占病例的34％，这表明在制定ADHD治疗策略时有必要考虑智力水平。
Attention deficit - hyperactivity disorder (ADHD) has been noted for its high rate of comorbidity. The present study is the first report in Japan evaluating the proportion of comorbidity in ADHD cases presenting in the clinical setting, aiming at clarifying the picture of ADHD in Japan. The subjects consisted of 68 child and adolescent cases meeting criteria for ADHD ( Diagnostic and Statistical Manual of Mental Disorders, 4th edn) under treatment at a child psychiatry clinic ( IQ > 50, mental age greater than or equal to 4 years old). Disorders evaluated as comorbid disorders were mood disorders, anxiety disorders, elimination disorders, sleep disorders, tic disorders, oppositional defiant disorder ( ODD), conduct disorder ( CD), school refusal, and epilepsy. Comorbidity with mood disorders, anxiety disorders, ODD, and CD, were found to be lower than the high rates conventionally reported in North America. The lower age of the present subjects, primarily in infancy and elementary school age with few adolescent cases, and a bias towards milder cases from an outpatient clinic without inpatient facilities are believed to be factors accounting for this disparity. Furthermore, it was a notable fact that mentally delayed cases (IQ: 51 - 84) amounted to 34% of the cases, indicating the necessity to consider intelligence level when formulating a treatment strategy for ADHD.