MEDICATED & UNMEDICATED ADHD BOYS AT MIDLIFE (35 TO 45)

描述：这是最早、规模最大、 最全面的前DSM-III美国研究的男孩与星座 行为问题，包括目前所谓的 注意力缺陷多动障碍（ADHD）。该项目将涉及364 受试者分为四组：（1）164名先证者， 中枢神经系统兴奋剂，如哌醋甲酯，平均3 年（MED组），（2）50名从未接受过药物治疗的先证者（UNMED），（3）75 这214名先证者的未转诊且从未接受过药物治疗的全兄弟（BRO），以及 (4)从先证者的中学教室中抽取75名正常男孩， 青少年随访（CLASS）。先证者被电流跟踪 研究小组，因为他们转诊的诊断评估和治疗， 爱荷华州大学儿童精神病门诊， 1978.他们的数据被用来推导和验证Loney及其同事的 双因素模型（1）评估注意力不集中-过度活跃（10）， 行为问题男孩的攻击-反抗（AG），（2）将这些男孩 将其分为两个亚组：10、AG、IO+AG和 （3）预测青少年和青年的结果。所有 将对35至45岁的受试者进行全面评估， 精神病学、心理学、认知学、神经心理学和社会心理学 领域来描述他们的中年功能，并回答有关 选定的成人精神病学结局：成人/残余ADHD、人格障碍 (e.g.,反社会、偏执、偏执型和回避型），成人双相型谱系 精神障碍（躁狂、轻躁狂和循环性心境障碍）、抑郁、酒精和药物 使用、滥用和依赖。诊断信息也将从 433父母作为儿童，先证者被分配到药物治疗条件 基本上是随机的。因此，研究人员将能够比较 （1）地中海和未地中海组的中年结局，以确定长期影响 儿童兴奋剂药物和（2）UNMED ADHD和CLASS组， 确定ADHD的影响，从而将障碍的影响与 最常见也是最有争议的治疗方法的效果分析内部 MED组将确定药物治疗的哪些方面（初始反应， 维持剂量、治疗持续时间）预测中年结局。的 调查人员还将检查双因素JO的外部效度， AG维度和DSM-IV ADHD注意力不集中，多动-冲动， 混合亚型。将提供更多信息，以确定 先证者童年和成年期疾病与儿童期 他们的儿子和女儿的症状。这项研究将提供有价值的 关于诊断、中年预后和世代的信息 ADHD和相关疾病的传播以及 兴奋剂药物

DESCRIPTION: This is the midlife follow-up phase of the earliest, largest, and most comprehensive pre-DSM-III U.S. study of boys with the constellation of behavior problems that includes what is currently called Attention-Deficit/Hyperactivity Disorder (ADHD). This phase will involve 364 subjects in four groups: (1) 164 probands who were medicated as children with a central nervous system stimulant such as methylphenidate for an average of 3 years (the MED group), (2) 50 probands who were never medicated (UNMED), (3) 75 unreferred and never medicated full brothers of these 214 probands (BRO), and (4) 75 normal boys drawn from middle school classrooms of the probands during an adolescent follow-up (CLASS). The probands have been followed by the current research team since their referral for diagnostic evaluation and treatment to the University of Iowa outpatient child psychiatry clinic between 1967 and 1978. Their data were used to derive and validate Loney and colleagues' two-factor model for (1) assessing inattention-overactivity (10) and aggression-defiance (AG) in boys with behavior problems, (2) placing such boys into symptomatically homogeneous diagnostic subgroups (10, AG, IO+AG, and neither), and (3) predicting their adolescent and young adult outcomes. All subjects will be comprehensively evaluated between ages 35 and 45 in psychiatric, psychological, cognitive, neuropsychological, and psychosocial domains to describe their midlife functioning and to answer questions about selected adult psychiatric outcomes: adult/residual ADHD, personality disorders (e.g., antisocial, paranoid, schizotypal, and avoidant), adult bipolar spectrum disorders (mania, hypomania, and cyclothymia), depression, and alcohol and drug use, abuse, and dependence. Diagnostic information will also be obtained from 433 parents. As children, probands were assigned to medication conditions essentially randomly. Therefore, the investigators will be able to compare the midlife outcomes of (1) MED and UNMED groups to determine the long-term impact of childhood stimulant medication and (2) UNMED ADHD and CLASS groups to determine the impact of ADHD, thus separating the effects of the disorder from the effects of its most common and controversial treatment. Analyses within the MED group will identify which aspects of medication (initial response, maintenance dosage, treatment duration) predict midlife outcomes. The investigators will also examine the external validity of the two-factor JO and AG dimensions and the DSM-IV ADHD inattentive, hyperactive-impulsive, and combined subtypes. Additional information will be available to determine the associations of the probands' childhood and adult disorders with the childhood symptoms of their sons and daughters. This study will provide valuable information about the diagnosis, midlife prognosis, and generational transmission of ADHD and related disorders and about the long-term effects of stimulant medication.