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

描述：这是中年随访阶段最早、规模最大、 DSM-III之前美国对男孩星座最全面的研究 行为问题，包括目前被称为 注意力缺陷/多动障碍(ADHD)。这一阶段将涉及364 受试者分为四组：(1)164名先证者，他们在儿童时期接受药物治疗 中枢神经系统刺激剂，如哌醋甲酯平均为3 (2)50名从未用药的先证者(埃厄特派团)，(3)75名 这214名先证者的未转介和从未用药的全兄弟(兄弟)，以及 (4)从先证者的中学教室中抽取75名正常男孩 青春期后续行动(班)。先驱者之后一直是潮流 研究团队自转诊进行诊断评估和治疗以来 爱荷华大学儿童精神科门诊1967年至 1978年。他们的数据被用来推导和验证Loney和同事的 双因素模型用于(1)评估注意力不集中-过度活动(10) 有行为问题的男孩的攻击性-挑衅(AG)，(2)安置这样的男孩 分成症状相同的诊断亚组(10、AG、IO+AG和 都不是)，以及(3)预测他们青春期和年轻人的结果。全 受试者的年龄将在35岁至45岁之间进行综合评估 精神病学、心理学、认知学、神经心理学和社会心理学 描述他们的中年功能并回答有关以下方面的问题 部分成人精神病学结果：成人/残留ADHD、人格障碍 (例如，反社会性、偏执、分裂型和回避型)、成人双相情感障碍 精神障碍(躁狂、轻躁狂和环胸症)、抑郁、酒精和药物 使用、滥用和依赖。诊断信息也将从以下地址获得 433名家长。在孩提时代，先证者被分配到药物治疗环境中 基本上是随机的。因此，调查人员将能够比较 (1)MED和埃厄特派团小组的中年结局，以确定长期影响 和(2)埃厄特派团ADHD和班级小组 确定ADHD的影响，从而将障碍的影响与 其最常见和最有争议的治疗方法的效果。中的分析 MED小组将确定药物的哪些方面(初始反应， 维持剂量、治疗持续时间)预测中年结局。这个 调查人员还将检查双因素联合调查的外部效度和 AG维度与DSM-IV ADHD注意力不集中、多动-冲动和 组合子类型。将提供更多信息来确定 先证者的童年和成人障碍与童年的关系 他们儿女的症状。这项研究将提供有价值的 有关诊断、中年预后和世代的信息 ADHD和相关疾病的传播及其长期影响 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.