Adult Outcome of Attention Deficit Hyperactivity Disorde

描述(由申请者提供)：我们建议对患有注意力缺陷多动障碍(ADHD)的男孩进行一项为期15年的跟踪研究。在基线评估中，我们确定了140名ADHD儿童和120名正常对照儿童，他们来自精神科和非精神科环境。这些群体分别有454名和368名一级生物亲属。我们对先证者及其兄弟姐妹进行了一年、四年和十年的跟踪调查。超过90%在基线确定的受试者在每一次后续评估中都进行了重新检查。我们现在提议一项为期五年的研究，在基线评估15年后，重新检查先证者和兄弟姐妹到成年的情况。我们有五个主要目标：1)评估ADHD儿童及其兄弟姐妹的持续性、功能正常化和缓解；2)评估精神障碍、神经心理和社会功能障碍共病的预测有效性；3)评估DSM-IV亚型ADHD的有效性；4)评估成人ADHD诊断的心理测量学特征；5)评估基因变异如何预测成人结果。在我们的初步工作中，我们已经开始处理作为拟议工作重点的每一个具体目标。出于几个原因，我们认为拟议的延长我们的工作是必要的一步。首先，尽管已经有七项对ADHD儿童的随访研究，只有两项(我们纳入)使用了DSM-III-R标准。此外，与大多数以前的后续研究不同，拟议的工作可以全面解决ADHD的精神共患问题，因为我们没有使用共病条件来排除基线情况下的病例，并且我们在每次评估中评估了广泛的共病条件。之前只有几项研究评估了智力、成就和学校功能，没有一项研究彻底检查了注意力-执行神经心理功能，只有一项研究检查了心理社会和家庭功能。相比之下，我们的研究采用了多维方法进行测量；我们在基线和每一次后续评估中评估了这些领域的功能。因为我们样本中使用的治疗干预措施没有得到控制，我们将能够记录治疗过程中的自然使用。此外，我们是唯一一项长期研究，收集所有一级亲属的临床和分子遗传学数据，并跟踪ADHD和对照受试者的兄弟姐妹直到成年。出于这些原因，我们希望拟议的工作将澄清ADHD的过程和结果。

DESCRIPTION (provided by applicant): We are proposing a fifteen year follow-up study of boys with attention deficit hyperactivity disorder (ADHD). At a baseline assessment, we ascertained 140 ADHD and 120 normal control children from psychiatric and non-psychiatric settings. These groups had 454 and 368 first degree biological relatives, respectively. We have followed the probands and their siblings at one, four and ten year follow-ups. Over 90% of the subjects ascertained at baseline were re-examined at each follow-up assessment. We now propose a five-year study that will re-examine the probands and siblings into adulthood, fifteen years after the baseline assessment. We have five main Aims: 1) To assess the persistence, normalization of functioning and remission in ADHD children and their siblings; 2) To assess the predictive validity of comorbidity with psychiatric disorders and neuropsychological and social dysfunction; 3) To evaluate the validity of DSM-IV subtypes of ADHD; 4) To assess the Psychometric Features of the Adult ADHD diagnosis; and 5) To assess how gene variants will predict adult outcome. In our preliminary work, we have begun to address each of the Specific Aims that are the focus of the proposed work. We view the proposed extension of our work as an essential step for several reasons. First, although there have been seven follow-up studies of ADHD children and only two (our included) used DSM-III-R criteria. Moreover, unlike most prior follow-up studies, the proposed work can comprehensively address psychiatric comobidity in ADHD because we did not use comorbid conditions to exclude cases at baseline and we assessed for a wide range of comorbid conditions at each assessment. Only a few prior studies assessed intelligence, achievement and school functioning, none have thoroughly examined attentional-executive neuropsychological functions and only one examined psychosocial and family functioning. In contrast, our study has taken a multidimensional approach to measurement; we have assessed these domains of functioning at baseline and each follow-up assessment. Because the treatment interventions used in our sample are not being controlled, we will be able to document to naturalistic course of treatment use. Also, we are the only long-term study to collect clinical and molecular genetic data on all first degree relatives and to follow the siblings of ADHD and control subjects into adulthood. For these reasons, we expect the proposed work to clarify the course and outcome of ADHD.