Patterns of remission and symptom decline in conduct disorder: A four-year prospective study of an ADHD sample
Patterns of remission and symptom decline in conduct disorder: A four-year prospective study of an ADHD sample
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DOI：
10.1097/00004583-200103000-00008
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发表时间：
2001-03-01
影响因子：
13.3
通讯作者：
Burback, M
中科院分区：
文献类型：
--
作者：
Biederman, J;Mick, E;Burback, M
目的：系统评价注意缺陷多动障碍（ADHD）青少年品行障碍（CD）的纵向病程，以确定持续病程对结局的影响。方法：对140名ADHD儿童及其核心家庭进行基线评估，并在1年和4年时再次进行评估。受试者通过DSM-III-R为基础的结构化访谈。他们还评估了认知和社会功能。确定了持续性（在任一次随访时表现出CD症状）和停止性（两次随访时均未出现CD症状）病例。结果：42%的CD病例持续病程。虽然持久性和desistent科目有较高的反社会障碍的亲属，增加家庭冲突和减少家庭凝聚力的选择性与一个持久的过程。此外，CD持续症状的受试者在儿童行为检查表的攻击和犯罪分量表上表现出更多的受损评级，以及双相情感障碍、对立违抗性障碍和物质使用障碍的发生率更高。结论：这些结果表明，CD相关的不良预后仅限于可识别的持续病程亚组。
Objective: To evaluate systematically the longitudinal course of conduct disorder (CD) in a sample of youths with attention-deficit hyperactivity disorder (ADHD) to determine the effects of a persistent course on outcome. Method: One hundred forty children with ADHD and their nuclear families were assessed at baseline and again at 1 and 4 years. Subjects were examined by means of DSM-III-R-based structured interviews. They were also evaluated for cognitive and social functioning. Persistent (exhibiting symptoms of CD at either follow-up) and desistent (symptoms of CD at neither follow-up) cases were identified. Results: Forty-two percent of CD cases followed a persistent course. Although both persistent and desistent subjects had high rates of antisocial disorders in relatives, increased family conflict and decreased family cohesion were selectively associated with a persistent course. In addition, subjects with persistent symptoms of CD exhibited more impaired ratings on the Aggression and Delinquency subscales of the Child Behavior Checklist, as well as higher rates of bipolar, oppositional defiant, and substance use disorders. Conclusions: These findings suggest that the poor prognosis associated with CD is limited to an identifiable subgroup with a persistent course.