HETEROGENEITY OF ADHD: PREDICTORS OF ADOLESCENT OUTCOME

描述：ADTHD儿童的异质性引起了人们对 它是否是一种可以与其他疾病相区别的单一性疾病 精神/认知障碍或由行为障碍引起的 正态分布的一端，但不是真正的绝对无序。 此外，人们对兴奋剂的长期影响知之甚少。 治疗。帮助建立AD/HD的有效性和界限，并 检查刺激性药物治疗对长期结果的影响 前瞻性随访研究侧重于确定更多同质亚组 可能与不同的结果相关的患者。这项研究将 对确诊为临床转诊儿童的大样本进行重新评估 在1990至1997年间使用结构化诊断性面谈进行AD/HID。 精神疾病的共病以及认知和学习功能 在基线上进行评估。主要目标是a)进行全面的 对这些儿童进行临床重新评估，以确定他们的精神状态， 16岁之间青少年的行为和神经心理状况 至19岁；b)确定治疗的持续时间和性质 他们接受的干预措施；以及c)确定哪些儿童亚群 与不同的结果相关。与精心匹配的社区相比 对照，三个相互竞争的假说将被测试：临床结果 AD/HD儿童的主要原因是共病，而不是 AD/HD的存在和/或严重程度；2)不良结局与 AD/HD的严重程度)持续到青春期的症状；3)AD/HD 儿童时期会增加不良结局的风险 由共病和/或AD/HID症状持续到 青春期。此外，刺激性药物治疗的程度 将审查与青少年药物使用/滥用有关的问题，并作为 与对照组相比，青少年亚组的神经心理状况 那些在童年时期被诊断为AD/HD的人将被定性。

DESCRIPTION: Heterogeneity among children with ADTHD raises concerns about whether it is a unitary disorder that can be differentiated from other psychiatric/cognitive disorders or from behavioral difficulties that represent one end of a normal distribution, but are not a true categorical disorder. Furthermore, little is know regarding the long-term impact of stimulant treatment. To help establish the validity and boundaries of AD/HD, and to examine the impact of stimulant treatment on long-term outcome, this prospective follow-up study focuses on identifying more homogeneous subgroups of patients that might be associated with distinct outcomes. This study will re-evaluate a large sample of clinically-referred children who were diagnosed with AD/HID between 1990 to 1997 using structured diagnostic interviews. Psychiatric comorbidity as well as cognitive and academic functioning were assessed at baseline. The primary goals are a) to conduct a comprehensive clinical re-evaluation of these children to determine their psychiatric, behavioral, and neuropsychological status as adolescents between the ages of 16 to 19 years-old; b) to ascertain the duration and nature of the treatment interventions they received; and c) to identify subgroups of children that are associated with distinct outcomes. As compared to carefully matched community controls, three competing hypotheses will be tested: Clinical outcome in children with AD/HD is accounted for primarily by comorbidity, rather than by the presence and/or severity of AD/HD; 2) Adverse outcome is related to the severity of AD/HD) symptomatology that persists into adolescence; 3) AD/HD during childhood poses increased risk for poor outcome above and beyond that accounted for by comorbidity and/or the persistence of AD/HID symptoms into adolescence. In addition, the extent to which stimulant medication treatment is associated with adolescent substance use/abuse will be examined, and, as compared to controls, the neuropsychological status of subgroups of adolescents who were diagnosed as having AD/HD during childhood will be characterized.