Adult Outcome of Attention Deficit Hyperactivity Disorde

描述（由申请人提供）：我们建议对患有注意缺陷多动障碍（ADHD）的男孩进行一项为期15年的随访研究。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，分别来自精神科和非精神科。这两组分别有454和368个一级血亲。我们对先证者及其兄弟姐妹进行了1年、4年和10年的随访。超过90%的基线时确定的受试者在每次随访评估时接受了重新检查。我们现在提出了一项为期五年的研究，将重新检查先证者和兄弟姐妹到成年，15年后的基线评估。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）评估与精神疾病和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局。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。出于若干原因，我们认为延长我们工作期限的建议是一个重要步骤。首先，虽然有七个ADHD儿童的后续研究，只有两个（包括我们）使用DSM-III-R标准。此外，与大多数先前的随访研究不同，拟议的工作可以全面解决ADHD中的精神共病，因为我们没有使用共病条件来排除基线病例，并且我们在每次评估时评估了广泛的共病条件。只有少数先前的研究评估了智力，成就和学校功能，没有彻底检查注意力执行神经心理功能，只有一个检查了心理社会和家庭功能。相比之下，我们的研究采取了多维度的测量方法;我们在基线和每次随访评估时评估了这些功能领域。由于我们的样本中使用的治疗干预措施不受控制，我们将能够记录治疗使用的自然过程。此外，我们是唯一一个收集所有一级亲属的临床和分子遗传数据，并跟踪ADHD和对照受试者的兄弟姐妹到成年的长期研究。基于这些原因，我们希望拟议的工作能够澄清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.