Course of psychopathology in female youth: Analysis with extant longitudinal data

描述（由申请人提供）：尽管注意缺陷多动障碍（ADHD）在男孩中比女孩更普遍，但毫无疑问，ADHD也是女孩精神残疾的一个重要原因。尽管如此，关于女性多动症的科学文献很少，而且大多是横向的。因此，对女孩ADHD的过程和结果进行大规模的研究是非常必要的。这些信息可以告知患者、家庭、教师和临床医生，并促进对女性多动症患者的预防和干预工作，这是一个未被充分研究的人群。我们提出了一个数据分析项目，利用现有的纵向数据库来解决这些问题。本应用程序的总体目标是使用纵向测量，多代视角和对多个功能领域的广泛评估来调查有和没有ADHD的女性青年的精神病理发展过程和结果。我们的具体目标是：1)在整个发展过程中检查与ADHD相关的精神病理风险；2)描述ADHD女孩的临床精神病理特征；3)评估前因危险因素对ADHD女孩精神病理的影响；4)评估精神病理学对ADHD女孩后续功能结局的影响。要检查的精神病理状况有：品行障碍、重度抑郁症、双相情感障碍、焦虑症和饮食障碍。我们将使用现有的数据来源，这将为我们提供充足的统计能力和可观的成本效益。该数据集由一项为期五年的前瞻性病例对照家庭遗传学研究组成，研究对象为6-18岁的患有（n=140）和未患有（n=122）多动症的女性青年，连续从社区儿科医生或学术医疗中心的精神科医生处确定。在五年的随访中，分别有123名（88%）和112名（92%）ADHD儿童和对照组儿童在平均年龄16.7岁时接受了重新评估。本研究采用盲法结构化精神病学诊断访谈、认知和神经心理学测试以及社会心理和整体功能测量来评估先证者及其一级亲属。将采用最先进的统计技术。更好地了解ADHD女孩精神病理的预测因素、过程和结果具有重要的临床和公共卫生意义。这些知识将提醒临床医生认识到ADHD女孩的精神共病对治疗计划和预测预后的重要性，并有助于设计改进的预防和干预方案。从公共卫生的角度来看，预测患有多动症的女孩的精神病理过程的能力可以帮助将有限的社会资源集中在那些患有复杂结果的持续性疾病的高风险人群身上。

DESCRIPTION (provided by applicant): Although attention-deficit/hyperactivity disorder (ADHD) is more prevalent in boys than girls, little doubt exists that ADHD is also an important cause of psychiatric disability in girls. Despite this, the scientific literature on females with ADHD is scarce, and mostly cross-sectional. Thus, large-scale studies examining the course and outcome of psychopathology in ADHD in girls are sorely needed. Such information can inform patients, families, teachers and clinicians and facilitate prevention and intervention efforts for females with ADHD, an understudied population. We propose a data analysis project that utilizes an existing longitudinal database to address these questions. The overall goal of this application is to use longitudinal measurements, a multigenerational perspective and an extensive assessment of multiple domains of functioning to investigate the developmental course and outcome of psychopathology in female youth with and without ADHD. Our specific aims are to: 1) examine the risk for psychopathology associated with ADHD across development; 2) describe the clinical characteristics of psychopathology in a sample of ADHD girls; 3) estimate the effect of antecedent risk factors on psychopathology in a sample of ADHD girls; and 4) to estimate the effect of psychopathology on subsequent functional outcomes in a sample of ADHD girls. The psychopathological conditions to be examined are: conduct disorder, major depression, bipolar disorder, anxiety disorders, and eating disorders. We will use an existing data source that will provide us with ample statistical power and considerable cost-effectiveness. The dataset is comprised of a five-year prospective case-control family-genetic study of female youth with (n=140) and without (n=122) ADHD, aged 6-18 years at baseline, consecutively ascertained from either community pediatricians or psychiatrists at an academic medical center. At the five-year follow-up, 123 (88 percent) and 112 (92 percent) of the ADHD and control children, respectively, were re-assessed at a mean age of 16.7 years. This study used blinded structured psychiatric diagnostic interviews, cognitive and neuropsychological tests and psychosocial and global functioning measures to assess the probands and their first-degree relatives. State of the art statistical techniques will be employed. A better understanding of the predictors, course and outcome of psychopathology among girls with ADHD has important clinical and public health implications. Such knowledge would alert clinicians to the importance of recognizing psychiatric comorbid disorders in girls with ADHD for treatment planning and forecasting prognosis, and could help design improved preventive and intervention programs. From a public health perspective, the ability to predict the course of psychopathology in girls with ADHD could help focus limited societal resources on those at higher risk for persistent illness with complicated outcomes.