Objective

To describe adult outcome of people with attention-deficit/hyperactivity disorder (ADHD) diagnosed in childhood and its several key predictors via a review of 7 North American controlled prospective follow-up studies: Montreal, New York, Milwaukee, Pittsburgh, Massachusetts General Hospital (MGH), Berkeley, and 7-site Multimodal Treatment Study of Children With ADHD (MTA).

Method

All studies were prospective and followed children with a diagnosis of ADHD and an age- and gender-matched control group at regular intervals from childhood (6-12 years of age) through adolescence into adulthood (20-40 years of age), evaluating symptom and syndrome persistence, functional outcomes, and predictors of these outcomes.

Results

The rates of ADHD syndrome persistence ranged from 5.7% to 77%, likely owing to varying diagnostic criteria and the source of information (self-report vs informant report) across the studies. However, all studies observed high rates of symptomatic persistence ranging from 60% to 86%. The 7 studies were largely consistent in finding that relative to control groups, research participants with childhood-diagnosed ADHD had significant impairments in the areas of educational functioning, occupational functioning, mental health, and physical health as well as higher rates of substance misuse, antisocial behavior, and unsafe driving. The most consistently observed predictors of functional outcomes included ADHD persistence and comorbidity, especially with disruptive behavior disorders.

Conclusion

Childhood ADHD has high rates of symptomatic persistence, which is associated with negative functional outcomes. Characteristics that predict these negative outcomes, such as comorbid disruptive behavior disorders, may be important targets for intervention.

中文翻译：

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评论：通过对成年后注意力缺陷/多动障碍儿童的对照前瞻性随访研究观察成人结果

客观的

通过回顾 7 项北美对照前瞻性随访研究：蒙特利尔、纽约、密尔沃基、匹兹堡、马萨诸塞州总医院，描述儿童期诊断出的注意力缺陷/多动障碍 (ADHD) 患者的成人结果及其几个关键预测因素(MGH)、伯克利和多动症儿童的 7 点多模式治疗研究 (MTA)。

方法

所有研究都是前瞻性的，从儿童期（6-12 岁）到青春期到成年期（20-40 岁）定期跟踪诊断为 ADHD 的儿童和年龄和性别匹配的对照组，评估症状和综合征持续性、功能结果以及这些结果的预测因素。

结果

ADHD 综合征的持续发生率从 5.7% 到 77% 不等，这可能是由于研究中的诊断标准和信息来源（自我报告与知情人报告）不同。然而，所有研究都观察到症状持续的高比率从 60% 到 86% 不等。这 7 项研究基本一致地发现，相对于对照组，儿童期诊断为 ADHD 的研究参与者在教育功能、职业功能、心理健康和身体健康方面存在显着障碍，并且药物滥用、反社会行为的发生率更高行为和不安全驾驶。最一致观察到的功能结果预测因素包括 ADHD 持续性和合并症，尤其是破坏性行为障碍。

结论

儿童多动症的症状持续率很高，这与负面的功能结果有关。预测这些负面结果的特征，例如共病破坏性行为障碍，可能是干预的重要目标。