Psychiatric Comorbidity Among Children and Adolescents With and Without Persistent Attention-Deficit Hyperactivity Disorder
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- Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan
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- Hsing-Chang Ni
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Child Psychiatry, Chang Gung Memorial University and Hospital, Taipei, Taiwan
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- Chi-Yung Shang
- Department of Psychiatry, National Taiwan University Hospital and College of Medicine, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan
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- Wei-Tsuen Soong
- Department of Psychiatry, National Taiwan University Hospital, Taipei Taiwan; St Joseph's Hospital, Yunlin County, Taiwan
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- Yu-Yu Wu
- Department of Child Psychiatry, Chang Gung Memorial University and Hospital, Taipei, Taiwan
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- Liang-Ying Lin
- Department of Psychiatry, Taipei City Hospital, Taipei, Taiwan
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- Yen-Nan Chiu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
抄録
<jats:p> Objectives: The aims of the present study were to examine the current psychiatric comorbidity among children and adolescents with and without persistent attention-deficit hyperactivity disorder (ADHD) as compared to school controls, and to determine the factors predicting psychiatric comorbidity. </jats:p><jats:p> Method: The sample included 296 patients (male, 85.5%), aged 11–17, who were diagnosed with DSM-IV ADHD at the mean age of 6.7 ± 2.7 years and 185 school controls. The ADHD and other psychiatric diagnoses were made based on clinical assessments and confirmed by psychiatric interviews. The ADHD group was categorized into 186 patients (62.8%) with persistent ADHD and 110 (37.2%) without persistent ADHD. </jats:p><jats:p> Results: Compared to the controls, the two ADHD groups were more likely to have oppositional defiant disorder (ODD), conduct disorder (CD), tics, mood disorders, past and regular use of substances, substance use disorders and sleep disorders (odds ratios (ORs) = 1.8–25.3). Patients with persistent ADHD had higher risks for anxiety disorders, particularly specific phobia than the controls. Moreover, patients with persistent ADHD were more likely to have ODD than their partially remitted counterparts. Advanced analyses indicated that more severe baseline ADHD symptoms predicted ODD/CD at adolescence; longer methylphenidate treatment duration was associated with an increased risk for tics and ODD/CD at adolescence; and older age predicted higher risks for mood disorders and substance use disorders. </jats:p><jats:p> Conclusion: Reduced ADHD symptoms at adolescence may not lead to decreased risks for psychiatric comorbidity, and identification of severe ADHD symptoms at childhood and age-specific comorbid patterns throughout the developmental stage is important to offset the long-term adverse psychiatric outcomes of ADHD. </jats:p>
収録刊行物
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- Australian & New Zealand Journal of Psychiatry
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Australian & New Zealand Journal of Psychiatry 44 (2), 135-143, 2010-02
SAGE Publications