注意缺陷与多动障碍学龄儿童焦虑、抑郁的共病情况以及比较患与未患有注意缺陷与多动障碍的学龄儿童其父母自我报告的注意缺陷与多动障碍、焦虑和抑郁症状（英文）

Comorbid anxiety and depression in school-aged children with attention deficit hyperactivity disorder(ADHD) and self-reported symptoms of ADHD, anxiety, and depression among parents of school-aged children with and without ADHD

背景:在儿童中,注意缺陷与多动障碍(attention deficit hyperactivity disorder,ADHD)是一种常见的精神障碍,可能会持续到成人期,并且往往与多种精神疾病的共病相关。目标:评估患有ADHD的学龄儿童焦虑、抑郁的共病情况,以及ADHD儿童的ADHD症状、焦虑症状和抑郁症状的严重程度与其父母相应症状严重程度的相关性。方法:本研究在上海新华医院进行,经过两阶段的筛选入组患有ADHD和未患有ADHD的7-10岁儿童。高年资的临床医师采用学龄期儿童情感障碍与精神分裂症检查表(Schedule for Affective Disorder and Schizophrenia for School-Aged Children,K-SADS-PL)诊断ADHD与其它符合DSM-IV诊断标准的疾病。每一个入组儿童的父亲或母亲完成三个自评量表:成人ADHD自评量表(ADHD Adult Self Report Scale,ASRS)、状态-特质焦虑问卷(State-Trait Anxiety Inventory,STAI)和Beck抑郁自评问卷(Beck Depression Inventory,BDI)。本研究共入组135名患有ADHD的儿童和65名未患有ADHD的儿童作对照组;94名患有ADHD的儿童的父母和63名未患ADHD的儿童的父母完成了针对家长的评估量表。结果:在135名ADHD儿童中,27%的儿童共病焦虑障碍,18%共病抑郁障碍,另外15%同时共病焦虑和抑郁障碍。ADHD儿童的母亲(不是父亲)与未患有的ADHD儿童母亲相比,有更严重的注意力缺陷症状、更严重的特质性焦虑症状以及更严重的抑郁症状。在ADHD儿童中,ADHD症状的严重程度与其父母的ADHD症状的严重程度之间无显著的相关性,但儿童的抑郁症状和焦虑症状与其父母的相应症状显著相关。结论:学龄期ADHD儿童常伴发焦虑、抑郁障碍。相较于未患有ADHD的儿童的父母,ADHD儿童的父母的自评ADHD症状更为常见。在患有ADHD的儿童父母中,母亲们自我报告的焦虑症状较父亲们更为严重。我们还需要开展随访研究来理清导致这一复杂的相互关系的遗传性、生物性和社会因素。

Background： Attention deficit hyperactivity disorder（ADHD） is a common psychiatric disorder in children that can extend into adulthood and that is often associated with a variety of comorbid psychiatric disorders. Aim： Assess the comorbidity of ADHD with anxiety disorders and depressive disorders in school-aged children, and the relationship of the severity of ADHD, anxiety, and depressive symptoms in children who have ADHD with the severity of the corresponding symptoms in their parents. Methods： A two-stage screening process identified children 7-10 years of age with and without ADHD treated at the Xin Hua Hospital in Shanghai. ADHD and other DSM-IV diagnoses were determined by a senior clinician using the Schedule for Affective Disorder and Schizophrenia for School-Aged Children（K-SADS-PL）. One parent for each enrolled child completed three self-report scales： the ADHD Adult Self Report Scale（ASRS）, the State-Trait Anxiety Inventory（STAI）, and the Beck Depression Inventory（BDI）. In total 135 children with ADHD and 65 control group children without ADHD were enrolled; parents for 94 of the children with ADHD and 63 of the children without ADHD completed the parental assessment scales.Results： Among the 135 children with ADHD, 27% had a comorbid anxiety disorder, 18% had a comorbid depressive disorder, and another 15% had both comorbid anxiety and depressive disorders. Parents of children with ADHD self-reported more severe ADHD inattention symptoms than parents of children without ADHD and were more likely to meet criteria for adult ADHD. Mothers（but not fathers） of children with ADHD had significantly more severe trait anxiety and depressive symptoms than mothers of children without ADHD. Among children with ADHD, the severity of ADHD symptoms was not significantly correlated with the severity of ADHD symptoms in parents, but depressive symptoms and anxiety symptoms in the children were significantly correlated with the corresponding symptoms in the parents. Conclusions： School-aged children with ADHD commonly suffer from comorbid anxiety and depressive disorders, and the severity of these symptoms parallels the level of anxiety and depressive symptoms in their parents. Self-reported symptoms of ADHD are significantly more common in parents of children with ADHD than in parents of children without ADHD. Longitudinal studies are needed to disentangle the genetic, biological, and social factors responsible for these complex inter-relationships.