MEDICATED & UNMEDICATED ADHD BOYS AT MIDLIFE (35 TO 45)

药

• 批准号: 6499385
• 负责人: JAN LONEY
• 金额: $ 63万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-02-16 至 2006-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6499385
• 关键词: attention deficit disorder; clinical research; criminal behavior; drug abuse; employment /unemployment; functional ability; hospital utilization; human middle age (35-64); human subject; human therapy evaluation; longitudinal human study; male; mental disorder chemotherapy; neuropsychological tests; outcomes research; stimulant /agonist; suicide; vehicular accident

DESCRIPTION: This is the midlife follow-up phase of the earliest, largest, and most comprehensive pre-DSM-III U.S. study of boys with the constellation of behavior problems that includes what is currently called Attention-Deficit/Hyperactivity Disorder (ADHD). This phase will involve 364 subjects in four groups: (1) 164 probands who were medicated as children with a central nervous system stimulant such as methylphenidate for an average of 3 years (the MED group), (2) 50 probands who were never medicated (UNMED), (3) 75 unreferred and never medicated full brothers of these 214 probands (BRO), and (4) 75 normal boys drawn from middle school classrooms of the probands during an adolescent follow-up (CLASS). The probands have been followed by the current research team since their referral for diagnostic evaluation and treatment to the University of Iowa outpatient child psychiatry clinic between 1967 and 1978. Their data were used to derive and validate Loney and colleagues' two-factor model for (1) assessing inattention-overactivity (10) and aggression-defiance (AG) in boys with behavior problems, (2) placing such boys into symptomatically homogeneous diagnostic subgroups (10, AG, IO+AG, and neither), and (3) predicting their adolescent and young adult outcomes. All subjects will be comprehensively evaluated between ages 35 and 45 in psychiatric, psychological, cognitive, neuropsychological, and psychosocial domains to describe their midlife functioning and to answer questions about selected adult psychiatric outcomes: adult/residual ADHD, personality disorders (e.g., antisocial, paranoid, schizotypal, and avoidant), adult bipolar spectrum disorders (mania, hypomania, and cyclothymia), depression, and alcohol and drug use, abuse, and dependence. Diagnostic information will also be obtained from 433 parents. As children, probands were assigned to medication conditions essentially randomly. Therefore, the investigators will be able to compare the midlife outcomes of (1) MED and UNMED groups to determine the long-term impact of childhood stimulant medication and (2) UNMED ADHD and CLASS groups to determine the impact of ADHD, thus separating the effects of the disorder from the effects of its most common and controversial treatment. Analyses within the MED group will identify which aspects of medication (initial response, maintenance dosage, treatment duration) predict midlife outcomes. The investigators will also examine the external validity of the two-factor JO and AG dimensions and the DSM-IV ADHD inattentive, hyperactive-impulsive, and combined subtypes. Additional information will be available to determine the associations of the probands' childhood and adult disorders with the childhood symptoms of their sons and daughters. This study will provide valuable information about the diagnosis, midlife prognosis, and generational transmission of ADHD and related disorders and about the long-term effects of stimulant medication.

描述：这是最早，最大和 美国最全面的DSM-III前研究 行为问题包括当前所谓的 注意缺陷/多动症（ADHD）。此阶段将涉及364 四个组的受试者：（1）164个被药物为儿童的概率 中枢神经系统刺激剂，例如平均3 年（Med Group），（2）50个从未服药（UNMED）的概率，（3）75 这214个概率（兄弟）和 （4）75个普通男孩从中学教室中汲取 青少年随访（类）。概率遵循了电流 研究团队自转诊以进行诊断评估和治疗 爱荷华大学在1967年至 1978年。他们的数据用于得出和验证Loney及其同事的数据 （1）评估注意力不集中的两因素模型（10）和 行为问题的男孩中的侵略性（AG），（2）放置这样的男孩 在症状上均质诊断子组（10，AG，IO+AG和 也不），（3）预测他们的青春期和年轻成人结果。全部 受试者将在35至45岁之间进行全面评估 精神病，心理学，认知，神经心理学和心理社会 描述其中年功能的领域并回答有关的问题 选定的成人精神病结果：成人/残留多动症，人格障碍 （例如，反社会，偏执，精神分裂和回避剂），成年双极光谱 疾病（躁狂症，躁狂症和环壳），抑郁症以及酒精和药物 使用，滥用和依赖。诊断信息也将从 433个父母。作为儿童，可能分配给药物条件 本质上是随机的。因此，调查人员将能够比较 （1）MED和UNMED组的中年结果以确定长期影响 儿童期兴奋剂药物和（2）Unmed ADHD和班级组 确定多动症的影响，从而将疾病的影响与 其最常见和有争议的待遇的影响。内部分析 MED组将确定药物的哪些方面（初始反应， 维持剂量，治疗持续时间）预测中年的结果。这 调查人员还将检查两因素JO的外部有效性和 Ag尺寸和DSM-IV ADHD注意力不集中，多动激动和 组合的亚型。其他信息将可以确定 概率的童年和成人疾病与童年的关联 儿子和女儿的症状。这项研究将提供有价值的 有关诊断，中年预后和世代的信息 多动症和相关疾病的传播以及有关的长期影响 刺激性药物。