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、规模最大、规模最大的中年随访阶段。 对具有以下星座的男孩进行的最全面的 DSM-III 前美国研究 行为问题，包括目前所谓的 注意力缺陷/多动症（ADHD）。此阶段将涉及 364 受试者分为四组：(1) 164 名先证者，他们在儿童时期接受过药物治疗，患有某种疾病 中枢神经系统兴奋剂，例如哌甲酯，平均 3 年（MED 组），(2) 50 名从未接受过药物治疗的先证者 (UNMED)，(3) 75 这 214 名先证者的未经转诊且从未接受药物治疗的亲兄弟 (BRO)，以及 (4)从先证者的中学教室中抽取75名正常男生 青少年随访（CLASS）。先证者已被当前跟踪 研究团队自转诊诊断评估和治疗以来 爱荷华大学儿童精神病学门诊 1967 年至 1978 年。他们的数据被用来推导和验证 Loney 及其同事的结论 用于 (1) 评估注意力不集中-过度活跃 (10) 和 有行为问题的男孩的攻击-反抗（AG），（2）将这些男孩置于 分为症状同质的诊断亚组（10、AG、IO+AG 和 两者都不是），以及（3）预测他们的青少年和年轻人的结局。全部 受试者将在35岁至45岁之间进行综合评估 精神病学、心理学、认知学、神经心理学和心理社会学 领域来描述他们的中年功能并回答有关的问题 选定的成人精神结局：成人/残余多动症、人格障碍 （例如，反社会、偏执、分裂型和回避型）、成人双相情感障碍 疾病（躁狂、轻躁狂和循环性精神障碍）、抑郁症、酒精和药物 使用、滥用和依赖。诊断信息也将从 第433章 父母。作为孩子，先证者被分配到药物条件 基本上是随机的。因此，研究人员将能够比较 (1) MED 和 UNMED 组的中年结果以确定长期影响 儿童兴奋剂药物和 (2) UNMED ADHD 和 CLASS 组 确定 ADHD 的影响，从而将疾病的影响与 最常见和最有争议的治疗方法的效果。分析范围内 MED 小组将确定药物治疗的哪些方面（初始反应、 维持剂量、治疗持续时间）可预测中年结果。这 研究人员还将检查双因素 JO 的外部有效性和 AG 维度和 DSM-IV ADHD 注意力不集中、多动冲动和 组合亚型。将提供更多信息来确定 先证者的童年和成年疾病与童年的关联 他们的儿子和女儿的症状。这项研究将提供有价值的 有关诊断、中年预后和世代相传的信息 ADHD 和相关疾病的传播及其长期影响 兴奋剂药物。