系统回顾和荟萃分析：儿童注意缺陷/多动障碍成人精神结局的预测因素。

IF 9.5 1区医学 Q1 PEDIATRICS

Journal of the American Academy of Child and Adolescent Psychiatry Pub Date : 2025-04-24 DOI:10.1016/j.jaac.2025.04.012

Noa E van der Plas,Siri D S Noordermeer,Jaap Oosterlaan,Marjolein Luman

{"title":"系统回顾和荟萃分析：儿童注意缺陷/多动障碍成人精神结局的预测因素。","authors":"Noa E van der Plas,Siri D S Noordermeer,Jaap Oosterlaan,Marjolein Luman","doi":"10.1016/j.jaac.2025.04.012","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\r\nPsychiatric disorders are highly prevalent in adults with childhood-onset attention-deficit/hyperactivity disorder (ADHD). Currently, little is known about childhood predictors for these outcomes.\r\n\r\nMETHOD\r\nPubMed, PsychInfo, WoS, and EMBASE were searched until June 2024. Eligible studies investigated childhood predictors of persistent ADHD, substance use disorders (SUD), conduct disorder, antisocial personality disorder, major depressive disorder (MDD), and/or anxiety disorders in adults diagnosed with childhood ADHD (PROSPERO #CRD42022320887). Meta-analytic models were tested when N ≥3 for a predictor with similar effect measures, otherwise predictors were discussed narratively when N ≥2. Newcastle-Ottawa scale was used to assess study quality.\r\n\r\nRESULTS\r\nThe selected 36 studies included 119 predictors, with 10 predictors eligible for meta-analyses. History of stimulant treatment (OR = 1.88, 95% CI 1.28-2.75, p = .001) was associated with increased, and higher childhood IQ with decreased (OR = 0.99, 95% CI 0.98-1.00, p =.039), risk of ADHD persistence in adulthood. ADHD persistence was associated with increased risk of SUDs (OR = 2.12, 95% CI 1.53-3.17, p =.004) and MDD (OR = 3.19, 95% CI 1.71-5.95, p <.001). Narratively reviewed predictors of fair/good quality studies showed potential predictors for ADHD persistence (i.e., ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunctioning, and socioeconomic status).\r\n\r\nCONCLUSION\r\nWe confirmed earlier reported childhood predictors (i.e., stimulant treatment history, ADHD persistence) and identified potential new predictors (i.e., childhood anxiety disorders, social problems, socioeconomic status) for psychiatric outcomes of ADHD. However, the available literature is hampered by methodological shortcomings. Future studies should focus on studying combined effects of potential predictors.","PeriodicalId":17186,"journal":{"name":"Journal of the American Academy of Child and Adolescent Psychiatry","volume":"83 1","pages":""},"PeriodicalIF":9.5000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Systematic Review and Meta-Analysis: Predictors of Adult Psychiatric Outcomes of Childhood Attention-Deficit/Hyperactivity Disorder.\",\"authors\":\"Noa E van der Plas,Siri D S Noordermeer,Jaap Oosterlaan,Marjolein Luman\",\"doi\":\"10.1016/j.jaac.2025.04.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\r\\nPsychiatric disorders are highly prevalent in adults with childhood-onset attention-deficit/hyperactivity disorder (ADHD). Currently, little is known about childhood predictors for these outcomes.\\r\\n\\r\\nMETHOD\\r\\nPubMed, PsychInfo, WoS, and EMBASE were searched until June 2024. Eligible studies investigated childhood predictors of persistent ADHD, substance use disorders (SUD), conduct disorder, antisocial personality disorder, major depressive disorder (MDD), and/or anxiety disorders in adults diagnosed with childhood ADHD (PROSPERO #CRD42022320887). Meta-analytic models were tested when N ≥3 for a predictor with similar effect measures, otherwise predictors were discussed narratively when N ≥2. Newcastle-Ottawa scale was used to assess study quality.\\r\\n\\r\\nRESULTS\\r\\nThe selected 36 studies included 119 predictors, with 10 predictors eligible for meta-analyses. History of stimulant treatment (OR = 1.88, 95% CI 1.28-2.75, p = .001) was associated with increased, and higher childhood IQ with decreased (OR = 0.99, 95% CI 0.98-1.00, p =.039), risk of ADHD persistence in adulthood. ADHD persistence was associated with increased risk of SUDs (OR = 2.12, 95% CI 1.53-3.17, p =.004) and MDD (OR = 3.19, 95% CI 1.71-5.95, p <.001). Narratively reviewed predictors of fair/good quality studies showed potential predictors for ADHD persistence (i.e., ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunctioning, and socioeconomic status).\\r\\n\\r\\nCONCLUSION\\r\\nWe confirmed earlier reported childhood predictors (i.e., stimulant treatment history, ADHD persistence) and identified potential new predictors (i.e., childhood anxiety disorders, social problems, socioeconomic status) for psychiatric outcomes of ADHD. However, the available literature is hampered by methodological shortcomings. Future studies should focus on studying combined effects of potential predictors.\",\"PeriodicalId\":17186,\"journal\":{\"name\":\"Journal of the American Academy of Child and Adolescent Psychiatry\",\"volume\":\"83 1\",\"pages\":\"\"},\"PeriodicalIF\":9.5000,\"publicationDate\":\"2025-04-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Academy of Child and Adolescent Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jaac.2025.04.012\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Academy of Child and Adolescent Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jaac.2025.04.012","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}

引用次数: 0

摘要

目的：精神疾病在儿童期发病的注意力缺陷/多动障碍（ADHD）成人中非常普遍。目前，对这些结果的童年预测因素知之甚少。方法检索pubmed、PsychInfo、WoS和EMBASE至2024年6月。符合条件的研究调查了儿童期诊断为儿童期ADHD的成人中持续性ADHD、物质使用障碍（SUD）、行为障碍、反社会人格障碍、重度抑郁症（MDD）和/或焦虑症的预测因素（PROSPERO #CRD42022320887）。当N≥3时，对具有类似效果测量的预测因子进行meta分析模型检验，否则，当N≥2时，对预测因子进行叙述性讨论。采用纽卡斯尔-渥太华量表评估研究质量。结果入选的36项研究包括119个预测因子，其中10个预测因子符合meta分析。兴奋剂治疗史（OR = 1.88, 95% CI 1.28-2.75, p = 0.001）与儿童时期智商升高（OR = 0.99, 95% CI 0.98-1.00, p = 0.039）与成年期ADHD持续风险降低相关。ADHD的持续存在与sud （OR = 2.12, 95% CI 1.53-3.17, p = 0.004）和MDD （OR = 3.19, 95% CI 1.71-5.95, p < 0.001）的风险增加相关。叙述性回顾了公平/高质量研究的预测因子，显示了ADHD持续性的潜在预测因子（即ADHD合并型、多动/冲动症状、焦虑障碍、外化问题、社会功能障碍和社会经济地位）。结论：我们证实了早期报道的ADHD精神预后的儿童预测因素（如兴奋剂治疗史、ADHD持续性），并确定了ADHD精神预后的潜在新预测因素（如儿童焦虑症、社会问题、社会经济地位）。然而，现有文献受到方法缺陷的阻碍。未来的研究应侧重于研究潜在预测因子的综合效应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Systematic Review and Meta-Analysis: Predictors of Adult Psychiatric Outcomes of Childhood Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE Psychiatric disorders are highly prevalent in adults with childhood-onset attention-deficit/hyperactivity disorder (ADHD). Currently, little is known about childhood predictors for these outcomes. METHOD PubMed, PsychInfo, WoS, and EMBASE were searched until June 2024. Eligible studies investigated childhood predictors of persistent ADHD, substance use disorders (SUD), conduct disorder, antisocial personality disorder, major depressive disorder (MDD), and/or anxiety disorders in adults diagnosed with childhood ADHD (PROSPERO #CRD42022320887). Meta-analytic models were tested when N ≥3 for a predictor with similar effect measures, otherwise predictors were discussed narratively when N ≥2. Newcastle-Ottawa scale was used to assess study quality. RESULTS The selected 36 studies included 119 predictors, with 10 predictors eligible for meta-analyses. History of stimulant treatment (OR = 1.88, 95% CI 1.28-2.75, p = .001) was associated with increased, and higher childhood IQ with decreased (OR = 0.99, 95% CI 0.98-1.00, p =.039), risk of ADHD persistence in adulthood. ADHD persistence was associated with increased risk of SUDs (OR = 2.12, 95% CI 1.53-3.17, p =.004) and MDD (OR = 3.19, 95% CI 1.71-5.95, p <.001). Narratively reviewed predictors of fair/good quality studies showed potential predictors for ADHD persistence (i.e., ADHD combined type, hyperactive/impulsive symptoms, anxiety disorders, externalizing problems, social dysfunctioning, and socioeconomic status). CONCLUSION We confirmed earlier reported childhood predictors (i.e., stimulant treatment history, ADHD persistence) and identified potential new predictors (i.e., childhood anxiety disorders, social problems, socioeconomic status) for psychiatric outcomes of ADHD. However, the available literature is hampered by methodological shortcomings. Future studies should focus on studying combined effects of potential predictors.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of the American Academy of Child and Adolescent Psychiatry 医学-精神病学

CiteScore

21.00

自引率

1.50%

发文量

1383

审稿时长

53 days

期刊介绍： The Journal of the American Academy of Child & Adolescent Psychiatry (JAACAP) is dedicated to advancing the field of child and adolescent psychiatry through the publication of original research and papers of theoretical, scientific, and clinical significance. Our primary focus is on the mental health of children, adolescents, and families. We welcome unpublished manuscripts that explore various perspectives, ranging from genetic, epidemiological, neurobiological, and psychopathological research, to cognitive, behavioral, psychodynamic, and other psychotherapeutic investigations. We also encourage submissions that delve into parent-child, interpersonal, and family research, as well as clinical and empirical studies conducted in inpatient, outpatient, consultation-liaison, and school-based settings. In addition to publishing research, we aim to promote the well-being of children and families by featuring scholarly papers on topics such as health policy, legislation, advocacy, culture, society, and service provision in relation to mental health. At JAACAP, we strive to foster collaboration and dialogue among researchers, clinicians, and policy-makers in order to enhance our understanding and approach to child and adolescent mental health.