دانلود رایگان مقاله انگلیسی توزیع علائم ADHD و همراهی همراه با آن، قرار گرفتن در معرض عوامل خطر و ناتوانی - الزویر 2018

Abstract

The aim of this study was to examine whether ADHD is a dimensional trait in the adult general population. We studied whether an increased number of ADHD symptoms was associated with higher comorbidity, exposure to risk factors (childhood abuse and parental psychopathology), and disability. We ascertained whether even low numbers of ADHD symptoms were associated with an increased burden of disease. Data were used from the second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2, N=5,303). NEMESIS-2 is a nationally representative face-toface survey on mental health of the Dutch general population. ADHD symptoms, mental comorbidity, and disability were assessed using the Adult ADHD Self-Report Scale Screener, the Composite International Diagnostic Interview version 3.0, and the Medical Outcomes Study Short Form Health Survey, respectively. Dose-response relationships were found between the number of ADHD symptoms and Axis I and II mental disorders; exposure to risk factors; and mental and physical disability. Our study supports the notion that ADHD is a dimensional trait in the adult general population. Even low numbers of symptoms were associated with an increased burden of disease, and therefore these should be identified and treated.

Discussion

This population-based study showed that an increased number of ADHD symptoms was associated with higher comorbidity, exposure to risk factors, and disability. Even low numbers of ADHD symptoms were associated with an increased burden of disease. These results confirm that ADHD is a dimensional trait in the general population. Concerning the distribution of ADHD symptoms and the associated sociodemographics, we found that 5.3% of subjects met the threshold of 4 or more symptoms on the ASRS screener, thereby having symptoms highly consistent with ADHD in adults. We further showed that a higher number of ADHD symptoms was significantly related to female gender, younger age, and living without a partner, suggesting that these characteristics may be considered risk factors for ADHD symptoms. No clear significant association was observed between two indicators of socioeconomic status (SES) and ADHD symptoms: educational level and job status (this showed a trend, p=0.06). This trend became significant when analyzing the association with the 4 ASRS strata instead of the association with the number of ADHD symptoms.. These findings coincide with earlier epidemiological reports among adults with ADHD or among adults with low numbers of ADHD symptoms (Bitter et al., 2010; Caci et al., 2014; Estevez et al., 2014; Fayyad et al., 2007; Polanczyk et al., 2010; Simon et al., 2009), with the exception of the relationship between female gender and ADHD symptoms. However, this gender difference was not present when comparing those with probable ADHD to those without probable ADHD, suggesting that females scored especially higher on a low numbers of symptoms.