A Follow-up, Family Study on Attention-deficit Hyperactivity Disorder
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 1,800
- 试验地点
- 1
研究概览
简要总结
Background: Attention deficit hyperactivity disorder (ADHD), characterized by inattention, hyperactivity and impulsivity, is an early onset, common (5-10% worldwide; 7.5% in Taiwan), clinically heterogeneous, impairing disorder. Despite the abundance of research on ADHD, the vast majority of samples have been limited to Caucasians; there is limited information about the expressions, patterns, correlates, and outcomes for ADHD in the Taiwanese population.
Specific Aims:
- to investigate the neuropsychological functioning, and psychiatric, academic, and social outcomes of ADHD at adolescence;
- to examine the psychopathology and neuropsychological functioning among parents and siblings of ADHD probands;
- to determine the components of ADHD and neuropsychological functioning with the greatest familial recurrence risks; and
- to validate the classification of ADHD and comorbid subtypes of ADHD using psychosocial, familial, neuropsychological and longitudinal data.
Subjects and Methods: This 5-year proposal consists of two parts: (1) a 3 year-retrospective cohort study and family study design; and (2) a 2 year-prospective cohort study design. Several Chinese version of rating scales will be prepared in the first 6 months. The sample will consist of probands with (n=180) and without (n=90) ADHD, ages 11-16, recruited from the Children's Mental Health Center, NTUH and an epidemiological study. The ADHD diagnosis has been made 3-6 years ago prior to recruitment. Probands and their parents will be assessed using the following measures (n=810) in the first 3 years. Only probands will be reassessed in the last 2 years. The measures will include a psychiatric interview using K-SADS-E and self-reports covering the individual and familial/environmental domains; and neuropsychological tests (WISC-III, CPT, WCST, CANTAB). The informants include probands and their parents and teachers.
Long-term Objectives: The long-term objectives are to identify the endophenotypes that are close to the biological expression of genes underlying ADHD, to determine the familial aggregation and its specificity regarding the components of ADHD, and neuropsychological deficit, and to identify the impact of ADHD on academic, psychiatric, family, and social outcomes; and to identify a cohort of families with ADHD for future neuroimaging, neurophysiological, and molecular genetic studies.
详细描述
(A) Specific Aims
The ultimate goals of this family study are to identify the endophenotypes that are closer to the biological expression of genes underlying ADHD, to identify patterns of familial aggregation with regards to ADHD and neuropsychological function, to examine the impact of ADHD on family functioning and parental psychosocial adjustment, and to characterize the long-term outcome of ADHD at adolescence in a Taiwanese sample. We propose to replicate previous studies on ADHD using a novel approach (an ambispective follow-up, bottom-up family study design using a mixed clinical and epidemiological sample) to validate the findings of previous studies in terms of the correlates, patterns, expression, outcome, and familial aggregation for ADHD and to attempt to determine whether neurological, and neuropsychological dysfunctioning also run in ADHD probands. With the accomplishment of these goals, this study will resolve controversies over inconsistent findings in previous studies and contribute to the literature on the validity of ADHD and ADHD comorbid subtypes using family data. The specific aims of this study are:
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Follow-up component:
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to explore the potential risk factors for the developing ADHD;
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to investigate the expression and patterns of ADHD at adolescence in terms of symptoms, neuropsychological, neurological, familial, school and social functions;
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to examine the symptoms continuity and the determinants of persistent ADHD symptoms;
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to identify the symptomatic, academic, and social outcomes of ADHD at early and late adolescence, including the use of tobacco, betel nut, alcohol and drug; and
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to validate the comorbid subtypes of ADHD using psychopathological, neuropsychological, behavioral, familial and social correlates.
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Family study component:
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to examine the psychopathology and neuropsychological functioning among parents and probably siblings of ADHD probands in comparison with those of control probands; and
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to identify the most familial correlated components of ADHD symptoms and neuropsychological measures.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
入排标准
- 年龄范围
- 10 Years 至 18 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Community-based sample for the development of several Chinese versions of instruments: SNAP-IV, SDQ, ASRI, and ASRS.
- •ADHD follow-up family studies (ADHD group): (1) that subjects either had the clinical diagnosis of DSM-IV ADHD, which was made by a full-time child psychiatrist at the first visit and following visits or by a child psychiatrist using the K-SADS-E as the second-stage case ascertainment at an epidemiological study; (2) the diagnoses of ADHD were made 3-6 years ago; (3) their ages range from 12 to 15 when we conduct study; (4) subjects have at least one sibling aged 6-18 and live with at least one biological parent; and (5) subjects and their family consent to participate in this study.
- •(control group)(1) that subjects were assessed either at a clinical setting or in an epidemiological study same as to those in the exposed group 6 years ago; (2) their ages range from 12 to 15 when we conduct study; (3) subjects have at least one sibling aged 6-18 and live with at least one biological parent; and (4) subjects and their family consent to participate in this study.
排除标准
- •The subjects, including those who in the exposed and unexposed groups, will be excluded from the study if they currently meet criteria or have a history of the following condition as defined by DSM-IV: Schizophrenia, Schizoaffective Disorder, Organic Psychosis, Mental Retardation, or Pervasive Developmental Disorder. Moreover, the subjects will be excluded from the unexposed group if have a history of the following condition as defined by DSM-IV: ADHD, ODD, or CD in addition to the above exclusion criteria.