在9/11后的退伍军人中评估注意力缺陷/多动性障碍:患病率,测量对应度和创伤后应激障碍的并发症
Arielle R Knight1, Sahra Kim1, Alyssa Currao1
1Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA 02130, USA.
Military medicine
|November 28, 2024
概括
注意缺陷/多动障碍 (ADHD) 在退伍军人中很常见,与PTSD有关. 对ADHD的自我报告测量结果显示一致性较差,使得该群体的诊断复杂化.
科学领域:
- 精神病学是一个精神病学.
- 军人卫生保健 军人卫生保健
- 神经发育障碍 神经发育障碍
背景情况:
- 经常在退伍军人中观察到注意力缺陷/多动症 (ADHD).
- 与创伤后应激障碍 (PTSD) 等疾病重叠的症状可以阻碍准确的ADHD诊断.
- 在9/11之后部署的战斗退伍军人代表了研究这些并发病症的关键人口统计.
研究的目的:
- 为了确定在9/11后部署的战斗退伍军人中ADHD的患病率.
- 评估不同ADHD自我报告工具之间的一致性.
- 在这个退伍军人队伍中调查ADHD和PTSD之间的关联.
主要方法:
- 这项研究包括332名911事件后部署的战斗退伍军人.
- 参与者完成了临床医生管理的PTSD评分表和两个ADHD自我报告问卷 (温德尔犹他评分表-25 [WURS-25]和成人ADHD自我报告表v1.1 [ASRSv1.1]).
- WURS-25作为标准标准,其结果与历史的ADHD诊断和ASRS-v1.1进行了比较;日志双项回归分析了ADHD和PTSD关系.
主要成果:
- 12.7%的退伍军人符合基于WURS-25.5的ADHD标准.
- 在WURS-25中,用于识别历史的ADHD诊断的敏感度低 (27.7%),但具有足够的特异性 (90.3%).
- WURS-25和ASRS-v1.1之间的一致性很差 (灵敏度为60.7%,特异性为60.8%). 患有PTSD史的人群中,ADHD的患病率是2.53倍,患有PTSD史的人群中是2.19倍.
结论:
- 在退伍军人中,ADHD很普遍,并且与当前和终身PTSD风险增加有显著的关联.
- 自我报告的多动症和多动症指标之间差的一致性突出显示了这种共患病群体的诊断挑战.
- 在诊断退伍军人的ADHD时,临床医生必须将PTSD视为潜在的贡献因素,以确保准确的评估和治疗.
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