文献综述

注意缺陷多动障碍共患情绪障碍的研究进展

  • 陆丁杰 ,
  • 王瑜
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  • 上海市儿童医院 上海交通大学医学院附属儿童医院儿童保健医学部康复医学科 (上海 200062)
王瑜 电子信箱: wy_rain@126.con

收稿日期: 2025-03-17

  录用日期: 2025-05-20

  网络出版日期: 2026-03-06

基金资助

波克医疗科技(上海)有限公司横向课题(HXIIT202501);上海市加强公共卫生体系建设三年行动计划(2020-2022年)重点学科建设项目(GWV-10.1-XK19);上海市卫生健康委员会,老龄化和妇儿健康研究专项计划(2020YJZX0203)

Research progress on comorbidity of attention deficit hyperactivity disorder and mood disorders

  • LU Dingjie ,
  • WANG Yu
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  • Department of Rehabilitaion of Child Health Care Medical Division, Shanghai Children′s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200062, China

Received date: 2025-03-17

  Accepted date: 2025-05-20

  Online published: 2026-03-06

摘要

注意缺陷多动障碍(ADHD)是一种慢性神经发育障碍性疾病,其特征是与发育水平不相称的注意缺陷和/或多动冲动。情绪障碍是ADHD常见的共患精神疾病之一,增加了治疗的难度,对ADHD核心症状和预后有消极影响。本文综述了ADHD共患情绪障碍的流行病学、发病机制、评估诊断和治疗措施的研究进展,为临床全面诊断和综合干预提供理论依据。

本文引用格式

陆丁杰 , 王瑜 . 注意缺陷多动障碍共患情绪障碍的研究进展[J]. 临床儿科杂志, 2026 , 44(3) : 258 -263 . DOI: 10.12372/jcp.2026.25e0251

Abstract

Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder defined by developmentally inappropriate inattention and/or hyperactivity-impulsivity that impairs daily functioning. Mood disorders are highly prevalent comorbidities in ADHD, exacerbating treatment complexity and exerting adverse effects on core symptom severity and long-term prognosis. This review synthesizes the latest research advances in the epidemiology, pathophysiological mechanisms, assessment-diagnostic strategies, and therapeutic interventions for ADHD comorbid with mood disorders, aiming to provide an evidence-based theoretical foundation for comprehensive clinical diagnosis and integrated management.

参考文献

[1] 中华医学会儿科学分会发育行为学组. 注意缺陷多动障碍早期识别、规范诊断和治疗的儿科专家共识[J]. 中华儿科杂志, 2020, 58(3): 188-193.
  The Subspecialty Group of Developmental and Behavioral Pediatrics, the Society of Pediatrics, Chinese Medical Association. Consensus on pediatric clinical practice of early identification, standardized diagnosis and treatment of attention deficit hyperactivity disorder[J]. Zhonghua Erke Zazhi, 2020, 58(3): 188-193.
[2] Li F, Cui Y, Li Y, et al. Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals[J]. J Child Psychol Psychiatry, 2021, 63(1): 34-46.
[3] Faraone SV, Bellgrove MA, Brikell I, et al. Attention-deficit/hyperactivity disorder[J]. Nat Rev Dis Primers, 2024, 10(1): 11.
[4] Cortese S, Song M, Farhat LC, et al. Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: data, with critical re-analysis, from the Global Burden of Disease study[J]. Mol Psychiatry, 2023, 28(11): 4823-4830.
[5] Charlson F, van Ommeren M, Flaxman A, et al. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis[J]. Lancet, 2019, 394(10194): 240-248.
[6] Gnanavel S, Sharma P, Kaushal P, et al. Attention deficit hyperactivity disorder and comorbidity: a review of literature[J]. World J Clin Cases, 2019, 7(17): 2420-2426.
[7] Leffa DT, Caye A, Rohde LA. ADHD in children and adults: diagnosis and prognosis[J] Curr Top Behav Neurosci, 2022, 57: 1-18.
[8] León-Barriera R, Ortegon RS, Chaplin MM, et al. Treating ADHD and comorbid anxiety in children: a guide for clinical practice[J]. Clin Pediatr, 2022, 62(1): 39-46.
[9] Choi WS, Woo YS, Wang SM, et al. The prevalence of psychiatric comorbidities in adult ADHD compared with non-ADHD populations: a systematic literature review[J]. PloS one, 2022, 17(11): e0277175.
[10] Njardvik U, Wergeland GJ, Riise EN, et al. Psychiatric comorbidity in children and adolescents with ADHD: a systematic review and meta-analysis[J]. Clin Psychol Rev, 2025: 102571.
[11] 刘家洪, 潘安乐, 朱程, 等. 儿童注意缺陷多动障碍症状伴发焦虑的影响因素及与儿童期创伤的相关性研究[J]. 中国妇幼保健, 2022, (15): 2861.
  Liu JH, Pan AL, Zhu C, et al. Study on the influencing factors of anxiety comorbidity in children with attention deficit hyperactivity disorder and its correlation with childhood trauma[J]. Zhongguo Fuyou Baojian, 2022, (15): 2861.
[12] 刘双. 儿童注意缺陷多动障碍症状患儿发生焦虑症状的影响因素分析[J]. 中国妇幼保健, 2022, 37(13):2460-2463.
  Liu S. Analysis of influencing factors of anxiety symptoms in children with attention deficit hyperactivity disorder[J]. Zhongguo Fuyou Baojian, 2022, 37(13): 2460-2463.
[13] 程芳, 胡珍玉, 敬攀, 等. 宁波市2218例中学生注意缺陷多动症状与抑郁情绪的调查研究[J]. 中国现代医生, 2017, 55(3): 125-129.
  Cheng F, Hu ZY, Jing P, et al. Questionnaire survey of attention deficit hyperactivity disorder and depression in 2218 middle school students in Ningbo[J]. Zhongguo Xiandai Yisheng, 2017, 55(3): 125-129.
[14] 黄娟. 学龄期6-11岁注意缺陷多动障碍儿童行为问题分析[D]. 成都医学院, 2023.
  Huang J. Analysis of behavior problems of children with attention deficit hyperactivity disorder aged school age 6-11 years[D]. Chengdu Medical College, 2023.
[15] Miller CJ, Golovina E, Gokuladhas S, et al. Unraveling ADHD: genes, co-occurring traits, and developmental dynamics[J]. Life Sci Alliance, 2025, 8(5): e202403029.
[16] Cornejo F, Cortés BI, Findlay GM, et al. LAR receptor tyrosine phosphatase family in healthy and diseased brain[J]. Front Cell Dev Biol, 2021, 9: 659951.
[17] de Araujo Tavares ME, Cupertino RB, Bandeira CE, et al. Refining patterns of MEF2C effects in white matter microstructure and psychiatric features[J]. J Neural Transm (Vienna), 2023, 130(5): 697-706.
[18] Lozano R, Gbekie C, Siper PM, et al. FOXP1 syndrome: a review of the literature and practice parameters for medical assessment and monitoring[J]. J Neural Transm (Vienna), 2021, 13(1): 18.
[19] 韩慧玲, 张杉杉, 陈芙蓉, 等. 注意缺陷多动障碍发病机制及治疗药物研究进展[J]. 中国药业, 2023, 32(21): 149-155.
  Han HL, Zhang SS, Chen FR, et al. Research progress on the pathogenesis and therapeutic drugs of attention deficit hyperactivity disorder[J]. Zhongguo Yaoye, 2023, 32(21): 149-155.
[20] 马娜, 颜晓磊, 徐军茹, 等. 癫痫共患注意缺陷多动障碍患儿外周血DRD2 DAT基因表达与焦虑抑郁情绪的关系[J]. 中国实用神经疾病杂志, 2023, 26(6): 714.
  Ma N, Yan XL, Xu JR, et al. Relationship between peripheral blood dopamine D2 receptor, dopamine transporter genes and anxiety-depression in children with epilepsy and attention deficit hyperactivity disorder[J]. Zhongguo Shiyong Shenjing Jibing Zazhi, 2023, 26(6): 714.
[21] Shaw P, Stringaris A, Nigg J, et al. Emotion dysregulation in attention deficit hyperactivity disorder[J]. Am J Psychiatry, 2014, 171(3): 276-293.
[22] van Hulst BM, de Zeeuw P, Bos DJ, et al. Children with ADHD symptoms show decreased activity in ventral striatum during the anticipation of reward, irrespective of ADHD diagnosis[J]. J Child Psychol Psychiatry, 2016, 58(2): 206-214.
[23] Rohr CS, Bray SL, Dewey DM. Functional connectivity based brain signatures of behavioral regulation in children with ADHD, DCD, and ADHD-DCD[J]. Dev Psychopathol, 2021, 35(1): 85-94.
[24] 李婉怡, 张荣荣, 申旭冉, 等. 精神分裂症纹状体神经影像学研究进展[J]. 中华行为医学与脑科学杂志, 2024, 33(4): 374-378.
  Li WY, Zhang RR, Shen XR, et al. Progress in neuroimaging of striatum in schizophrenia[J]. Zhonghua Xingwei Yixue Yu Naokexue Zazhi, 2024, 33(4): 374-378.
[25] Hiser J, Koenigs M. The Multifaceted role of the ventromedial prefrontal cortex in emotion, decision making, social cognition, and psychopathology[J]. Biol Psychiatry, 2018, 83(8): 638-647.
[26] Dunn GA, Nigg JT, Sullivan EL. Neuroinflammation as a risk factor for attention deficit hyperactivity disorder[J]. Pharmacol Biochem Behav, 2019, 182: 22-34.
[27] Kokkosis AG, Madeira MM, Hage Z, et al. Chronic psychosocial stress triggers microglial‐/macrophage‐induced inflammatory responses leading to neuronal dysfunction and depressive‐related behavior[J]. Glia, 2023, 72(1): 111-132.
[28] Spencer NJ, Ludvigsson J, Bai G, et al. Social gradients in ADHD by household income and maternal education exposure during early childhood: Findings from birth cohort studies across six countries[J]. Plos One, 2022, 17(3): e0264709.
[29] 张亚利, 张建根, 李红霞, 等. 社会经济地位与抑郁的关系:系统综述和元分析[J]. 心理科学进展, 2022, 30(12): 2650-2665.
  Zhang YL, Zhang JG, Li HX, et al. The relationship between socioeconomic status and depression: a systematic review and meta-analysis[J]. Xinli Kexue Jinzhan, 2022, 30(12): 2650-2665.
[30] Claussen AH, Holbrook JR, Hutchins HJ, et al. All in the family? A systematic Review and neta-analysis of parenting and family environment as risk factors for attention-deficit/hyperactivity disorder (ADHD) in children[J]. Prev Sci, 2024, 25(2): 249-271.
[31] 李春兰, 刘红艳, 张珂, 等. 基于多维度ADHD危险因素的优生策略探讨[J]. 中国优生与遗传杂志, 2024, 32(11): 2438-2445.
  Li CL, Liu HY, Zhang K, et al. Discussion on eugenic strategies based on multidimensional risk factors of ADHD[J]. Zhongguo Yousheng Yu Yichuan Zazhi, 2024, 32(11): 2438-2445.
[32] Mayer JS, Bernhard A, Fann N, et al. Cognitive mechanisms underlying depressive disorders in ADHD: A systematic review[J]. Neurosci Biobehav Rev, 2021, 121: 307-345.
[33] 兰红艳, 吴丹, 汪秀莲, 等. 基于近红外光谱的注意缺陷多动障碍患儿前额叶皮质功能研究[J]. 中国儿童保健杂志, 2021, 29(2): 134-137.
  Lan HY, Wu D, Wang XL, et al. study on prefrontal cortical function in children with attention deficit hyperactivity disorder based on near-infrared spectroscopy[J]. Zhonguo Ertong Baojian Zazhi, 2021, 29(2): 134-137.
[34] 程奥博, 樊家琦, 刘力慧, 等. 青少年抑郁患者在言语流畅性任务下脑氧合血红蛋白水平的变化[J]. 中华行为医学与脑科学杂志, 2022, 31(7): 629-633.
  Cheng AB, Fan JQ, Liu LH, et al. Changes of brain oxygenated hemoglobin concentration in adolescent patients with depression under speech fluency task[J]. Zhonghua Xingwei Yixue Yu Naokexue Zazhi, 2022, 31(7): 629-633.
[35] Moghaddari M, Lighvan MZ, Danishvar S. Diagnose ADHD disorder in children using convolutional neural network based on continuous mental task EEG[J]. Comput Methods Programs Biomed, 2020, 197: 105738.
[36] Sibley MH, Bruton AM, Zhao X, et al. Non-pharmacological interventions for attention-deficit hyperactivity disorder in children and adolescents[J]. Lancet Child Adolesc Health, 2023, 7(6): 415-428.
[37] Sciberras E, Mulraney M, Anderson V, et al. Managing anxiety in children with ADHD using cognitive-behavioral therapy: a pilot randomized controlled trial[J]. J Atten Disord, 2018, 22(5): 515-520.
[38] 许梦佳, 孙超妃. 基于信息-动机-行为技巧模型的认知行为疗法对注意缺陷多动障碍儿童焦虑状况的影响[J]. 中国妇幼保健, 2024, 39(6): 977-980.
  Xu MJ, Sun CF. The impact of cognitive behavioral therapy based on the information-motivation-behavior skills model on anxiety in children with attention deficit hyperactivity disorder[J]. Zhongguo Fuyou Baojian, 2024, 39(6): 977-980.
[39] Sun W, Yu M, Zhou X. Effects of physical exercise on attention deficit and other major symptoms in children with ADHD: a meta-analysis[J]. Psychiatry Res, 2022, 311: 114509.
[40] 梁煜卿, 王欢, 徐玲玲. 认知参与运动对儿童抑制控制功能和前额叶脑区激活的影响:情绪的遮掩效应[J]. 中国体育科技, 2024, 60(5): 39-49.
  Liang YQ, Wang H, Xu LL. Effects of cognitive engagement exercise on children's inhibitory control function and activation of prefrontal cortex: the masking effect of mood[J]. Zhongguo Tiyu Keji, 2024, 60(5): 39-49.
[41] Stubbs B, Vancampfort D, Rosenbaum S, et al. An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: a meta-analysis[J]. Psychiatry Res, 2017, 249: 102-108.
[42] Kollins SH, DeLoss DJ, Ca?adas E, et al. A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial[J]. Lancet Digit Health, 2020, 2(4): E168-E178.
[43] 谷倩, 茅洁, 黄涛, 等. 沉浸式虚拟现实游戏对青年人执行功能的影响:游戏中运动强度的作用[J]. 中国体育科技, 2023, 59(12): 35-43.
  Gu Q, Mao J, Huang T, et al. Effects of immersive virtual reality exergaming on executive function among young adults: the role of exercise intensity in exergaming[J]. Zhonguo Tiyu Keyi, 2023, 59(12): 35-43.
[44] Malik N, Amber S, Zahid S. Rosmarinus officinalis and methylphenidate exposure improves cognition and depression and regulates anxiety-like behavior in AlCl3-induced mouse model of Alzheimer’s disease[J]. Front Pharmacol, 2022, 13: 943163.
[45] 李媛, 张雯雯, 张雨晨. 基于美国FDA不良事件报告系统数据库的儿童使用哌甲酯不良事件风险信号挖掘[J]. 药物不良反应杂志, 2024, 26(12): 737-742.
  Li Y, Zhang WW, Zhang YC. Risk signal mining of adverse events related to methylphenidate in children based on US FDA Adverse Event Reporting System database[J]. Yaowu Buliang Fanying Zazhi, 2024, 26(12): 737-742.
[46] Wang Z, Zuschlag ZD, Myers US, et al. Atomoxetine in comorbid ADHD/PTSD: a randomized, placebo controlled, pilot, and feasibility study[J]. Depress Anxiety, 2022, 39(4): 286-295.
[47] Carlucci L, Saggino A, Balsamo M. On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: a systematic review and meta-analysis[J]. Clin Psychol Rev, 2021, 87: 101999.
[48] Lee DY, Kim C, Shin Y, et al. Combined methylphenidate and selective serotonin reuptake inhibitors in adults with attention-deficit/hyperactivity disorder[J]. AMA Netw Open, 2024, 7(10): e2438398.
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