Wigal Sharon B, Wigal Timothy L
Department of Pediatrics, University of California-Irvine, Irvine, CA, USA.
CNS Spectr. 2007 Jun;12(6 Suppl 9):1-14; quiz 15-6. doi: 10.1017/s1092852900026092.
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent chronic condition that affects people of all ages, including young children, school-aged children, adolescents, and adults. Symptoms can be noted as early as preschool age, tend to progress into functional impairment and behavioral problems in later childhood, and typically persist into adulthood. Contrary to previous belief, the disorder does not resolve with puberty for the majority of children; rather, the symptoms are manifested differently throughout the lifecycle. Presentation in adults is heavily biased toward inattentive symptoms, which are less likely to draw notice than hyperactive or impulsive symptoms and may contribute to the underrecognition of ADHD in this patient population. Diagnosis is particularly difficult due in large part to the pronounced comorbidity of psychiatric disorders in this patient population. Identification may be even more difficult in adults than children as the diagnostic criteria are not as clear, adults have difficulty remembering symptoms prior to 7 years of age, and there is a high prevalence of comorbid psychiatric disorders in adults. Early identification and treatment of symptoms of ADHD in preschool-age children is essential to effective long-term management of the disorder. Both medication and behavioral treatments appear to alleviate the symptoms of ADHD, and evidence suggests that discontinuation of treatment leads to the reemergence of the condition. Efforts are currently continuing toward understanding the genetic underpinnings of ADHD. This expert review supplement will address the prevalence, comorbidity, treatment issues, and special considerations surrounding ADHD management throughout each stage of the lifecycle beginning with ADHD in preschool-aged children, continuing with school-aged children and adolescents, and ending with adulthood.
注意力缺陷多动障碍（ADHD）是一种常见的慢性疾病，影响着所有年龄段的人群，包括幼儿、学龄儿童、青少年和成年人。症状早在学龄前就可能出现，在儿童后期往往会发展为功能障碍和行为问题，并通常会持续到成年期。与以往的看法相反，对于大多数儿童来说，这种疾病并不会随着青春期的到来而缓解；相反，症状在整个生命周期中表现各异。成人患者的症状主要表现为注意力不集中，与多动或冲动症状相比，这些症状不太容易引起注意，这可能导致该患者群体中ADHD的诊断不足。由于该患者群体中精神疾病的共病现象非常明显，诊断尤其困难。在成人中进行ADHD的识别可能比儿童更困难，因为诊断标准不那么明确，成人难以回忆起7岁之前的症状，而且成人中精神疾病共病的患病率很高。学龄前儿童ADHD症状的早期识别和治疗对于该疾病的有效长期管理至关重要。药物治疗和行为治疗似乎都能缓解ADHD的症状，而且有证据表明，停止治疗会导致病情复发。目前正在继续努力了解ADHD的遗传基础。本专家综述增刊将探讨ADHD在整个生命周期各阶段管理中所涉及的患病率、共病情况、治疗问题以及特殊注意事项，从学龄前儿童的ADHD开始，接着是学龄儿童和青少年，最后是成年人。
