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成人注意力缺陷多动障碍诊断与治疗的当前问题及趋势

Current issues and trends in the diagnosis and treatment of adults with ADHD.

作者信息

Cumyn Lucy, Kolar Dusan, Keller Amanda, Hechtman Lily

机构信息

McGill University, Department of Educational & Counselling Psychology, 3700 McTavish St., Montreal, Quebec, H3A 1Y2.

出版信息

Expert Rev Neurother. 2007 Oct;7(10):1375-90. doi: 10.1586/14737175.7.10.1375.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) has been commonly thought of as a childhood disorder that diminished over time. It is one of the most common developmental disorders and it is estimated that ADHD affects 5-10% of children. Two-thirds of children with ADHD will continue to have symptoms of ADHD that persist throughout adolescence. Longitudinal studies have demonstrated that symptoms of ADHD can also remain in adulthood, affecting 4.4% of the adult population. However, diagnosing adults with ADHD can prove difficult because they often find that their symptoms are egosyntonic. In addition, the development of comorbid conditions, such as anxiety, depression, personality disorders or substance abuse, can often overshadow underlying ADHD symptoms. Nonetheless, treatments such as stimulant and nonstimulant medication (e.g., atomoxetine), and cognitive-behavior therapy have been effective in treating adults with ADHD. This article reviews the prevalence of adults with ADHD, followed by a discussion of the neurobiological and genetic underpinnings of the disorder. Issues regarding the diagnosis and treatment of ADHD are also addressed.

摘要

注意力缺陷多动障碍(ADHD)通常被认为是一种会随时间逐渐减轻的儿童期疾病。它是最常见的发育障碍之一,据估计,ADHD影响着5%至10%的儿童。三分之二患有ADHD的儿童在整个青春期都会持续出现ADHD症状。纵向研究表明,ADHD症状在成年期也可能持续存在,影响着4.4%的成年人口。然而,诊断成年ADHD患者可能会很困难,因为他们常常发现自己的症状与自身观念相符。此外,共病情况的出现,如焦虑、抑郁、人格障碍或药物滥用,往往会掩盖潜在的ADHD症状。尽管如此,兴奋剂和非兴奋剂药物(如托莫西汀)以及认知行为疗法等治疗方法在治疗成年ADHD患者方面已被证明是有效的。本文回顾了成年ADHD患者的患病率,随后讨论了该疾病的神经生物学和遗传学基础。还探讨了ADHD的诊断和治疗问题。

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