Mayes Rick, Bagwell Catherine, Erkulwater Jennifer
Department of Political Science, University of Richmond, Richmond, VA 23173, USA.
Harv Rev Psychiatry. 2008;16(3):151-66. doi: 10.1080/10673220802167782.
Attention-deficit/hyperactivity disorder (ADHD) holds the distinction of being the most extensively studied pediatric mental disorder and one of the most controversial, in part because it is also the most commonly diagnosed mental disorder among minors. Currently, almost 8% of youth aged 4 to 17 years have a diagnosis of ADHD, and approximately 4.5% both have the diagnosis and are using a stimulant (methylphenidate or amphetamine) as treatment for the disorder. Yet a diagnosis of ADHD is not simply a private medical finding; it carries with it a host of policy ramifications. The enduring controversy over ADHD in the public arena therefore reflects the discomfort over what happens when science is translated into policies and rules that govern how children will be treated medically, educationally, and legally. This article (1) summarizes the existing knowledge of ADHD, (2) provides the relevant history and trends, (3) explains the controversy, (4) discusses what is and is not unique about ADHD and stimulant pharmacotherapy, (5) outlines future directions of research, and (6) concludes with a brief analysis of how two North Carolina counties have established community protocols that have improved the screening, treatment, and societal consensus over ADHD and stimulants.
注意力缺陷多动障碍（ADHD）是研究最为广泛的儿童精神障碍之一，也是最具争议性的精神障碍之一，部分原因在于它也是未成年人中最常被诊断出的精神障碍。目前，4至17岁的青少年中近8%被诊断患有ADHD，约4.5%既被诊断患有该疾病，又在使用兴奋剂（哌甲酯或苯丙胺）进行治疗。然而，ADHD的诊断并非仅仅是一项个人医疗结果；它还带来了一系列政策影响。因此，公众对ADHD的持久争议反映出当科学转化为管理儿童医疗、教育和法律待遇方式的政策和规则时所产生的不安。本文（1）总结了ADHD的现有知识，（2）提供了相关历史和趋势，（3）解释了争议所在，（4）讨论了ADHD及兴奋剂药物治疗的独特与非独特之处，（5）概述了未来研究方向，（6）最后简要分析了北卡罗来纳州的两个县如何制定社区协议，从而改善了对ADHD及兴奋剂的筛查、治疗以及社会共识。
