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注意缺陷多动障碍学龄前儿童的心理药理学及其他治疗:当前证据与实践

Psychopharmacological and other treatments in preschool children with attention-deficit/hyperactivity disorder: current evidence and practice.

作者信息

Ghuman Jaswinder K, Arnold L Eugene, Anthony Bruno J

机构信息

Department of Psychiatry, University of Arizona, Tucson, Arizona 85724-5002, USA.

出版信息

J Child Adolesc Psychopharmacol. 2008 Oct;18(5):413-47. doi: 10.1089/cap.2008.022.

Abstract

OBJECTIVE

This article reviews rational approaches to treating attention-deficit/hyperactivity disorder (ADHD) in preschool children, including pharmacological and nonpharmacological treatments. Implications for clinical practice are discussed.

DATA SOURCES

We searched MEDLINE, PsychINFO, Cumulative Index to Nursing & Allied Health, Educational Resources Information Center, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects for relevant literature published in English from 1967 to 2007 on preschool ADHD. We also reviewed the references cited in identified reports.

STUDY SELECTION

Studies were reviewed if the sample included at least some children younger than 6 years of age or attending kindergarten, the study participants had a diagnosis of ADHD or equivalent symptoms, received intervention aimed at ADHD symptoms, and included a relevant outcome measure.

DATA EXTRACTION

Studies were reviewed for type of intervention and outcome relevant to ADHD and were rated for the level of evidence for adequacy of the data to inform clinical practice.

CONCLUSIONS

The current level of evidence for adequacy of empirical data to inform clinical practice for short-term treatment of ADHD in preschool children is Level A for methylphenidate and Level B for parent behavior training, child training, and additive-free elimination diet.

摘要

目的

本文综述了治疗学龄前儿童注意力缺陷多动障碍(ADHD)的合理方法,包括药物治疗和非药物治疗。并讨论了对临床实践的启示。

数据来源

我们检索了MEDLINE、PsychINFO、护理及相关健康累积索引、教育资源信息中心、Cochrane系统评价数据库和循证医学数据库,以查找1967年至2007年期间发表的关于学龄前ADHD的英文相关文献。我们还查阅了已识别报告中引用的参考文献。

研究选择

如果样本中至少包括一些6岁以下儿童或幼儿园儿童,研究参与者被诊断为ADHD或有等效症状,接受了针对ADHD症状的干预,并包括相关结局指标,则对研究进行综述。

数据提取

对研究的ADHD相关干预类型和结局进行综述,并对数据充分性以指导临床实践的证据水平进行评级。

结论

目前关于经验数据是否足以指导学龄前儿童ADHD短期治疗临床实践的证据水平,哌甲酯为A级,父母行为训练、儿童训练和无添加剂排除饮食为B级。

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