Rader Robert, McCauley Larry, Callen Erin C
Saint Anthony Family Medicine Residency, Oklahoma City, Oklahoma 73102, USA.
Am Fam Physician. 2009 Apr 15;79(8):657-65.
Symptoms of childhood attention-deficit/hyperactivity disorder affect cognitive, academic, behavioral, emotional, social, and developmental functioning. Attention-deficit/hyperactivity disorder is the most commonly diagnosed neurodevelopmental disorder in children and adolescents. An estimated 2 to 16 percent of school-aged children have been diagnosed with the disorder. The prevalence of attention-deficit/hyperactivity disorder in the primary care setting is similar to that in the general community, depending on the diagnostic criteria and population studied. The causality of attention-deficit/hyperactivity disorder is relatively unknown. Most recent studies focus on the role of dopamine; norepinephrine; and, most recently, serotonin neurotransmitters. The disorder is classified into three general subtypes: predominantly hyperactive-impulsive, predominantly inattentive, and combined. Screening tools and rating scales have been devised to assist with the diagnosis. Appropriate treatment can dramatically improve the function and quality of life of the patient and family. Pharmacologic treatment includes stimulants, such as methylphenidate and mixed amphetamine salts, or nonstimulants, such as atomoxetine. Behavioral approaches, particularly those that reward desirable behavior, are also effective. A combination of pharmacologic and behavioral therapies is recommended.
儿童注意力缺陷/多动障碍的症状会影响认知、学业、行为、情绪、社交和发育功能。注意力缺陷/多动障碍是儿童和青少年中最常被诊断出的神经发育障碍。据估计，2%至16%的学龄儿童被诊断患有该障碍。在初级保健机构中，注意力缺陷/多动障碍的患病率与普通社区相似，这取决于所研究的诊断标准和人群。注意力缺陷/多动障碍的病因相对不明。最近的研究主要关注多巴胺、去甲肾上腺素，以及最近的血清素神经递质的作用。该障碍通常分为三种亚型：以多动-冲动为主型、以注意力不集中为主型和混合型。已设计出筛查工具和评定量表来辅助诊断。适当的治疗可显著改善患者及其家庭的功能和生活质量。药物治疗包括兴奋剂，如哌甲酯和混合苯丙胺盐，或非兴奋剂，如托莫西汀。行为疗法，尤其是那些奖励期望行为的疗法，也很有效。建议将药物治疗和行为疗法相结合。
