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[注意缺陷多动障碍(ADHD)与道路交通——ADHD青少年治疗的特殊考量]

[Attention Deficit Hyperactivity Disorder (ADHD) and road traffic - special considerations for the treatment of adolescents with ADHD].

作者信息

Ludolph Andrea G, Kölch Michael, Plener Paul L, Schulze Ulrike M, Spröber Nina, Fegert Jörg M

机构信息

Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie, Universitätsklinikum Ulm, Ulm.

出版信息

Z Kinder Jugendpsychiatr Psychother. 2009 Sep;37(5):405-11. doi: 10.1024/1422-4917.37.5.405.

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is not only a childhood disorder but symptoms persist into adolescence and adulthood in approximately one third of the patients. Especially inattention and poor concentration impair driving performance in road traffic. Adolescents and young adults with ADHD are twice as likely to be involved in traffic accidents as people of the same age. This review sums up the legal situation in Germany and provides an overview of the current existing experimental studies on driving performance of adolescents and young adults with ADHD. Psychostimulant therapy seems to improve driving performance in ADHD patients. At the same time psychostimulants are prohibited, according to the road traffic act. Atomoxetine as a non-stimulant is not mentioned there. Therefore it could be unproblematically prescribed, however, the evidence for improved driving is not as unequivocal as for methylphenidate. The psychoeducation of adolescents and young adults with ADHD concerning their increased risk in road traffic often seems to be insufficient in clinical practice. Given the high number of traffic deaths in these young age groups consulting regarding this matter should be of high priority.

摘要

注意力缺陷多动障碍(ADHD)不仅是一种儿童期疾病,约三分之一的患者症状会持续到青少年期及成年期。特别是注意力不集中和专注力差会影响道路交通中的驾驶表现。患有ADHD的青少年和青年发生交通事故的可能性是同龄人两倍。这篇综述总结了德国的法律情况,并概述了目前关于患有ADHD的青少年和青年驾驶表现的现有实验研究。精神兴奋剂疗法似乎能改善ADHD患者的驾驶表现。与此同时,根据道路交通法,精神兴奋剂是被禁止的。那里没有提及作为非兴奋剂的托莫西汀。因此,它可以毫无问题地被开处方,然而,其改善驾驶的证据并不像哌甲酯那样明确。在临床实践中,对患有ADHD的青少年和青年进行关于其道路交通风险增加的心理教育往往似乎不足。鉴于这些年轻年龄组交通死亡人数众多,关于此事的咨询应该是高度优先事项。

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