Cincinnati Children's Hospital, Cincinnati, OH 45229, USA.
Curr Psychiatry Rep. 2011 Oct;13(5):333-44. doi: 10.1007/s11920-011-0221-3.
Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurobehavioral disorder affecting 5% to 10% of children. Although considered to be a highly familial disorder, ADHD heritability estimates of 60% to 80% highlight the considerable role that environmental factors may still play in disorder susceptibility. Proposed ADHD environmental risk factors include prenatal substance exposures, heavy metal and chemical exposures, nutritional factors, and lifestyle/psychosocial factors. This paper reviews the literature published in 2010 investigating the association between environmental risk factors and ADHD or related symptomatology. Sources of risk factor exposure and the proposed mechanism by which each exposure is linked to ADHD-related neurobehavioral changes are also reported. Methodologic limitations of the current literature are discussed, and guidelines for future study are proposed. An improved understanding of the role that environmental factors play in ADHD etiology is critical to future ADHD prevention efforts.
注意缺陷多动障碍（ADHD）是一种常见的神经行为障碍，影响 5%至 10%的儿童。尽管 ADHD 被认为是一种高度家族性疾病，但 ADHD 的遗传率估计为 60%至 80%，这突出表明环境因素在疾病易感性中仍可能发挥相当大的作用。ADHD 的环境风险因素包括产前物质暴露、重金属和化学物质暴露、营养因素以及生活方式/心理社会因素。本文综述了 2010 年发表的研究环境风险因素与 ADHD 或相关症状之间关系的文献。还报告了风险因素暴露的来源，以及每种暴露与 ADHD 相关神经行为变化之间的潜在联系的机制。讨论了当前文献的方法学局限性，并提出了未来研究的指导方针。深入了解环境因素在 ADHD 病因学中的作用对于未来的 ADHD 预防工作至关重要。
