Hässler Frank, Thome Johannes
Klinik für Psychiatrie, Neurologie, Psychosomatik und Psychotherapie im Kindes- und Jugendalter, Universität Rostock.
Z Kinder Jugendpsychiatr Psychother. 2012 Mar;40(2):83-93; quiz 93-4. doi: 10.1024/1422-4917/a000155.
Hyperactivity syndromes and disorders (ADHD and HKD) include the symptoms of overactivity, inattention, and impulsivity, which occur in many other mental disorders as well, including mental retardation (MR). It is not surprising that symptoms of ADHD occur significantly higher in children with learning disabilities. Dekker and Koot (2003) found a prevalence of 14.8 % for ADHD in Dutch children attending special schools, and Emerson (2003) reported rates of 8.7 % for HKD in children with global learning disability, representing a 10-fold increased risk compared to the prevalence of hyperactivity (0.9 %) in the general population sample. Yet only very few studies have been published concerning ADHD in children with mental retardation. Several features distinguish the diagnoses of ADHD and MR. In contrast to the limited knowledge about the differences and similarities of ADHD and MR, many studies considered stimulant medication as a pharmacological management strategy for children suffering from ADHD, MR, or both. According to these studies, psychostimulants may improve the target symptoms of hyperactivity, impulsivity, disinhibition, and inattention, albeit with caveats: ADHD symptoms in patients with MR may be less responsive to medical treatment than in patients without MR. Moreover, people with MR may be more susceptible to side effects.
多动综合征及相关障碍（注意力缺陷多动障碍和多动障碍）包括多动、注意力不集中和冲动等症状，这些症状在许多其他精神障碍中也会出现，包括智力障碍。患有学习障碍的儿童中注意力缺陷多动障碍症状的发生率显著更高也就不足为奇了。德克尔和库特（2003年）发现，在荷兰就读特殊学校的儿童中，注意力缺陷多动障碍的患病率为14.8%，而埃默森（2003年）报告称，在患有全面学习障碍的儿童中，多动障碍的发生率为8.7%，与一般人群样本中多动障碍的患病率（0.9%）相比，风险增加了10倍。然而，关于智力障碍儿童注意力缺陷多动障碍的研究发表得很少。有几个特征可以区分注意力缺陷多动障碍和智力障碍的诊断。与对注意力缺陷多动障碍和智力障碍之间差异和相似性的了解有限形成对比的是，许多研究将兴奋剂药物作为治疗患有注意力缺陷多动障碍、智力障碍或两者兼有的儿童的药物管理策略。根据这些研究，精神兴奋剂可能会改善多动、冲动、行为抑制障碍和注意力不集中等目标症状，尽管有一些注意事项：患有智力障碍的患者的注意力缺陷多动障碍症状对药物治疗的反应可能不如没有智力障碍的患者。此外，患有智力障碍的人可能更容易出现副作用。
