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心理治疗对注意力缺陷多动障碍(ADHD)有效吗?对患有ADHD的儿童和青少年的非药物治疗的综述。

Is psychological treatment efficacious for attention deficit hyperactivity disorder (ADHD)? Review of non-pharmacological treatments in children and adolescents with ADHD.

作者信息

Serrano-Troncoso Eduardo, Guidi Monica, Alda-Díez José Ángel

机构信息

Unidad de TDAH, Servicio de Psiquiatría y Psicología, Hospital Sant Joan de Déu, Barcelona, Spain.

出版信息

Actas Esp Psiquiatr. 2013 Jan-Feb;41(1):44-51. Epub 2013 Jan 1.

Abstract

INTRODUCTION

Attention deficit hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder in children and adolescents, and has a great impact on the psychological development of affected patients. Even though its efficacy is proven, the use of medication for ADHD has several limitations, and non-pharmacological interventions are considered a necessary component of treatment.

METHODOLOGY

This work is a review of evidence-based non-pharmacological treatments with demonstrated efficacy for ADHD in children and adolescents, analyzed by age groups.

RESULTS

Non-pharmacological treatments that have shown scientific evidence of efficacy are psychological and psychoeducational interventions. Psychological interventions include behavioral therapy, parent training (PT) and social skills training. Psychoeducational interventions include a set of practices to improve learning and are carried out in the school setting. Scientific evidence of efficacy in preschool children is limited to PT, while different psychological and psychoeducational interventions have been shown to be beneficial in school-age children. The available evidence for non-pharmacological treatment in adolescence is so far insufficient.

CONCLUSIONS

Though more randomized controlled trials are necessary for non-pharmacological interventions to become established practices, there are clear indications of their efficacy. For more severe cases of ADHD, a combination of non-pharmacological and pharmacological treatment is recommended.

摘要

引言

注意缺陷多动障碍(ADHD)是儿童和青少年中最常见的精神障碍,对受影响患者的心理发展有很大影响。尽管药物治疗ADHD的疗效已得到证实,但药物治疗存在一些局限性,非药物干预被认为是治疗的必要组成部分。

方法

这项工作是对已证明对儿童和青少年ADHD有效的循证非药物治疗的综述,并按年龄组进行分析。

结果

已显示出科学疗效证据的非药物治疗方法包括心理和心理教育干预。心理干预包括行为疗法、家长培训(PT)和社交技能培训。心理教育干预包括一套在学校环境中开展的提高学习能力的实践。学龄前儿童疗效的科学证据仅限于家长培训,而不同的心理和心理教育干预已被证明对学龄儿童有益。目前关于青少年非药物治疗的证据尚不充分。

结论

尽管非药物干预要成为既定疗法还需要更多的随机对照试验,但已有明确迹象表明其疗效。对于更严重的ADHD病例,建议采用非药物和药物治疗相结合的方法。

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