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注意缺陷多动障碍与向成人心理健康服务的过渡:一项范围综述

ADHD and transitions to adult mental health services: a scoping review.

作者信息

Swift K D, Sayal K, Hollis C

机构信息

Child and Adolescent Mental Health Services (CAMHS), Nottinghamshire Healthcare NHS Trust, Nottingham, UK.

出版信息

Child Care Health Dev. 2014 Nov;40(6):775-86. doi: 10.1111/cch.12107. Epub 2013 Oct 25.

Abstract

There is increased awareness that attention deficit hyperactivity disorder (ADHD) continues into adulthood. Thus, health services are faced with a new challenge in providing a 'smooth' transition to adult services appropriate for young people with ADHD. This scoping review sought to identify the literature addressing transition for young people with ADHD to adult mental health services (AMHS). A scoping review, in which the search terms 'ADHD' and 'Transition' or 'Transfer' were entered into eight healthcare publication databases facilitated by NHS Evidence to identify both published and unpublished papers between 2000 and June 2013. Additional informal searches were also undertaken. Twenty-three papers were selected for this review. This review confirms the lack of research explicitly tracking transition from Paediatrics/Child and Adolescent Mental Health Services (CAMHS) to AMHS for young people with ADHD. Only four papers directly studying transition for ADHD patients were identified. Three further studies surveyed clinician perspectives. Taken together, the studies address a number of issues in relation to transition, including the developmental course of ADHD symptoms, appropriate adult care, knowledge and communication, unmet need, comorbidities, environmental demands and medication cessation/dosage during the transition period. While literature surrounding transition exists, the scope of the evidence showing successful and unsuccessful transition activity from Paediatric and CAMHS to AMHS for young people with ADHD is limited. Future quality research in the form of audits, longitudinal tracking studies and service evaluations are required if we are truly to understand and identify what is needed and currently available for successful transition to an appropriate adult service for ADHD patients.

摘要

人们越来越意识到注意力缺陷多动障碍(ADHD)会持续到成年期。因此,医疗服务机构在为患有ADHD的年轻人提供向适合其的成人服务的“平稳”过渡方面面临着新的挑战。本范围综述旨在找出关于患有ADHD的年轻人向成人心理健康服务(AMHS)过渡的文献。通过在由英国国家医疗服务体系证据平台提供便利的八个医疗保健出版物数据库中输入搜索词“ADHD”和“过渡”或“转移”进行范围综述,以识别2000年至2013年6月期间已发表和未发表的论文。还进行了额外的非正式搜索。本综述挑选了23篇论文。该综述证实,缺乏明确跟踪患有ADHD的年轻人从儿科/儿童及青少年心理健康服务(CAMHS)向AMHS过渡的研究。仅识别出四篇直接研究ADHD患者过渡情况的论文。另有三项研究调查了临床医生的观点。综合来看,这些研究涉及了与过渡相关的一些问题,包括ADHD症状的发展过程、适当的成人护理、知识与沟通、未满足的需求、共病、环境需求以及过渡期间的药物停用/剂量。虽然存在关于过渡的文献,但显示患有ADHD的年轻人从儿科和CAMHS向AMHS成功和不成功过渡活动的证据范围有限。如果我们真的想理解并确定成功过渡到适合ADHD患者的成人服务所需的以及当前可用的条件,未来需要进行以审计、纵向跟踪研究和服务评估形式的高质量研究。

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