Batstra Laura, Nieweg Edo H, Hadders-Algra Mijna
Department of Special Needs Education and Child Care, University of Groningen, Groningen, the Netherlands.
Acta Paediatr. 2014 Jul;103(7):696-700. doi: 10.1111/apa.12642. Epub 2014 Apr 17.
The number of children diagnosed with attention deficit hyperactivity disorder (ADHD) and treated with medication is steadily increasing. The aim of this paper was to critically discuss five debatable assumptions on ADHD that may explain these trends to some extent. These are that ADHD (i) causes deviant behaviour, (ii) is a disease, (iii) is chronic and (iv) is best treated by medication and (v) that classification should precede treatment.
We argue that ADHD is not a disease, not the cause of deviant behaviour and in most cases not chronic. Treatment for attention and hyperactivity problems could start with psychosocial interventions and without a diagnostic label. A stepped diagnosis approach may reduce overdiagnosis without risking undertreatment.
被诊断患有注意力缺陷多动障碍(ADHD)并接受药物治疗的儿童数量正在稳步增加。本文的目的是批判性地讨论关于ADHD的五个有争议的假设,这些假设在一定程度上可能解释了这些趋势。这些假设是:ADHD(i)导致行为偏差,(ii)是一种疾病,(iii)是慢性疾病,(iv)药物治疗是最佳治疗方法,以及(v)分类应先于治疗。
我们认为ADHD不是一种疾病,不是行为偏差的原因,在大多数情况下也不是慢性疾病。针对注意力和多动问题的治疗可以从心理社会干预开始,且无需诊断标签。逐步诊断方法可能会减少过度诊断,同时不会有治疗不足的风险。