Hamed Alaa M, Kauer Aaron J, Stevens Hanna E
Child and Adolescent Psychiatry Division, Department of Psychiatry, University of Iowa Carver College of Medicine , Iowa City, IA , USA.
Child and Adolescent Psychiatry Division, Department of Psychiatry, University of Iowa Carver College of Medicine , Iowa City, IA , USA ; Neuroscience Program, Pappajohn Biomedical Institute, University of Iowa , Iowa City, IA , USA.
Front Psychiatry. 2015 Nov 26;6:168. doi: 10.3389/fpsyt.2015.00168. eCollection 2015.
Attention Deficit Hyperactivity disorder (ADHD) is one of the most common and challenging childhood neurobehavioral disorders. ADHD is known to negatively impact children, their families, and their community. About one-third to one-half of patients with ADHD will have persistent symptoms into adulthood. The prevalence in the United States is estimated at 5-11%, representing 6.4 million children nationwide. The variability in the prevalence of ADHD worldwide and within the US may be due to the wide range of factors that affect accurate assessment of children and youth. Because of these obstacles to assessment, ADHD is under-diagnosed, misdiagnosed, and undertreated.
We examined factors associated with making and receiving the diagnosis of ADHD. We sought to review the consequences of a lack of diagnosis and treatment for ADHD on children's and adolescent's lives and how their families and the community may be involved in these consequences.
We reviewed scientific articles looking for factors that impact the identification and diagnosis of ADHD and articles that demonstrate naturalistic outcomes of diagnosis and treatment. The data bases PubMed and Google scholar were searched from the year 1995 to 2015 using the search terms "ADHD, diagnosis, outcomes." We then reviewed abstracts and reference lists within those articles to rule out or rule in these or other articles.
Multiple factors have significant impact in the identification and diagnosis of ADHD including parents, healthcare providers, teachers, and aspects of the environment. Only a few studies detailed the impact of not diagnosing ADHD, with unclear consequences independent of treatment. A more significant number of studies have examined the impact of untreated ADHD. The experience around receiving a diagnosis described by individuals with ADHD provides some additional insights.
ADHD diagnosis is influenced by perceptions of many different members of a child's community. A lack of clear understanding of ADHD and the importance of its diagnosis and treatment still exists among many members of the community including parents, teachers, and healthcare providers. More basic and clinical research will improve methods of diagnosis and information dissemination. Even before further advancements in science, strong partnerships between clinicians and patients with ADHD may be the best way to reduce the negative impacts of this disorder.
注意力缺陷多动障碍(ADHD)是儿童期最常见且最具挑战性的神经行为障碍之一。已知ADHD会对儿童及其家庭和社区产生负面影响。约三分之一至二分之一的ADHD患者成年后仍会有持续症状。据估计,美国的患病率为5%-11%,全国有640万儿童患病。全球及美国境内ADHD患病率的差异可能是由于影响儿童和青少年准确评估的多种因素所致。由于这些评估障碍,ADHD存在诊断不足、误诊和治疗不足的情况。
我们研究了与ADHD诊断及被诊断相关的因素。我们试图回顾ADHD未被诊断和治疗对儿童及青少年生活的影响,以及他们的家庭和社区如何受到这些影响。
我们查阅了寻找影响ADHD识别和诊断因素的科学文章,以及展示诊断和治疗自然结果的文章。使用搜索词“ADHD、诊断、结果”在1995年至2015年期间搜索了PubMed和谷歌学术数据库。然后我们查阅了这些文章中的摘要和参考文献列表,以排除或纳入这些或其他文章。
多种因素对ADHD的识别和诊断有重大影响,包括父母、医疗保健提供者、教师和环境因素。只有少数研究详细阐述了未诊断ADHD的影响,其后果不明确且与治疗无关。更多研究探讨了未经治疗的ADHD的影响。ADHD患者描述的诊断经历提供了一些额外的见解。
ADHD的诊断受到儿童所处社区中许多不同成员观念的影响。包括父母、教师和医疗保健提供者在内的许多社区成员对ADHD及其诊断和治疗的重要性仍缺乏清晰的认识。更多的基础和临床研究将改进诊断方法和信息传播。甚至在科学取得进一步进展之前,临床医生与ADHD患者之间建立紧密的合作关系可能是减少该疾病负面影响的最佳方式。