Mahaj Muhammad, Sharkia Rajech, Shorbaji Nadeem, Zelnik Nathanel
Isr Med Assoc J. 2016 Jun;18(6):322-5.
Despite the increased worldwide recognition of attention deficit/hyperactivity disorder (ADHD), there is a variability in the diagnostic rate of both ADHD and its co-morbidities. These diversities are probably related to the methodology and instruments used for the diagnosis of ADHD and to awareness and cultural interpretation of its existence.
To identify consistent differences in the clinical profile of Arab and Jewish children with ADHD in Israel who differ in cultural, ethnic and socioeconomic background.
We analyzed the data of 823 children and adolescents with ADHD (516 Jews and 307 Arabs) and compared the clinical characteristics between these two ethnic groups. All patients were evaluated in two neuropediatric and child development centers in northern Israel: one in Haifa and one in Hadera. Children with autism and intellectual disabilities were excluded.
The distribution of ADHD subtypes was similar in both populations. However, learning disorders and psychiatric co-morbidities (behavioral difficulties and anxiety) were reported more frequently in the Jewish population. The most commonly reported adverse effects to psychostimulants were mood changes, anorexia, headache, insomnia and rebound effect, and were more frequently reported in the Jewish population (42.0% vs.18.0%, P < 0.05).
We assume that these differences are related to cultural and socioeconomic factors. We suggest that the physician take cultural background into consideration when treating patients with ADHD.
尽管全球对注意力缺陷多动障碍（ADHD）的认识有所提高，但ADHD及其共病的诊断率存在差异。这些差异可能与用于ADHD诊断的方法和工具以及对其存在的认识和文化解读有关。
确定以色列文化、种族和社会经济背景不同的患有ADHD的阿拉伯和犹太儿童临床特征上的一致差异。
我们分析了823名患有ADHD的儿童和青少年（516名犹太人和307名阿拉伯人）的数据，并比较了这两个种族群体的临床特征。所有患者均在以色列北部的两个神经儿科和儿童发育中心接受评估：一个在海法，一个在哈代拉。排除患有自闭症和智力残疾的儿童。
两个群体中ADHD亚型的分布相似。然而，犹太人群中学习障碍和精神共病（行为困难和焦虑）的报告更为频繁。对精神兴奋剂最常报告的不良反应是情绪变化、厌食、头痛、失眠和反跳效应，且在犹太人群中的报告更为频繁（42.0%对18.0%，P<0.05）。
我们认为这些差异与文化和社会经济因素有关。我们建议医生在治疗ADHD患者时考虑文化背景。
