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基于专家共识的注意缺陷/多动障碍及相关胎儿酒精谱系障碍个体的识别与治疗指南

Guidelines for identification and treatment of individuals with attention deficit/hyperactivity disorder and associated fetal alcohol spectrum disorders based upon expert consensus.

作者信息

Young Susan, Absoud Michael, Blackburn Carolyn, Branney Polly, Colley Bill, Farrag Emad, Fleisher Susan, Gregory Ges, Gudjonsson Gisli H, Kim Keira, O'Malley Kieran D, Plant Moira, Rodriguez Alina, Ozer Susan, Takon Inyang, Woodhouse Emma, Mukherjee Raja

机构信息

Imperial College London, London, UK.

Broadmoor Hospital, West London Mental Health Trust, Crowthorne, Berkshire, UK.

出版信息

BMC Psychiatry. 2016 Sep 22;16(1):324. doi: 10.1186/s12888-016-1027-y.

Abstract

BACKGROUND

The association of attention deficit/hyperactivity disorder (ADHD) and fetal alcohol spectrum disorders (FASD) results in a complex constellation of symptoms that complicates the successful diagnosis and treatment of the affected individual. Current literature lacks formal guidelines, randomized control trials, and evidence-based treatment plans for individuals with ADHD and associated FASD. Therefore, a meeting of professional experts was organized with the aim of producing a consensus on identification and treatment guidelines that will aid clinicians in caring for this unique patient population.

METHODS

Experts from multiple disciplines in the fields of ADHD and FASD convened in London, United Kingdom, for a meeting hosted by the United Kingdom ADHD Partnership (UKAP; www.UKADHD.com ) in June 2015. The meeting provided the opportunity to address the complexities of ADHD and FASD from different perspectives and included presentations, discussions, and group work. The attendees worked towards producing a consensus for a unified approach to ADHD and associated FASD.

RESULTS

The authors successfully came to consensus and produced recommended guidelines with specific regards to identification and assessment, interventions and treatments, and multiagency liaisons and care management, highlighting that a lifespan approach to treatment needs to be adopted by all involved. Included in the guidelines are: 1) unique 'red flags', which when identified in the ADHD population can lead to an accurate associated FASD diagnosis, 2) a treatment decision tree, and 3) recommendations for multiagency care management.

CONCLUSIONS

While clinically useful guidelines were achieved, more research is still needed to contribute to the knowledge base about the diagnosis, treatment, and management of those with ADHD and associated FASD.

摘要

背景

注意力缺陷多动障碍(ADHD)与胎儿酒精谱系障碍(FASD)之间的关联导致了一系列复杂的症状,这使得对受影响个体的成功诊断和治疗变得复杂。目前的文献缺乏针对患有ADHD及相关FASD个体的正式指南、随机对照试验和循证治疗方案。因此,组织了一次专业专家会议,目的是就识别和治疗指南达成共识,以帮助临床医生照料这一独特的患者群体。

方法

ADHD和FASD领域多个学科的专家于2015年6月在英国伦敦召开会议,由英国ADHD伙伴关系组织(UKAP;www.UKADHD.com)主办。该会议提供了从不同角度探讨ADHD和FASD复杂性的机会,包括演讲、讨论和小组工作。与会者努力就ADHD及相关FASD的统一处理方法达成共识。

结果

作者成功达成共识,并制定了关于识别与评估、干预与治疗以及多机构联络与护理管理的推荐指南,强调所有相关方都需要采用全生命周期的治疗方法。指南内容包括:1)独特的“警示信号”,在ADHD人群中识别出这些信号可导致准确的相关FASD诊断;2)一个治疗决策树;3)多机构护理管理的建议。

结论

虽然达成了具有临床实用性的指南,但仍需要更多研究来丰富关于ADHD及相关FASD患者诊断、治疗和管理的知识库。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bada/5032241/347eb874e85d/12888_2016_1027_Fig1_HTML.jpg

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