Katzman Martin A, Bilkey Timothy S, Chokka Pratap R, Fallu Angelo, Klassen Larry J
START Clinic for Mood and Anxiety Disorders, 32 Park Road, Toronto, ON, M4W 2N4, Canada.
Adler Graduate Professional School, Toronto, ON, Canada.
BMC Psychiatry. 2017 Aug 22;17(1):302. doi: 10.1186/s12888-017-1463-3.
Attention-deficit/hyperactivity disorder (ADHD) in the adult population is frequently associated with comorbid psychiatric diseases that complicate its recognition, diagnosis and management.The prevalence of ADHD in the general adult population is 2.5% and it is associated with substantial personal and individual burden. The most frequent comorbid psychopathologies include mood and anxiety disorders, substance use disorders, and personality disorders. There are strong familial links and neurobiological similarities between ADHD and the various associated psychiatric comorbidities. The overlapping symptoms between ADHD and comorbid psychopathologies represent challenges for diagnosis and treatment. Guidelines recommend that when ADHD coexists with other psychopathologies in adults, the most impairing condition should generally be treated first.Early recognition and treatment of ADHD and its comorbidities has the potential to change the trajectory of psychiatric morbidity later in life. The use of validated assessment scales and high-yield clinical questions can help identify adults with ADHD who could potentially benefit from evidence-based management strategies.
成人注意力缺陷/多动障碍（ADHD）常与共病的精神疾病相关，这使其识别、诊断和管理变得复杂。普通成年人群中ADHD的患病率为2.5%，且它会带来相当大的个人和个体负担。最常见的共病精神病理包括情绪和焦虑障碍、物质使用障碍及人格障碍。ADHD与各种相关精神共病之间存在很强的家族联系和神经生物学相似性。ADHD与共病精神病理之间重叠的症状给诊断和治疗带来了挑战。指南建议，当成人ADHD与其他精神病理共存时，通常应首先治疗最具损害性的病症。对ADHD及其共病的早期识别和治疗有可能改变后期精神疾病的发病轨迹。使用经过验证的评估量表和高收益临床问题有助于识别可能从循证管理策略中获益的成年ADHD患者。
