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注意缺陷多动障碍与青少年过渡期

Attention-Deficit/Hyperactivity Disorder and Transitional Aged Youth.

机构信息

Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD Massachusetts General Hospital, YAW 6A, 55 Fruit Street, Boston, MA, 02114, USA.

Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA.

出版信息

Curr Psychiatry Rep. 2018 Sep 17;20(11):100. doi: 10.1007/s11920-018-0968-x.

Abstract

PURPOSE OF REVIEW

Extensive research has been conducted on attention-deficit/hyperactivity disorder (ADHD) in children and adults; however, less is known about ADHD during the transition from childhood to adulthood. Transitional aged youth (TAY) with ADHD represents a particularly vulnerable population as their newfound independence and responsibility often coincides with the development of comorbid disorders. The purpose of this review is to provide an update on the evaluation, diagnosis, and treatment of TAY-ADHD.

RECENT FINDINGS

Recent studies discovering ADHD symptoms emerging in TAY call the classification of ADHD as a disorder necessarily developing in childhood into question. TAY-ADHD are also shown to be vulnerable to academic and social impairments, increased risky behavior, and comorbid psychiatric disorders. Due to the risk of stimulant diversion in TAY, providers are advised to take precaution when prescribing medication to this population. Recent studies demonstrating the efficacy of psychotherapy in conjunction with non-stimulant or extended release stimulant medication provide a feasible alternative. This review highlights research on the course and evaluation of ADHD, impairments and comorbidities specific to TAY, and treatments tailored to address the unique challenges associated with TAY-ADHD.

摘要

目的综述

大量研究集中于儿童和成人的注意缺陷多动障碍(ADHD);然而,对于从儿童到成年的过渡时期的 ADHD 知之甚少。患有 ADHD 的过渡年龄青年(TAY)是一个特别脆弱的群体,因为他们新获得的独立性和责任感通常与共病的发展同时发生。本综述的目的是提供 TAY-ADHD 的评估、诊断和治疗的最新信息。

最新发现

最近的研究发现 TAY 中出现 ADHD 症状,这使得 ADHD 作为一种必然在儿童期发展的疾病的分类受到质疑。TAY-ADHD 也容易出现学业和社交障碍、增加风险行为和共患精神障碍。由于 TAY 中兴奋剂滥用的风险,建议提供者在为该人群开处方时要小心。最近的研究表明,心理治疗与非兴奋剂或缓释兴奋剂药物联合使用具有疗效,为可行的替代方案提供了证据。本综述强调了 ADHD 病程和评估、TAY 特有的障碍和共病以及针对 TAY-ADHD 相关独特挑战的治疗方面的研究。

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