Childress Ann C, Stark Jeffrey G
1 Center for Psychiatry and Behavioral Medicine, Inc. , Las Vegas, Nevada.
2 Worldwide Clinical Trials , Austin, Texas.
J Child Adolesc Psychopharmacol. 2018 Nov;28(9):606-614. doi: 10.1089/cap.2018.0057. Epub 2018 Nov 2.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder defined as a persistent pattern of inactivity and/or hyperactivity that interferes with behavioral function or development. Diagnosis and treatment of ADHD in the preschool-aged population (children 3-5 years old) is more complicated compared with older children because of developmental and physiological differences. This article reviews the available literature regarding the challenges associated with ADHD diagnosis and treatment in preschool-aged children, as well as the unmet needs of preschool-aged children with ADHD.
Key considerations for ADHD diagnosis and treatment patterns in preschool-aged children are summarized in this review, including the need for early intervention, the association with comorbidities, and the differences in pharmacokinetic profiles between preschool-aged children and older children.
Efficacy and safety data are lacking, as clinical trial design and execution pose unique challenges in this population. Preschool-aged children often have difficulty with pill swallowing and tolerating phlebotomy necessary for the collection of pharmacokinetic and safety data. However, early diagnosis and treatment are essential to mitigate ADHD symptoms and comorbidities that may develop during childhood and adolescence in patients with persistent ADHD.
This review describes the established diagnostic and treatment modalities, along with the unmet needs of preschool-aged children with ADHD.
注意力缺陷多动障碍（ADHD）是一种神经发育障碍，其定义为持续的多动和/或注意力不集中模式，干扰行为功能或发育。由于发育和生理差异，学龄前儿童（3至5岁）ADHD的诊断和治疗比大龄儿童更为复杂。本文综述了有关学龄前儿童ADHD诊断和治疗相关挑战以及ADHD学龄前儿童未满足需求的现有文献。
本综述总结了学龄前儿童ADHD诊断和治疗模式的关键考虑因素，包括早期干预的必要性、与共病的关联以及学龄前儿童与大龄儿童药代动力学特征的差异。
由于临床试验设计和实施在该人群中带来独特挑战，因此缺乏疗效和安全性数据。学龄前儿童通常难以吞咽药片，且难以耐受采集药代动力学和安全性数据所需的静脉穿刺。然而，早期诊断和治疗对于减轻持续性ADHD患者在儿童期和青春期可能出现的ADHD症状和共病至关重要。
本综述描述了既定的诊断和治疗方式，以及ADHD学龄前儿童未满足的需求。
