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青少年药物使用者中共患注意力缺陷多动障碍的临床医生指南:共病、神经发育风险及循证治疗方案

A Clinician's Guide to Co-occurring ADHD among Adolescent Substance Users: Comorbidity, Neurodevelopmental Risk, and Evidence-based Treatment Options.

作者信息

Hogue Aaron, Evans Steven W, Levin Frances R

机构信息

National Center on Addiction and Substance Abuse, New York, NY, USA.

Ohio University, Athens, OH, USA.

出版信息

J Child Adolesc Subst Abuse. 2017;26(4):277-292. doi: 10.1080/1067828X.2017.1305930. Epub 2017 Apr 24.

Abstract

This article introduces neurodevelopmental and clinical considerations for treating adolescents with co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) and substance use (ASU) in outpatient settings. We first describe neurobiological impairments common to ADHD and ASU, including comorbidity with conduct disorder, that evoke a profile of multiplicative developmental risk. We then present two evidence-based options for targeting ADHD-related problems during ASU treatment. utilize family ADHD psychoeducation to prompt decision-making about ADHD medication and integrate medication management into behavioral services. Clinic-based utilize family interventions to improve the home academic environment and boost organization skills. We conclude with recommendations for ADHD assessment and intervention sequencing.

摘要

本文介绍了在门诊环境中治疗同时患有注意力缺陷多动障碍(ADHD)和物质使用障碍(ASU)的青少年时的神经发育和临床考量。我们首先描述了ADHD和ASU共有的神经生物学损伤,包括与品行障碍的共病,这些损伤引发了多重发育风险的特征。然后,我们提出了两种在ASU治疗期间针对ADHD相关问题的循证方案。基于诊所的方案利用家庭ADHD心理教育来促进关于ADHD药物治疗的决策,并将药物管理纳入行为服务中。基于诊所的方案利用家庭干预来改善家庭学习环境并提高组织技能。我们最后给出了关于ADHD评估和干预顺序的建议。

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