Service de gériatrie, centre hospitalier universitaire, 14000 Caen, France; Centre mémoire Ressources et recherche, centre hospitalier universitaire, 14000 Caen, France; Inserm, U1077, EPHE, UNICAEN, Normandie université, PSL research university, 14000 Caen, France.
Service de neurologie, centre hospitalier universitaire, 14000 Caen, France; Centre mémoire Ressources et recherche, centre hospitalier universitaire, 14000 Caen, France.
Rev Neurol (Paris). 2019 Jun;175(6):358-366. doi: 10.1016/j.neurol.2018.09.021. Epub 2019 May 2.
Attention deficit hyperactivity disorder (ADHD) is a frequent neurodevelopmental mental disorder. It can persist in adulthood and be expressed as a cognitive complaint.
We conducted a descriptive study in a French memory center concerning patients seen over a period of two years. All patients for whom the final diagnosis was ADHD were included. All patients benefited from standard neuropsychological tests and a psychiatric specific consultation.
Thirteen patients were included with an average age of 50.2±19 years. Main complaints related to memory, attention, focusing and organizational functioning. These difficulties had negative social, professional and academic consequences. ADHD history in descendants was noted in 46% of patients. More than 20% of subjects had motor, verbal or mental restlessness. Neuropsychological assessment highlighted impaired performances in executive functions (38%), sustained attention (67%), divided attention (45%), working memory (46%) and information processing speed (75%). A psychiatric history or comorbidities were present in 85% of patients, mostly of the anxio-depressive type. The more prevalent presentations of ADHD were the combined (38%) and inattentive (38%) types.
Adult ADHD can masquerade as a cognitive impairment, including a stable cognitive complaint from infancy to old age. Inattentive, hyperactive and impulsive symptoms change with time and become more internalized (such as concentration difficulties or mental restlessness). No neuropsychological pattern has been reported but fluctuating deficits in sustained, divided attention, working memory and information processing speed are frequently observed in adult ADHD. A specific psychiatric expertise is essential in diagnosis and care for ADHD and its commonly associated psychiatric comorbidities.
注意缺陷多动障碍（ADHD）是一种常见的神经发育性精神障碍。它可能会持续到成年期，并表现为认知障碍。
我们在一家法国记忆中心进行了一项描述性研究，涉及在两年期间就诊的患者。所有最终诊断为 ADHD 的患者均纳入研究。所有患者均接受了标准神经心理学测试和特定的精神科咨询。
共纳入 13 名患者，平均年龄为 50.2±19 岁。主要主诉与记忆力、注意力、集中力和组织功能有关。这些困难对患者的社会、职业和学术产生了负面影响。在 46%的患者中，发现了后代的 ADHD 病史。超过 20%的患者存在运动、言语或精神不安。神经心理学评估强调了执行功能（38%）、持续注意力（67%）、分散注意力（45%）、工作记忆（46%）和信息处理速度（75%）受损。85%的患者存在精神病史或合并症，主要为焦虑抑郁型。ADHD 更常见的表现形式是混合型（38%）和注意力不集中型（38%）。
成人 ADHD 可能表现为认知障碍，包括从婴儿期到老年期稳定的认知障碍。注意力不集中、多动和冲动症状随时间而变化，变得更加内向化（如注意力集中困难或精神不安）。尚未报道特定的神经心理学模式，但在成人 ADHD 中经常观察到持续性、分散注意力、工作记忆和信息处理速度的波动缺陷。对于 ADHD 及其常见的相关精神共病，特定的精神科专业知识对于诊断和治疗至关重要。
