Terán Prieto Antonio
Centro Ambulatorio de Atención a Drogodependencias San Juan de Dios, Palencia, España. E-mail:
Medicina (B Aires). 2020;80 Suppl 2:76-79.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental alteration of biological basis that started in childhood may persist during adolescence-youth and, despite what was believed until not many years ago, also in adulthood up to 50-60% of those affected, producing a significant clinical and psychosocial deterioration. In spite of being a syndrome easily identifiable by the triad: inattention, hyperactivity and impulsivity that characterizes it, in clinical practice there are different circumstances that hinder and complicate its diagnosis and treatment. One of the most significant is the presence, both in childhood and adulthood, of other comorbid mental disorders. It is from adolescence-youth when together with ADHD we can detect the presence of personality, mood and anxiety disorders and especially the use of several substances. The evidences existing until now show how the comorbidity of ADHD and substance use disorder influence the evolutionary course of both, complicating the approach, the treatment and, therefore, aggravating the final prognosis. The difficulties in their approach and the scarcity of treatment options make us underline the importance of preventive treatment in the infantile stage, starting from psychoeducation programs focused on the vulnerability of these patients to substances and the consequences associated with consumption.
注意力缺陷多动障碍（ADHD）是一种始于童年期、可能持续至青少年期甚至成年期（尽管直到几年前人们还持有不同看法，但实际上高达50%-60%的患者在成年期仍受影响）的具有生物学基础的神经发育性改变，会导致显著的临床和社会心理功能恶化。尽管该综合征可通过其特征性的三联征（注意力不集中、多动和冲动）轻松识别，但在临床实践中，仍存在多种情况会阻碍并使ADHD的诊断和治疗复杂化。其中最显著的一点是，无论在儿童期还是成年期，ADHD患者常伴有其他共病性精神障碍。从青少年期开始，除了ADHD，我们还能发现患者存在人格、情绪和焦虑障碍，尤其是多种物质的使用问题。目前的证据表明，ADHD与物质使用障碍的共病如何影响两者的病程发展，使诊断方法、治疗过程变得复杂，进而加重最终预后。对这些共病的应对困难以及治疗选择的匮乏，凸显了婴幼儿期预防性治疗的重要性，这种预防性治疗应从以这些患者对物质的易感性以及与物质使用相关后果为重点的心理教育项目入手。
