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儿童注意力缺陷多动障碍的诊断与管理方法

Approach to diagnosis and management of childhood attention deficit hyperactivity disorder.

作者信息

Jerome David, Jerome Laurence

机构信息

Assistant Professor at the Northern Ontario School of Medicine and Assistant Adjunct Professor at the University of Alberta.

Adjunct Professor at Western University in London, Ont.

出版信息

Can Fam Physician. 2020 Oct;66(10):732-736.

Abstract

OBJECTIVE

To provide primary care clinicians with an approach to the diagnosis and management of attention deficit hyperactivity disorder (ADHD) by reviewing and summarizing the relevant practice guidelines and recent evidence from the literature.

SOURCES OF INFORMATION

Published guidelines on the management of ADHD were reviewed. A PubMed search was conducted with the MeSH terms and . Results were limited to articles published in English within the past 15 years.

MAIN MESSAGE

Attention deficit hyperactivity disorder is a common neurodevelopmental disorder. Guidelines agree that diagnosis and management of ADHD is appropriate within primary care. Attention deficit hyperactivity disorder is diagnosed by applying the criteria defined within the 5th edition, and is supplemented by validated rating scales. Behavioural management is first-line management in all patients, and stimulant medications are first-line management in patients 6 years of age and older. The Canadian ADHD Resource Alliance provides free resources to help clinicians care for patients with ADHD.

CONCLUSION

Most patients with ADHD can be managed by family physicians. It is a chronic condition that requires ongoing follow-up. Attention deficit hyperactivity disorder that is complicated by comorbidities might require referral to a specialist.

摘要

目的

通过回顾和总结相关实践指南及近期文献证据,为基层医疗临床医生提供注意力缺陷多动障碍(ADHD)的诊断和管理方法。

信息来源

查阅了已发表的ADHD管理指南。使用医学主题词在PubMed上进行了检索。结果仅限于过去15年内发表的英文文章。

主要信息

注意力缺陷多动障碍是一种常见的神经发育障碍。指南一致认为,ADHD在基层医疗中进行诊断和管理是合适的。ADHD通过应用《精神疾病诊断与统计手册》第5版中定义的标准进行诊断,并辅以经过验证的评定量表。行为管理是所有患者的一线管理方法,而兴奋剂药物是6岁及以上患者的一线管理方法。加拿大ADHD资源联盟提供免费资源,以帮助临床医生照顾ADHD患者。

结论

大多数ADHD患者可由家庭医生管理。这是一种需要持续随访的慢性疾病。伴有合并症的ADHD可能需要转诊至专科医生。

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