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[成人注意力缺陷多动障碍的筛查与诊断评估——漏诊和过度诊断相关风险]

[Screening and diagnostic assessment of ADHD in adults - risks associated with both underdiagnosis and overdiagnosis].

作者信息

Hirvikoski Tatja, Billstedt Eva, Lundström Sebastian, Brar Annika

机构信息

docent, leg psykolog, specialist i neuropsykologi, Habilitering & hälsa, Region Stockholm; Center for Neurodevelopmental Disorders at Karolinska institutet (KIND), institutionen för kvinnors och barns hälsa, Karolinska institutet; Centrum för psykiatri-forskning (CPF), Stockholm.

professor, leg psykolog, Gillbergcentrum, institutionen för neuroveten-skap och fysiologi, Göteborgs universitet; Barn-neuropsykiatri/BNK, Sahlgrenska universitetssjukhuset.

出版信息

Lakartidningen. 2022 Feb 22;119:21097.

Abstract

ADHD in adults is commonly associated with severe impairments in many major life activities, and an adequate diagnosis is a first step towards treatment and support. Negative consequences follow both underdiagnosis and overdiagnosis of adult ADHD, which can be confused with other psychiatric diagnoses and sometimes overlooked in people with high intellectual capacity, and in women in general. In a clinical practice, most physicians meet adults with ADHD - with or without a diagnosis - and therefore need competence in screening of ADHD in adults. Experienced clinicians conduct the consequent diagnostic assessment, to reduce risk of both underdiagnosis and overdiagnosis. Several national and international clinical guidelines summarize evidence-based practices for adults with ADHD. European Network Adult ADHD, ENAA, revised consensus statement recommends pharmacological treatment and psychoeducation as a first step after ADHD diagnosis in adulthood.

摘要

成人注意力缺陷多动障碍(ADHD)通常与许多主要生活活动中的严重障碍相关,而准确诊断是迈向治疗和支持的第一步。成人ADHD诊断不足和诊断过度都会带来不良后果,它可能与其他精神疾病诊断相混淆,有时在高智商人群以及一般女性中被忽视。在临床实践中,大多数医生都会遇到患有ADHD的成年人——无论是否已被诊断——因此需要具备筛查成人ADHD的能力。经验丰富的临床医生会进行后续的诊断评估,以降低诊断不足和诊断过度的风险。一些国家和国际临床指南总结了针对成人ADHD的循证实践。欧洲成人ADHD网络(ENAA)修订的共识声明建议,在成年期诊断出ADHD后,首先采取药物治疗和心理教育。

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