Pujalte George G A, Narducci Dusty Marie, Smith Michael Seth, King Rebecca, Logan Kelsey, Callender Shelley Street, Liebman Catherine A, Kane Shawn F, Israel Michael P, Wolf Sigrid F, Nuti Rathna, Khodaee Morteza
Department of Family Medicine and Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, Florida.
Department of Family Medicine, University of South Florida College of Medicine, Tampa, Florida.
Clin J Sport Med. 2023 May 1;33(3):195-208. doi: 10.1097/JSM.0000000000001152.
Athletes of all ages may be affected by medical and mental health issues. Sports medicine physicians should be familiar with common conditions that may affect the well-being of athletes, such as attention-deficit/hyperactivity disorder (ADHD). ADHD behaviors have the potential to affect a person's ability to concentrate. It is likely that social and cognitive therapies combined with pharmacotherapy will be the most effective way to treat ADHD in athletes. Medications used for ADHD, especially stimulant types, are known to improve alertness, reaction time, anaerobic performance, and endurance, which would potentially improve athletic performance. Furthermore, stimulant medications may enable student athletes with ADHD to focus on academic studies for longer periods of time, beyond usual levels of fatigue, important for those who may be exhausted after practices and games. The purported performance enhancement effects and potential adverse effects of stimulant medications have prompted many sports governing bodies to ban prescription stimulants or establish strict rules for their use. Athletes taking physician-prescribed stimulants to treat ADHD need to provide the appropriate documentation for approval before competition or risk punitive measures. Physicians should strive to provide a high quality of care to athletes with ADHD through early diagnosis, appropriate and careful multidisciplinary treatment, and complete and timely documentation to facilitate continued sports participation.
各年龄段的运动员都可能受到医学和心理健康问题的影响。运动医学医生应熟悉可能影响运动员健康的常见病症，如注意力缺陷多动障碍（ADHD）。ADHD行为有可能影响一个人的注意力集中能力。社会和认知疗法与药物疗法相结合可能是治疗运动员ADHD的最有效方法。用于治疗ADHD的药物，尤其是兴奋剂类药物，已知可提高警觉性、反应时间、无氧运动表现和耐力，这有可能提高运动成绩。此外，兴奋剂药物可能使患有ADHD的学生运动员能够在超过通常疲劳水平的情况下，更长时间地专注于学业，这对那些在训练和比赛后可能疲惫不堪的人来说很重要。兴奋剂药物所谓的提高成绩效果和潜在的不良反应促使许多体育管理机构禁止使用处方兴奋剂或对其使用制定严格规定。服用医生开的兴奋剂来治疗ADHD的运动员需要在比赛前提供适当的文件以获得批准，否则可能会面临惩罚措施。医生应努力通过早期诊断、适当且谨慎的多学科治疗以及完整及时的文件记录，为患有ADHD的运动员提供高质量的护理，以促进他们继续参与体育运动。
