Eom Tae Hoon, Kim Young-Hoon
Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Pediatrics, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
Clin Exp Pediatr. 2024 Jan;67(1):26-34. doi: 10.3345/cep.2021.01466. Epub 2023 Jun 14.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders found in children and adolescents. The American Academy of Pediatrics (AAP) first published a clinical practice guideline on ADHD in 2000, which was revised in 2011 and republished together with an accompanying process-of-care algorithm. More recently, the 2019 clinical practice guideline revision was published. Since the 2011 guideline, the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), was released. In addition, the Society of Developmental and Behavioral Pediatrics (SDBP) recently released another clinical practice guideline for complex ADHD. Although there are nonessential changes reflected in these updates, a number of changes have still been made; for example, the DSM-5 criteria lowered the diagnostic threshold for ADHD in older teens and adults. Additionally, the criteria were revised to facilitate application to older teens and adults, and a comorbid diagnosis with autism spectrum disorder is now allowed. Meanwhile, the 2019 AAP guideline added the recommendation related to comorbid conditions with ADHD. Lastly, SDBP developed a complex ADHD guideline, covering areas such as comorbid conditions, moderate-to-severe impairment, treatment failure, and diagnostic uncertainty. In addition, other national ADHD guidelines have been published, as have European guidelines for managing ADHD during the coronavirus disease 2019 pandemic. To facilitate ADHD management in a primary care, it is important to provide and review clinical guidelines and recent updates. In this article, we will review and summarize the recent clinical guidelines and their updates.
注意缺陷多动障碍（ADHD）是儿童和青少年中最常见的神经发育障碍之一。美国儿科学会（AAP）于2000年首次发布了关于ADHD的临床实践指南，并于2011年进行了修订，同时发布了一份配套的诊疗流程算法。最近，2019年临床实践指南修订版发布。自2011年指南发布以来，《精神疾病诊断与统计手册》第五版（DSM-5）问世。此外，发育与行为儿科学会（SDBP）最近发布了另一项针对复杂ADHD的临床实践指南。尽管这些更新中存在一些非实质性变化，但仍有许多变化；例如，DSM-5标准降低了大龄青少年和成年人ADHD的诊断阈值。此外，标准进行了修订，以方便应用于大龄青少年和成年人，现在允许与自闭症谱系障碍进行共病诊断。同时，2019年AAP指南增加了与ADHD共病情况相关的建议。最后，SDBP制定了一项复杂ADHD指南，涵盖共病情况、中度至重度损害、治疗失败和诊断不确定性等领域。此外，还发布了其他国家的ADHD指南，以及2019冠状病毒病大流行期间欧洲ADHD管理指南。为便于在初级保健中管理ADHD，提供和审查临床指南及其最新更新非常重要。在本文中，我们将回顾和总结近期的临床指南及其更新内容。
