Blum Kenneth, Dennen Catherine, Carney Paul R, Gilley Elizabeth, Thanos Panayotis K, Braverman Eric R, Baron David, Hanna Colin, Modestino Edward J, Gold Mark S, Elman Igor, Badgaiyan Rajendra D
Division of Addiction Research & Education, Center for Sports, Exercise & Mental Health, Western University Health Sciences, Pomona, CA, USA.
The Kenneth Blum Institute of Neurogenetics & Behavior, LLC., Austin, TX, USA.
J Addict Psychiatry. 2023;7(1):1-4. Epub 2023 Apr 22.
An estimated 3% to 10% of school children meet the DSM-V criteria for ADHD (Attention-Deficit/Hyperactivity Disorder), however, to be over-diagnosed, the rate of children inappropriately diagnosed with ADHD (false positives) would have to be larger than the number of children with ADHD who are under-identified and not diagnosed (false negatives). Accordingly, a number of investigators take the position that under-treatment with psychostimulants, especially in children and adolescence, will result in continued ADHD symptomatology including future Substance Use Disorder (SUD). However, other researchers and clinicians believe otherwise and espouse laudable arguments for caution and prolonged methamphetamine treatment. While there is ongoing controversy of the role of genetics and epigenetics linked to ADHD, it seems clear that a number of dopaminergic genes and their risk polymorphisms act as DNA antecedents impacted by epigenetic induced methylation. Our hypothesis and literature review suggest that one possible solution is to embrace non addictive interventions to induce global dopamine homeostasis.
据估计，3%至10%的学童符合精神疾病诊断与统计手册第五版（DSM-V）中注意力缺陷多动障碍（ADHD）的标准。然而，要存在过度诊断的情况，被不恰当地诊断为ADHD（假阳性）的儿童比例必须高于未被识别和诊断的ADHD儿童数量（假阴性）。因此，一些研究人员认为，精神兴奋剂治疗不足，尤其是在儿童和青少年中，会导致ADHD症状持续存在，包括未来的物质使用障碍（SUD）。然而，其他研究人员和临床医生则持不同观点，并主张谨慎和延长甲基苯丙胺治疗时间，这一观点值得称赞。虽然关于与ADHD相关的遗传学和表观遗传学作用仍存在争议，但似乎很明显，一些多巴胺能基因及其风险多态性作为受表观遗传诱导甲基化影响的DNA前体。我们的假设和文献综述表明，一种可能的解决方案是采用非成瘾性干预措施来诱导整体多巴胺稳态。
