一种常见的儿童时期发病的疾病,特征是在两个或以上场合(例如家庭和学校)中表现出注意力不集中、活动过度和/或冲动。
阅读更多一些损害须在 12 岁以前出现,且功能损害会在 60% 至 70% 的患者中持续至成年期。
根据临床病史进行诊断,病史要包括多渠道信息,譬如家长、养育者和老师。
主要治疗方法为兴奋剂治疗,对 85% 的患者有效;而非兴奋剂治疗的有效率较低,但非兴奋剂治疗的作用持续时间,或在特殊人群可能有其他益处。
兴奋剂药物与心血管副作用有关联。在患有心脏疾病的儿童中应用时要监测这些副作用。
美国精神病学会认为,注意缺陷多动障碍 (attention deficit hyperactivity disorder, ADHD) 的问题表现在注意力缺陷、活动过度和冲动。[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Publishing; 2013.这种疾病得到了全球性认可,在欧洲和使用世界卫生组织分类体系的其他国家称为多动障碍。[2]World Health Organization. International classification of diseases: 10th revision, second edition. Geneva, Switzerland: World Health Organization; 2004.ADHD 是一种慢性疾病,症状始于幼童时期,但常常持续至成年后。一个关键的定义元素是两个或两个以上场合(常常为学校和家庭)中的功能受损。[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric Publishing; 2013.因此,ADHD 可能在学业、人际和职业方面的成就不佳,并可能导致过当的冒险行为和事故。[3]Schonwald A, Lechner E. Attention deficit/hyperactivity disorder: complexities and controversies. Curr Opin Pediatr. 2006;18:189-195.http://www.ncbi.nlm.nih.gov/pubmed/16601502?tool=bestpractice.com此外,ADHD 患者更可能出现共存的精神障碍(例如对立违抗性障碍 (ODD)、品行障碍、物质滥用以及可能的情感障碍(例如抑郁症和躁狂症)。[4]Barkley RA. Attention deficit hyperactivity disorder: a clinical handbook, 3rd ed. New York: Guilford; 2005.[5]Faraone SV, Biederman J, Jetton JG, et al. Attention deficit disorder and conduct disorder: longitudinal evidence for a familial subtype. Psychol Med. 1997;27:291-300.http://www.ncbi.nlm.nih.gov/pubmed/9089822?tool=bestpractice.com[6]Biederman J, Wilens T, Mick E, et al. Is ADHD a risk factor for psychoactive substance use disorders? Findings from a four-year prospective follow-up study. J Am Acad Child Adolesc Psychiatry. 1997;36:21-29.http://www.ncbi.nlm.nih.gov/pubmed/9000777?tool=bestpractice.com[7]Milberger S, Biederman J, Faraone SV, et al. ADHD is associated with early initiation of cigarette smoking in children and adolescents. J Am Acad Child Adolesc Psychiatry. 1997;36:37-44.http://www.ncbi.nlm.nih.gov/pubmed/9000779?tool=bestpractice.com[8]Faraone SV, Biederman J. Do attention deficit hyperactivity disorder and major depression share familial risk factors? J Nerv Ment Dis. 1997;185:533-541.http://www.ncbi.nlm.nih.gov/pubmed/ 9307614?tool=bestpractice.com[9]Biederman J, Faraone S, Mick E, et al. Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity? J Am Acad Child Adolesc Psychiatry. 1996;35:997-1008.http://www.ncbi.nlm.nih.gov/pubmed/8755796?tool=bestpractice.com