User:It's gonna be awesome/成人注意力不足過動症 --former ADHD的徵狀與管理 (to be published)--

维基百科,自由的百科全书
注意力不足過動症(ADHD)
Attention Deficit Hyperactivity Disorder
同义词注意力缺失症、過度活躍症=Hyperkinetic disorder (ICD-10)
An image of children
注意力不足過動症兒童患者可能比較難以專注在學校的作業,因此也不容易在期限內完成作業
分类和外部资源
ICD-10F90
ICD-9-CM314.00314.01
OMIM143465
DiseasesDB6158
MedlinePlus001551
eMedicinemed/3103 ped/177
MeSHD001289
[编辑此条目的维基数据]
「ADHD」的各地常用譯名
中国大陸注意力缺陷多动障碍
臺灣注意力不足過動症
香港專注力失調/過度活躍症
澳門專注力失調/過度活躍症
日本注意欠陥・多動性障害
大韓民國注意力缺乏過多行動障礙
越南𦇒亂增動減注意

由於注意力不足過動症(ADHD)的症狀表現十分多元,容易讓人誤以為是其他疾病引起的,因此本條目旨在詳列ADHD的症狀表現形式,協助讀者釐清。

ADHD典型症狀包括忘東忘西、粗心大意、寫作業很久、吃飯很久、常恍神、媽媽交代的事一下就忘、東西不會收、今天念的書明天就忘掉大半、怎麼教都沒用。且/或有明顯的焦慮症狀,咬手指甲,連所有的腳趾甲都咬光。[1]

ADHD在腦部發育尚平均比同一年紀的人慢了三年,因此有較慢發展的認知功能(包括注意,記憶,結構,組織,學習,反應及解決事情能力),及自我動作及情緒控制能力表現,表現出來被簡要描述的症狀就是注意力不足,衝動及過動表現。[1]

症狀表現[编辑]

ADHD symptoms by age.

兒童(6-12歲)Children (6-12 Years) 青年(13-17歲)Teenagers (13-17 Years) 成人(18歲以上)Adult
容易分心
(Easily distracted)
內在的不安寧
(Displays inner restlessness)
專注力上的問題
(Inattention/concentration problems)
難以井然有序地完成家庭作業,常導致遲交,且作業內夾雜粗心的錯誤
(Homework poorly organized, contains careless errors, often not completed)
難以在各項學校/學習事務中保持有計畫性、秩序性的。常常有始無終。
(Schoolwork disorganized, shows poor follow-through)
生活缺乏秩序與組織且難以在行動前事先做計劃
(Disorganized and fails to plan ahead)
在問題尚未結束時搶答
(Blurts out answers in class before the question is completed)
肢體上的過動可能轉變為內心的不安寧
(Hyperactivity may become less visible)
錯誤判斷剩餘時間以及完成一件事所需的時間
(Misjudges available time)
難以完成家務事
(Fails to complete chores at home)
-
難以開始即完成一個計畫
(Difficulty initiating and completing projects)
難以在遊戲中輪流
(Has difficulty awaiting turn in games)
-
一件事情還沒做到一個階段就轉移注意力到另一件事情
(Shifts activities prematurely)
常常離開座位
(Often out of seat)
-
健忘,常常遺失東西
(Forgetful; often loses things)
常在不適當的時機點找人說話、常不自覺闖入他人的空間 (Often interrupts or intrudes on others)
-
做出衝動的決定
(Makes impulsive decisions)

[2]

Purple texts stand for translated sentences. :D

前兆與症狀: ADHD是一個慢性病,通常在早期出現症狀且持續一輩子。

Signs and symptoms: ADHD is a chronic condition, beginning in early childhood and persisting throughout a person's lifetime. It is estimated that 33-66% of children with ADHD will continue to have significant ADHD-related symptoms persisting into adulthood, resulting in a significant impact on education, employment, and interpersonal relationships. [3] [4]

ADHD患者往往缺乏自我管理能力(Self-control/self-regulation)、自我動機(/自我激勵/self-motivation),進而形成的特質,例如:分心拖延、和缺乏規劃。ADHD患者常被其他人認為嘈雜且偏好追求高度刺激好讓自己比較不會分心且變得比較有效率。 其實ADHD患者的學習潛力及整體資質與常人無異。

Individuals with ADHD exhibit deficiencies in self-regulation and self-motivation which in turn foster problematic characteristics such as distractibility, procrastination and disorganization. They are often perceived by others as chaotic, with a tendency to need high stimulation to be less distracted and function effectively. The learning potential and overall intelligence of an adult with ADHD, however, are no different from the potential and intelligence of adults who do not have the disorder.

Whereas teachers and caregivers responsible for children are often attuned to the symptoms of ADHD, employers and others who interact with adults are less likely to regard such behaviors as a symptom. In part, this is because symptoms do change with maturity; adults who have ADHD are less likely to exhibit obvious hyperactive behaviors. Instead they may report constant mental activity and inner restlessness, as their hyperactivity internalizes. [5]

Symptoms of ADHD (see table below) can vary widely between individuals and throughout the lifetime of an individual. As the neurobiology of ADHD is becoming increasingly understood, it is becoming evident that difficulties exhibited by individuals with ADHD are due to problems with the parts of the brain responsible for executive functions (see below: Pathophysiology). These result in problems with sustaining attention, planning, organization, prioritization, time blindness, impulse control and decision making.

The difficulties generated by these deficiencies can range from moderate to extreme, resulting in the inability to effectively structure their lives, plan daily tasks, or think of and act accordingly even when aware of potential consequences. These lead to poor performance in school and work, followed by underachievement in these areas. In young adults, poor driving record with traffic violations[6] as well as histories of alcoholism or substance abuse may surface. The difficulty is often due to the ADHD person's observed behaviour (e.g. the impulsive types, who may insult their boss for instance, resulting in dismissal), despite genuinely trying to avoid these and knowing that it can get them in trouble. Often, the ADHD person will miss things that an adult of similar age and experience should catch onto or know. These lapses can lead others to label the individuals with ADHD as "lazy" or "stupid" or "inconsiderate".

As problems accumulate, a negativistic self-view becomes established and a vicious circle of failure is set up. Up to 80% of adults may have some form of psychiatric comorbidity[7] such as depression or anxiety.[3] Many with ADHD also have associated learning disabilities, such as dyslexia, which contributes to their difficulties.[8]

Studies on adults with ADHD have shown that, more than often, they experience self stigma and depression in childhood, commonly resulting from feeling neglected and different from their peers.[9] These problems may play a role to the high levels of depression, substance abuse, and relationship problems that affect adults with ADHD later in life.[10]


Inattentive-type (ADHD-PI) Hyperactive/Impulsive-type (ADHD-PH)
In children:
  • Forgetful during daily activities
  • Easily distracted by extraneous stimuli
  • Losing important items (e.g. pencils, homework, toys, etc.)
  • Always asking for attention, but
  • Not listening and not responding to name being called out
  • Unable to focus on tasks at hand, cannot sustain attention in activities
  • Avoids or dislikes tasks requiring sustained mental effort
  • Makes careless mistakes by failing to pay attention to details
  • Difficulty organizing tasks and activities
  • Fails to follow-through on complex instructions and tasks (e.g. homework, chores, etc.)

In children:

  • Squirms and fidgets (with hands and/or feet)
  • Cannot sit still
  • Cannot play quietly or engage in leisurely activities
  • Talks excessively
  • Runs and climbs excessively
  • Always on the go, as if "driven by a motor"
  • Cannot wait for their turn
  • Blurts out answers
  • Intrudes on others and interrupts conversations
In adults, these evolve into:[7]
  • Avoiding tasks or jobs that require concentration
  • Procrastination
  • Difficulty initiating tasks
  • Difficulty organizing details required for a task
  • Difficulty recalling details required for a task
  • Difficulty multitasking
  • Poor time management, losing track of time
  • Indecision and doubt
  • Hesitation of execution
  • Difficulty persevering or completing and following through on tasks
  • Delayed stop and transition of concentration from one task to another

In adults:

  • Chooses highly active, stimulating jobs
  • Avoids situations with low physical activity or sedentary work
  • May choose to work long hours or two jobs
  • Seeks constant activity
  • Easily bored
  • Impatient
  • Intolerant and frustrated, easily irritated
  • Impulsive, snap decisions and irresponsible behaviors
  • Loses temper easily, angers quickly
  • The tendency to hyperfocus on particularly stimulating or emotionally engaging tasks.

兒童時期[编辑]

青年時期[编辑]

成人時期[编辑]

成人注意力不足過動症(Adult ADHD, Adult with ADHD, ADHD in Adult)\其實是注意力不足過動症的症狀從幼年延續到成年期,並不是成年後才出現的疾病。其症狀基本上仍未脫離分心、過動-衝動的核心概念,只是表現方式有很多(比起幼年期更為多樣),一般大眾不一定能將這些多樣的表現型式與ADHD的核心症狀相連結。

研究發現,兒童青少年時期的ADHD症狀若未經治療,約有六成進入成年期後仍有明顯症狀。

有鑑於目前臺灣社會對於成人ADHD的認識有限,不少成人ADHD患者在生活中經歷了可能比別人更多的困難和挫折且在迷糊和混亂中度過了不少歲月,卻不知其問題的根源,於是只能不斷的自我批判欲藉此改善現況,然而卻反而使自己變得更負面以及精神狀況每況愈下。因此下表主要乃根據國立臺灣大學醫學院附設醫院精神醫學部、基因醫學部主任高淑芬醫師之著作摘要整理出成人ADHD的特徵,幫助疑似患者自我察覺。[11]

  • 當患者必須進行一件枯燥或困難的計劃時,可能常粗心犯錯。[12]
  • 當患者正在做枯燥或重複性的工作時,常有持續專注的困難。[12]
  • 患者常難以專注於他人跟患者講話的內容(比如說:聽演講等),甚至是當有人直接一對一對著患者說話。[12]
  • 一旦患者完成任何計劃中最具挑戰性的部份後,常會有完成該計劃最後細節的困難。[12]
  • 當患者必須從事需要有組織規劃性的事時,常會發現自己難以井然有序地去做。 [12]
  • 當患者有一件需要動腦的事情時,患者常逃避或是延後開始去做。[12]
  • 患者在家裡或是在工作時,常沒有把東西物歸原位或是常找不到東西。[12]
  • 患者常因周遭的活動或聲音而分心。[12]
  • 患者可能發現自己很健忘,常忘了做該做的事、個人應盡到的義務(obligations)和行事曆上的任務(appointments)。[12]

--上述為「注意力缺損」的表現型的大致歸納--

--下述為「過動/衝動」的表現型的大致歸納--

  • 當患者必須長時間坐著時,患者常出現「坐不安穩」或「扭動手腳」的情形。[12]
  • 患者可能常在開會時或在其他被認為應該坐好的場合中離開座位。[12]
  • 患者可能常覺得靜不下來或煩躁不安。[12]
  • 患者在自己獨處的時間時,可能常覺得使自己保持平靜和放鬆是有困難的。[12]
  • 患者可能常感覺自己像被馬達所驅動一樣,覺得自己過度地活躍,不得不做事情。 [12]
  • 在社交場合中,患者會可能常發現自己話講得太多。[12]
  • 當與他人交談時,患者可能常在別人還沒把話講完前就插嘴或接話替對方把話講完。[12]
(When you are in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?)
  • 在需要輪流排隊的場合時,患者可能(發覺自己)難以輪流等待。[12]
  • 患者可能常在別人忙碌時打斷別人。[12]

以下為更詳細的症狀表現型概述

  • 經常天馬行空地想東想西,腦海中不斷迸發出新的點子,興致勃勃地告訴別人後卻鮮少具體實踐,讓美麗的夢想成真。即便興沖沖開始執行,通常也只是三分鐘熱度。
  • 喜歡熱心主動的幫助別人或提供別人各式各樣的建議,不過與此同時,對自己的事卻顯得吊兒啷噹,拖拖拉拉,好像沒有作完的一天。
  • 喜歡說話,無論是在會議中或是上課的場合中,仍會忍不住一直跟旁邊的人聊天。經常吵到人而不自知。
  • 對注意力不足過動症患者來說,跟別人好好聊天可能不是一件容易的事,因為不耐於傾聽,經常插嘴或岔(離)題。
  • 對於時間這個東西沒什麼概念,常常無法準時赴約,不是遲到,就是根本把這件事拋到九雲通宵外,把這件事情給忘了。(缺乏時間觀念)
  • 粗心、忽略細節、因為不耐煩而便宜行事。只想求快的結果就是做事的品質令人不敢恭維。
  • 因為注意力不足過動症的緣故,患者顯得容易衝動又沒耐心,例如:開快車,搶黃燈或闖紅燈、插嘴、插隊、搶話、發生交通事故、收到罰單或與人起衝突。
  • 注意力不足過動症患者常挨批評像長不大的人、迷迷糊糊、懶懶散散、不用心、說說哥、說說姊、不負責任、白目、生活習慣不好、以自己為中心等。
  • 患者每當遭受到類似的批判,往往覺得無奈又委屈並為此而焦慮。因為患者本身也不想這樣,但就是心有餘而力不足,無法自我控制。
  • ADHD患者的言行舉止往往令周遭的親友感到納悶,一來是他們的表現有時候很不錯、學習力也不差,但為何就是需要旁人再三提醒專心把事情做好,還需周遭親友們不時替患者操心。
  • 一心只講求快速、效率,卻未顧及到做事的品質,以至於語焉不詳、字跡潦草、漏洞百出。像是剛拿到一樣新東西,連看說明書都不耐煩,便直接動手安裝或使用,導致事倍功半,或是不小心就把東西給弄壞了。
  • 對於金錢和財務不太有概念、粗心大意,因此在收支上維持平衡對於成人ADHD患者來說,可能不是一件輕鬆的事情。
  • 對於ADHD-患者來說,時間通常只有『現在』沒有『未來』,所以常會把很多事情都擠在同一個時間。ADHD患者的空間能力也不太好,家中的桌子、地上、床鋪、和櫃子經常堆滿東西。書桌上的東西堆積成了一座小山坡,沒有歸類,然而其抽屜可能空空的,只裝了點小紙屑。
  • 當ADHD患者想要或需要某些人、事、物時,他們可能會立馬插嘴或打斷別人,無論別人是不是正在忙、談話中。ADHD可能就會要對方放下正在做的事,立即回應他們。ADHD患者之所以會急性子,除了是肇因於衝動的核心症狀外,他們也擔心如果不現在說出來,未來可能就會忘記啦。
  • 為了找東西而浪費很多寶貴的時間,甚至為此進出家門多次而遲到。
  • 分辨事情緩急輕重的能力不好。例如:明明人家急著要一份資料,ADHD患者卻因為別人的一句話或一個動作而分心,轉而關注其他的人事時地物,於是原本正在進行的事情全拋諸腦後。對於ADHD來說,一旦應該做的事被打斷,就很難再回來持續做完。
  • 常常會從ADHD患者身上觀察到一些好似不安、不安穩的小動作,例如:摸東摸西、拉扯衣服、碰碰文具、在椅子上旋轉、剝指甲、在紙上塗鴉等。
  • 常覺得靜不下來。
  • 丟三落四的,不是找不到手機、錢包、鑰匙、帳單就是忘了帶應該記得帶的重要東西。
  • 說話的時候常常更換主題,使得別人不易釐清重點。
  • 因為衝動的特質,ADHD患者經常不假思索就脫口而出不得體的話。(常講錯話)
  • 不耐於傾聽他人,往往對方的話還沒講完,他們就插嘴或急著接話:「我知道,我知道,我告訴你⋯⋯」。但別人要說的並不一定與ADHD患者預測的相同。
  • 可能會藉由超車、闖紅燈來擺脫等待停等紅燈、堵車時的不耐煩。因此容易出車禍和吃罰單。
  • 排隊、等待火車對於ADHD來說可能是件非常煩人的事情。
  • 可能因為肢體容易碰撞到別人而引起人際衝突。(肢體協調性可能不足)
  • 遇到稍微比較複雜的指令,就容易亂掉。即便是每天的例行公事,也需要不斷地叮嚀。
  • 倘若沒有明確嚴格的時間限制,ADHD可能會把他應該做的事、應該繳交的作業、......,無限期的延後,沒有完成的一天。
  • 經常從一件事情切換至另一件事情的結果可能是每一件事情都沒做完或花很長的時間才能做完。
  • 做事欠缺規劃、分辨事情緩急輕重的能力有待加強、缺乏時間觀念可能帶給人不可靠、不守信的感覺。
  • ADHD患者們也不太容易與別人維持長時間的對話和互動、或者看電視(鎖定同一個節目)。總之就是很難持續,還沒有到一個段落,就中斷離開了。
  • 是一個熱心的人,點子很多也很好動,但就是常常恍神、糊裡糊塗、少根筋似的。
  • 做事情容易拖拖拉拉,拖延到最後一刻。
  • 思考或者做事情上常看起來心不在焉、虎頭蛇尾,講不聽。
  • 不耐久坐、才剛坐下看東西、看資料,不到幾分鐘就想站起來找人聊天。
  • 各種坐姿,有時候會把腳擱在桌上,或者一直扭動,旁若無人似的。
  • 手上的書已經翻開超過半小時,卻因為一直無法專心閱讀,所以書還停留在剛翻開時的那一頁。
  • 不擅於整理東西、打理生活,不論是隨身攜帶的包包裡、家裡的房間、抑或是桌子上,基本上都塞著或堆著各種東西。隨著時間的流轉,這些小平原、小丘陵會變成亂亂的大台地和大山坡。
  • 忘東忘西的,經常忘記答應別人的事情、東西放在哪裡、安排好的行程規劃、證件、約會的時間地點、資料、應該做到的事、......。注意力不足過動症患者腦部的記憶功能並無缺損,但就是太健忘了,讓自己和周邊的人都感到十分的無奈。
  • 易粗心犯錯、工作效率不足、不易與人建立並維持良好的溝通、常常換工作、換老闆、虎頭蛇尾、有始無終、恍神、處事亂無章法、坦率直接、沒有心機、天真、興趣廣泛、少根筋的樂天派、活潑好動、熱心助人、講義氣、喜歡打抱不平、愛講話所以很容易交朋友、創意十足、熱情洋溢、活力充沛、開朗活潑、單純、時間管理能力有待加強、三思而後行的能力不足。

同為注意力不足過動症患者之哈洛威爾醫師對於成人注意力不足過動症的觀察 [13]

哈洛威爾:「雖然『注意力不足過動症』常認為是好發於兒童青少年時期,然而到目前為止,我們已經知道,成人『注意力不足過動症』的數量遠多於我們原本的預測。即便有些幼年『注意力不足過動症』患者會在其成年時期擺脫『注意力不足過動症』,但我們已經了解到,其實絕大多數的幼年『注意力不足過動症』患者之症狀會持續至成年時期。」

哈洛威爾:以下表列之特徵為我們歷經數年臨床經驗所得之成人注意力不足過動症患者的特徵:

  • 不耐煩。
  • 搖擺不定的心情。
  • 忽略真實的危機。
  • 易怒、容易被激怒。
  • 挫折容忍度。
  • 不安全感常縈繞在心頭。
  • 心理上或身(肢)體上的不安寧。
  • 常常追求高度的刺激感。
  • 容易不耐煩或感到無聊、難忍無聊的感覺。
  • 難以讓自己的人生有組織。
  • 長期的(慢性的)低自尊、低自信。
  • 衝動。(言語上或是行動上)
  • 常有花錢的衝動。(此乃屬行動上的衝動)
  • 常帶有高度創意、精確的直覺。十分聰穎。
  • 常常杞人憂天,無止盡的、不必要的擔憂。
  • 不一定按照既有的管道、尋常的程序行事。
  • 慢(慣)性拖延、逃避,不然就是難以開始行動。
  • 想到什麼就立刻說出來,沒有考慮到時機與場合是否合適。(此乃屬言語上的衝動)
  • 成癮高危險群。(較負面的解讀。以負面角度觀之。)
  • 過度投入有興趣的事物。(較正面的解讀。以正面角度觀之。)
  • 不一定正確的自我觀察。(特別是在盲目的樂觀或悲觀的心境下。)
  • ADHD或任何情感性疾患、衝動控制問題、物質濫用的家庭病史。
  • 無論已達成過何種目標/成就,心中一直有種覺得自己沒有發揮應有能力/潛力/實力的感覺。
  • 容易分心,難以維持注意力。看似對於一篇文章或是一段對話(交談)不理不睬(或注意力/專注力/心思不知不覺地就飄離了已讀到一半的文章或進行到一半的交談、......)並長期伴隨著難以維持專注力的障礙。
  • 計畫常常變來變去,無論在計畫或生涯規劃上都顯得三分鐘熱度。
  • 常常用眼睛掃描地平線、水平線等視野範圍去尋找事情來擔心、檢查所擔心的東西(頻繁地反覆檢查)。
  • 當(或被迫)離開某人或某事的時候,心情上會有過於重大的負面衝擊及剝奪感。
  • 因為難以隨著時間演進有效訂定和掌握各計劃的進度與期程,遂乾脆讓好幾個計畫同時進行。

哈洛威爾:「治療成人ADHD患者與治療兒童青少年ADHD患者,兩者是同等重要的。因為ADHD對於一位成人的衝擊相當廣泛,例如:生涯英语career婚姻家庭、......等。」 [13]

症狀的管理[编辑]

Treatment for adult ADHD may combine medication and behavioral, cognitive, or vocational interventions. Treatment often begins with medication selected to address the symptoms of ADHD, along with any comorbid conditions that may be present. Medication alone, while effective in correcting the physiological symptoms of ADHD, will not address the paucity of skills which many adults will have failed to acquire because of their ADHD (e.g., one might regain ability to focus with medication, but skills such as organizing, prioritizing and effectively communicating have taken others time to cultivate).[14]

The Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study (MTA):Questions and Answers

Medications[编辑]

Stimulants, the first line medications in adult ADHD are typically formulated in immediate and long-acting formulations.

Methylphenidate, a stimulant, with short and long-acting formulations, is often the first-line therapy and appears effective.[15] In the short term, methylphenidate is well tolerated. However, long term studies have not been conducted in adults and concerns about increases in blood pressure have not been established.[16] Methylphenidate increases concentrations of dopamine and norepinephrine in the synaptic cleft, promoting increased neurotransmission. It acts to block the dopamine and norepinephrine reuptake transporters, thus slowing the removal at which these neurotransmitters are cleared from the synapses.

Amphetamine and its derivatives, prototype stimulants, are likewise available in immediate and long-acting formulations. Amphetamines act by multiple mechanisms including reuptake inhibition, displacement of transmitters from vesicles, reversal of uptake transporters and reversible MAO inhibition. Thus amphetamines actively increases the release of these neurotransmitters into the synaptic cleft.[17] They may have a better side-effect profile than methylphenidate cardiovascularly and potentially better tolerated.[18]

The non-stimulant atomoxetine (Strattera), is also an effective treatment for adult ADHD. Although atomoxetine has a half life similar to stimulants it exhibits delayed onset of therapeutic effects similar to antidepressants. Unlike the stimulants which are controlled substances, atomoxetine lacks abuse potential. It is particularly effective for those with the predominantly inattentive concentration type of attention deficit due to being primarily a norepinephrine reuptake inhibitor.[19] It is often prescribed in adults who cannot tolerate the side effects of amphetamines or methylphenidate. It is also approved for ADHD by the US Food and Drug Administration. A rare but potentially severe side effect includes liver damage and increased suicidal ideation.[20]

Bupropion and desipramine are two antidepressants that have demonstrated some evidence of effectiveness in the management of ADHD particularly when there is comorbid major depression,[21] although antidepressants have lower treatment effect sizes.[22]

[14] [23] [24] [25] [17] [18] [19] [20] [22]

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【注意力不足過動兒的認識與行為治療技術】馬偕紀念醫院精神科 / 早療中心兒童臨床心理師 王加恩心理師

文章--注意力不足過動症(張學岺醫師提供)

注意力不足過動症的認識和治療

注释[编辑]

参考文献[编辑]

書目[编辑]

引用[编辑]

  1. ^ 1.0 1.1 嘉義長庚精神科副教授級主治醫師、教育部部定副教授 陳錦宏 醫師. 心動家族:注意力不足過動症ADHD的第三條路. 台灣心動家族兒童青少年關懷協會. Tc-adhd.com. 2016-12-13 [February 2017] (中文(臺灣)). 典型症狀包括忘東忘西,粗心大意,寫作業很久,吃飯很久,常恍神,媽媽交代的事一下就忘,東西不會收,今天念的書明天就忘掉大半,怎麼教都沒用。且有明顯的焦慮症狀,咬手指甲,連所有的腳趾甲都咬光。...注意力不足過動症(ADHD),長期追蹤研究顯示主要是腦部發育較慢(平均慢了三年),因此比同一年紀的人有較慢發展的認知功能(包括注意,記憶,結構,組織,學習,反應及解決事情能力),及自我動作及情緒控制能力表現,表現出來被簡要描述的症狀就是注意力不足,衝動及過動表現。因現代研究發展,逐漸了解大多數是生理的問題,症狀起源無關教養及教育環境,但表現嚴重度及後續後遺症會受到教養及教育環境的影響。 其診斷並非根據症狀有無而已,還包含持續長時間,症狀嚴重度,要對功能造成影響及排除其他疾病。每一個部分均需有經驗的專家評估,而非症狀學字面上的意義。ADHD經多年研究,治療改善率至少80%,比許多內外科疾病治療效果要好。治療主要是整合性模式,包括藥物治療、(認知)行為治療及學校特教環境,也是少數做過上百個對照研究的疾病。 
  2. ^ ADHD and You. ADHD: What Do Symptoms Look Like at Different Ages?. [2017-03-09]. 
  3. ^ 3.0 3.1 Gentile, J. P.; Atiq, R.; Gillig, P. M. Adult ADHD: Diagnosis, Differential Diagnosis, and Medication Management. Psychiatry (Edgmont (Pa. : Township)). 2006, 3 (8): 25–30. PMC 2957278可免费查阅. PMID 20963192. 
  4. ^ Valdizán, JR; Izaguerri-Gracia, AC. Trastorno por deficit de atencion/hiperactividad en adultos [Attention deficit hyperactivity disorder in adults]. Revista de neurologia. 27 February 2009, 48 (Suppl 2): S95–9. PMID 19280582 (Spanish). 
  5. ^ Kooij, SJ; Bejerot, S; Blackwell, A; Caci, H; Casas-Brugué, M; Carpentier, PJ; Edvinsson, D; Fayyad, J; Foeken, K; Fitzgerald, M; Gaillac, V; Ginsberg, Y; Henry, C; Krause, J; Lensing, MB; Manor, I; Niederhofer, H; Nunes-Filipe, C; Ohlmeier, MD; Oswald, P; Pallanti, S; Pehlivanidis, A; Ramos-Quiroga, JA; Rastam, M; Ryffel-Rawak, D; Stes, S; Asherson, P. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry. 3 September 2010, 10: 67. PMC 2942810可免费查阅. PMID 20815868. doi:10.1186/1471-244X-10-67.  开放获取
  6. ^ Stanford, Clare; Tannock, Rosemary. Behavioral Neurobiology of Attention Deficit Hyperactivity Disorder and Its Treatment. Springer. 29 February 2012: 10–. ISBN 978-3-642-24611-1. 
  7. ^ 7.0 7.1 Katragadda, S; Schubiner, H. ADHD in Children, Adolescents, and Adults. Primary Care: Clinics in Office Practice. June 2007, 34 (2): 317–341. PMID 17666230. doi:10.1016/j.pop.2007.04.012. 
  8. ^ Eden, GF; Vaidya, CJ. ADHD and developmental dyslexia: two pathways leading to impaired learning.. Annals of the New York Academy of Sciences. 2008, 1145: 316–27. PMID 19076406. doi:10.1196/annals.1416.022. 
  9. ^ McKeague, Lynn; Hennessy, Eilis; O'Driscoll, Claire; Heary, Caroline. Retrospective Accounts of Self-Stigma Experienced by Young People With Attention-Deficit/Hyperactivity Disorder (ADHD) or Depression. Psychiatric Rehabilitation Journal. 2015, 38 (2): 158–163 [15 October 2015]. PMID 25799297. doi:10.1037/prj0000121. 
  10. ^ Derrer, David. Conditions Similar to ADHD. WebMD. WebMD. [16 October 2015]. 
  11. ^ 高淑芬. 找回專注力:成人ADHD全方位自助手冊. 台北: 心靈工坊. 2016-05-09 [2016-12-12]. ISBN 9789863570592 (中文(臺灣)). from section of 成人ADHD的診斷 
  12. ^ 12.00 12.01 12.02 12.03 12.04 12.05 12.06 12.07 12.08 12.09 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 Adler, Lenard; Kessler, Ronald C; Spencer, Thomas, 成人 ADHD 自填量表 (ASRS)症狀 檢核表 (PDF), Gau, Susan Shur-Fen (编), Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1) Symptoms Checklist from WHO Composite International Diagnostic Interview (PDF), V1.1, Harvard Medical School, New York University Medical School.: World Health Organization, 2005 
  13. ^ 13.0 13.1 Dr. Hallowell on the Today show discussing Adult ADD. Drhallowell.com. 2014-10-16 [2016-12-09]. Dr. Hallowell on the Today show discussing Adult ADHD\ While ADHD tends to be associated with childhood, we’ve learned that it is far more widespread among adults than previously understood. While there are some children with ADHD who will outgrow it, we now know that the vast majority will not. Listed below are criteria for adult ADHD that we developed from our clinical experience: A sense of underachievement, of not meeting one’s goals , regardless of how much one has actually accomplished. Difficulty getting organized. Chronic procrastination or trouble getting started. Many projects going simultaneously; trouble with follow through. A tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark. A frequent search for high stimulation. An intolerance of boredom. Easy distractibility; trouble focusing attention, tendency to tune out or drift away in the middle of a page or conversation, often coupled with an inability to focus at times. Often creative, intuitive, highly intelligent. Trouble in going through established channels and following “proper” procedure. Impatient; low tolerance of frustration. Impulsive, either verbally or in action, as an impulsive spending of money. Changing plans, enacting new schemes or career plans and the like; hot-tempered. A tendency to worry needlessly, endlessly; a tendency to scan the horizon looking for something to worry about, alternating with attention to or disregard for actual dangers. A sense of insecurity. Mood swings, mood iability, especially when disengaged from a person or a project. Physical or cognitive restlessness. A tendency toward addictive behavior. Chronic problems with self-esteem. Inaccurate self-observation. Family history of ADHD or manic depressive illness or depression or substance abuse or other disorders of impulse control or mood.Recognizing and treating ADHD is just as important for adults as it is for children, as it has a wide ranging impact in careers, marriages and families. 
  14. ^ 14.0 14.1 Searight, H. Russel; Burke, John M.; Rottnek, Fred. Adult ADHD: Evaluation and Treatment in Family Medicine. American Family Physician. November 2000, 62 (9): 2077–2086 [22 March 2013]. PMID 11087189. 
  15. ^ Epstein, T; Patsopoulos, NA; Weiser, M. Immediate-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. The Cochrane database of systematic reviews. Sep 18, 2014, 9 (9): CD005041. PMID 25230710. doi:10.1002/14651858.CD005041.pub2. 
  16. ^ Godfrey J. Safety of therapeutic methylphenidate in adults: a systematic review of the evidence. J. Psychopharmacol. (Oxford). May 2008, 23 (2): 194–205. PMID 18515459. doi:10.1177/0269881108089809. 
  17. ^ 17.0 17.1 Retz W, Retz-Junginger P, Thome J, Rösler M. Pharmacological treatment of adult ADHD in Europe. World J. Biol. Psychiatry. September 2011,. 12 Suppl 1: 89–94. PMID 21906003. doi:10.3109/15622975.2011.603229. 
  18. ^ 18.0 18.1 Kolar D, Keller A, Golfinopoulos M, Cumyn L, Syer C, Hechtman L. Treatment of adults with attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat. April 2008, 4 (2): 389–403. PMC 2518387可免费查阅. PMID 18728745. 
  19. ^ 19.0 19.1 Simpson D, Plosker GL. Spotlight on atomoxetine in adults with attention-deficit hyperactivity disorder. CNS Drugs. 2004, 18 (6): 397–401. PMID 15089111. doi:10.2165/00023210-200418060-00011. 
  20. ^ 20.0 20.1 Santosh PJ, Sattar S, Canagaratnam M. Efficacy and tolerability of pharmacotherapies for attention-deficit hyperactivity disorder in adults. CNS Drugs. September 2011, 25 (9): 737–63. PMID 21870887. doi:10.2165/11593070-000000000-00000. 
  21. ^ Wilens, Timothy E.; Morrison, Nicholas R.; Prince, Jefferson. An update on the pharmacotherapy of attention-deficit/hyperactivity disorder in adults. Expert Review of Neurotherapeutics. October 2011, 11 (10): 1443–65. PMC 3229037可免费查阅. PMID 21955201. doi:10.1586/ern.11.137. 
  22. ^ 22.0 22.1 Verbeeck W, Tuinier S, Bekkering GE. Antidepressants in the treatment of adult attention-deficit hyperactivity disorder: a systematic review. Adv Ther (systematic review (secondary source)). February 2009, 26 (2): 170–184. PMID 19238340. doi:10.1007/s12325-009-0008-7. 
  23. ^ ADA Division, Office of Legal Counsel. Enforcement Guidance: Reasonable Accommodation and Undue Hardship Under the Americans with Disabilities Act. The U.S. Equal Employment Opportunity Commission. 22 October 2002. 
  24. ^ Office of Civil Rights. Questions and Answers on Disability Discrimination under Section 504 and Title II. U.S. Department of Education. 25 June 2012. 
  25. ^ Division of Human Development, National Center on Birth Defects and Developmental Disabilities. Attention-Deficit / Hyperactivity Disorder (ADHD): Symptoms and Diagnosis. Centers for Disease Control and Prevention. 29 September 2014. 

参见[编辑]


外部連結[编辑]