• 文章类型: Journal Article
    使用基于证据的标准化结果测量越来越被认为是指导心理健康临床决策的关键。由于缺乏对测量什么以及如何以可靠和标准化的方式进行测量的清晰度,因此阻碍了这些措施在临床实践中的实施。
    为了开发一组针对特定神经发育障碍(NDD)的核心结果指标,如注意力缺陷/多动障碍(ADHD),沟通障碍,特定的学习障碍,和运动障碍,可以在一系列地理和文化背景下使用。
    召集了一个由临床和研究专家以及服务用户(n=27)组成的国际工作组,以开发一套标准的可访问核心集,有效,以及儿童和青少年NDD的可靠结局指标。该工作组在2021年3月1日至2022年6月30日期间参加了9次视频电话会议和8次调查。修改后的Delphi方法定义了范围,结果,包括措施,大小写混合变量,和测量时间点。经过发展,NDD集分发给专业人员和服务用户进行公开审查,反馈,和外部验证。
    最后一组建议在3个关键领域测量12个结果:(1)与诊断相关的核心症状;(2)影响,功能,和生活质量;(3)常见的共存问题。应至少每6个月实施以下14项措施以监测这些结果:ADHD评定量表5,范德比尔特ADHD诊断评定量表,或者Swanson,诺兰,和Pelham评定量表IV;情感反应指数;儿童沟通清单2;科罗拉多学习障碍问卷;儿童睡眠习惯问卷;发育障碍儿童全球评估量表;发育协调障碍问卷;家庭应变指数;上下文中的适应性量表;Vineland行为量表或重复行为量表-修订和社会反应量表;全球儿童焦虑量表外部审查调查由32名专业人员和40名服务用户完成。在公开审查调查中,超过70%的专业人员和服务用户认可了NDD设置项目。
    NDD集涵盖了患者和护理人员最关心的结果。使用NDD组有可能改善临床实践和研究。
    UNASSIGNED: The use of evidence-based standardized outcome measures is increasingly recognized as key to guiding clinical decision-making in mental health. Implementation of these measures into clinical practice has been hampered by lack of clarity on what to measure and how to do this in a reliable and standardized way.
    UNASSIGNED: To develop a core set of outcome measures for specific neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder (ADHD), communication disorders, specific learning disorders, and motor disorders, that may be used across a range of geographic and cultural settings.
    UNASSIGNED: An international working group composed of clinical and research experts and service users (n = 27) was convened to develop a standard core set of accessible, valid, and reliable outcome measures for children and adolescents with NDDs. The working group participated in 9 video conference calls and 8 surveys between March 1, 2021, and June 30, 2022. A modified Delphi approach defined the scope, outcomes, included measures, case-mix variables, and measurement time points. After development, the NDD set was distributed to professionals and service users for open review, feedback, and external validation.
    UNASSIGNED: The final set recommends measuring 12 outcomes across 3 key domains: (1) core symptoms related to the diagnosis; (2) impact, functioning, and quality of life; and (3) common coexisting problems. The following 14 measures should be administered at least every 6 months to monitor these outcomes: ADHD Rating Scale 5, Vanderbilt ADHD Diagnostic Rating Scale, or Swanson, Nolan, and Pelham Rating Scale IV; Affective Reactivity Index; Children\'s Communication Checklist 2; Colorado Learning Disabilities Questionnaire; Children\'s Sleep Habits Questionnaire; Developmental-Disability Children\'s Global Assessment Scale; Developmental Coordination Disorder Questionnaire; Family Strain Index; Intelligibility in Context Scale; Vineland Adaptive Behavior Scale or Repetitive Behavior Scale-Revised and Social Responsiveness Scale; Revised Child Anxiety and Depression Scales; and Yale Global Tic Severity Scale. The external review survey was completed by 32 professionals and 40 service users. The NDD set items were endorsed by more than 70% of professionals and service users in the open review survey.
    UNASSIGNED: The NDD set covers outcomes of most concern to patients and caregivers. Use of the NDD set has the potential to improve clinical practice and research.
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  • 文章类型: Journal Article
    背景:24小时运动行为(24-HMB)指南建议儿童和青少年应限制屏幕时间(ST),获得充足的睡眠(SL),并进行足够的体育锻炼(PA)以确保健康和健康发展。符合24-HMB指南与积极的心理健康结果相关(例如,社会和情感功能)在普通人群中。然而,目前尚不清楚这些发现是否适用于患有自闭症谱系障碍(ASD)和注意力缺陷/多动障碍(ADHD)的儿童和青少年.因此,在患有ASD/ADHD的儿童和青少年中,我们研究了符合24-HMB指南与社会和情绪功能的相关性.
    方法:来自2020-2021年全国儿童健康调查的数据-美国国民,以人口为基础,横断面研究-使用。我们提取并分析了诊断为ASD/ADHD共病的儿童和青少年(6至17岁)的数据。运动行为数据(PA,ST,和SL)和特定结果变量(社会功能和情绪功能)通过照顾者代理报告收集。进行Logistic回归以检查符合24-HMB指南与调整协变量的社会和情感结果之间的关联(例如,年龄,性别,种族,体重状态,出生状况,社会经济地位,并接受药物/行为治疗)。
    结果:在979名患有ASD/ADHD的儿童和青少年中,只有3.8%符合所有三个24-HMB指南。总的来说,45.0%的参与者至少符合一项指南,25.5%的人至少符合两项准则。与那些不符合任何24-HMB指南的人相比,符合SL+ST指南与社会功能较差的几率较低显著相关(被欺负:OR=0.3,95CI[0.1-0.7];争论:OR=0.2,95CI[0.1-0.4]).此外,符合PA+ST+SL指南与情绪功能较差的几率较低相关(抑郁:OR=0.5,95CI[0.3-0.7]).
    结论:会议24-HMB指南与患有ASD/ADHD的美国儿童和青少年更好的社交和情感功能有关;然而,目前很少有患有ASD/ADHD的患者符合所有24-HMB指南。这些结果强调了在面临ASD/ADHD合并症挑战的儿童和青少年中促进遵守24-HMB指南的重要性。这些横断面发现表明,需要从纵向研究中获得进一步的经验证据来支持我们的结论。
    BACKGROUND: The 24-hour movement behavior (24-HMB) guidelines recommend that children and adolescents (youth) should limit screen time (ST), get an adequate amount of sleep (SL), and engage in sufficient physical activity (PA) to ensure health and healthy development. Meeting 24-HMB guidelines is associated with positive mental health outcomes (e.g., social and emotional function) in the general population. However, it is unclear whether such findings extend to youth with Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). Thus, we examined associations of meeting 24-HMB guidelines with social and emotional function in youth with comorbid ASD/ADHD.
    METHODS: Data from the 2020-2021 National Survey of Children\'s Health - a U.S. national, population-based, cross-sectional study - were used. We extracted and analyzed data on youth (aged between 6 and 17 years) diagnosed with comorbidity of ASD/ADHD. Data on movement behaviors (PA, ST, and SL) and specific outcome variables (social function and emotional function) were collected through caregiver-proxy reports. Logistic regressions were performed to examine the associations between meeting 24-HMB guidelines and social and emotional outcomes adjusting for covariates (e.g., age, sex, ethnicity, weight status, birth status, socio-economic status, and receiving medication/behavioral treatment).
    RESULTS: Among 979 children and adolescents with comorbid ASD/ADHD, only 3.8 % met all three 24-HMB guidelines. In total, 45.0 % of participants met at least one guideline, and 25.5 % of those met at least two guidelines. Compared to those who did not meet any 24-HMB guidelines, meeting SL + ST guidelines was significantly associated with lower odds of poorer social function (being bullied: OR = 0.3, 95%CI [0.1-0.7]; arguing: OR = 0.2, 95%CI[0.1-0.4]). Furthermore, meeting PA + ST + SL guidelines was associated with lower odds of poorer emotional function (depression: OR = 0.5, 95%CI[0.3-0.7]).
    CONCLUSIONS: Meeting 24-HMB guidelines was associated with better social and emotional function in U.S. youth with comorbid ASD/ADHD; however, currently very few with comorbid ASD/ADHD meet all 24-HMB guidelines. These results emphasize the importance of promoting adherence to the 24-HMB guidelines among youth facing the challenges of comorbid ASD/ADHD. These cross-sectional findings point to the need for further empirical evidence from longitudinal studies to support our conclusions.
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  • 文章类型: Journal Article
    目标:这篇综述旨在介绍注意力缺陷/多动障碍(ADHD)护理的最新创新和进步。包括国际共识声明,新的药物配方,数字疗法,和神经刺激装置。方法:对近5年发表的相关文章进行全面文献检索,强调证据基础,功效,安全,以及这些进步的实际意义。结果:世界多动症联盟共识声明提供了根植于全球科学证据的最新诊断和治疗框架。有几种较新的多动症药物配方,包括非兴奋剂(维洛嗪缓释)和第一个批准用于治疗ADHD的经皮苯丙胺贴剂。这些选项提供了一些独特的好处,可以根据症状概况个性化治疗,生活方式,preferences,和回应。数字工具为患有多动症的个人提供了重建环境的额外手段,减少损害和对他人的依赖。此外,数字疗法增强了访问,负担能力,个性化,多动症护理的可行性,补充或加强现有的干预措施。三叉神经刺激是一种耐受性良好的非药物治疗,基于设备的小儿多动症治疗,初步试验表明,效果大小与非兴奋剂药物相当。结论:ADHD护理的这些创新代表了临床上重要的新治疗选择和个性化护理的机会。卫生保健专业人员应将这些发展融入临床实践,注意个体患者和家庭的需求和偏好。未来的研究应该评估长期结果,成本效益,以及这些创新的可接受性。
    Objectives: This review aims to present recent innovations and advancements in attention-deficit/hyperactivity disorder (ADHD) care, encompassing international consensus statement, new medication formulations, digital therapeutics, and neurostimulation devices. Methods: A comprehensive literature search of relevant articles published in the past five years was conducted, emphasizing the evidence base, efficacy, safety, and practical implications of these advancements. Results: The World Federation of ADHD Consensus Statement offers an updated diagnostic and treatment framework rooted in global scientific evidence. There are several newer ADHD medication formulations, including a nonstimulant (Viloxazine extended release) and the first transdermal amphetamine patch approved to treat ADHD. These options offer some unique benefits to personalize treatment based on symptom profile, lifestyle, preferences, and response. Digital tools offer additional means to restructure environments for individuals with ADHD, reducing impairment and reliance on others. In addition, digital therapeutics enhance access, affordability, personalization, and feasibility of ADHD care, complementing or augmenting existing interventions. Trigeminal nerve stimulation emerges as a well-tolerated nonpharmacological, device-based treatment for pediatric ADHD, with initial trials indicating effect sizes comparable to nonstimulant medications. Conclusions: These innovations in ADHD care represent clinically significant new treatment options and opportunities for personalized care. Health care professionals should integrate these developments into clinical practice, mindful of individual patient and family needs and preferences. Future research should assess long-term outcomes, cost-effectiveness, and acceptability of these innovations.
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  • 文章类型: Journal Article
    注意力缺陷/多动障碍(ADHD)是最常见和可遗传的神经发育障碍之一,可能持续一生。先前编写了一份关于土耳其青年多动症诊断和管理的共识报告。然而,与会者和管理选择相当有限,过去十年的发展需要修订和更新共识。因此,本综述旨在总结Türkiye儿童和青少年精神科医生对儿童ADHD的性质和管理的共识。为了这些目标,多动症的病因,诊断和评估过程,流行病学,发展演讲,鉴别诊断和合并症,我们回顾了课程/结局和药理学以及非药理学管理方案,并提出了临床实践建议.由于ADHD是一种对功能有广泛影响的慢性疾病,经常伴有其他精神障碍,建议采用多维治疗方法.然而,因为这种疾病有神经生物学基础,药物治疗是治疗的主要手段。其他疗法可能包括心理社会疗法,行为疗法,以学校为基础的治疗方法,和家庭教育。本综述在国家和全球层面为多动症提供了建议。它包含有关ADHD的信息,这些信息将有助于并促进临床医生的决策过程。建议在临床实践中考虑该指南。
    Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common and heritable neurodevelopmental disorders which may last through the life-span. A consensus report on diagnosis and management of ADHD among Turkish youth was prepared previously. However, the participants as well as the management options were rather limited and developments in the past decade necessitated a revision and update of the consensus. Therefore, this review aims to summarize the consensus among Child and Adolescent Psychiatrists from Türkiye on the nature and management of pediatric ADHD. For those aims, the etiology of ADHD, diagnostic and evaluation process, epidemiology, developmental presentations, differential diagnoses and comorbidities, course/outcome and pharmacological as well as non-pharmacological management options were reviewed and suggestions for clinical practice are presented. Since ADHD is a chronic disorder with wide-ranging effects on functionality that is frequently accompanied by other mental disorders, a multidimensional therapeutic approach is recommended. However, since the disorder has neurobiological basis, pharmacotherapy represents the mainstay of treatment. Additional therapies may include psychosocial therapy, behavioral therapy, school-based therapeutic approaches, and family education. This review provides recommendations for ADHD at the national and global levels. It contains information about ADHD that will contribute to and facilitate clinicians\' decision-making processes. It is advisable to consider this guideline in clinical practice.
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  • 文章类型: Journal Article
    注意缺陷/多动障碍(ADHD)是一种神经发育障碍,其特征是持续的注意力不集中。多动症,和冲动。这是儿科服务中最常见的神经发育障碍,儿科医生经常参与早期评估,诊断,和治疗儿童多动症。多动症的治疗通常涉及多模式方法,包括心理教育的组合,家长/教师培训,社会心理/心理治疗干预,和药物治疗。关于药物治疗,指南在药物选择和测序方面各不相同,用精神兴奋剂,如哌醋甲酯和(LIS)右旋氨胺,通常是首选的初始治疗。替代品包括托莫西汀和胍法辛。药物治疗被证明是有效的,但是密切关注身体生长,心血管监测,以及对包括抽搐在内的潜在副作用的监测,情绪波动,和精神病症状,是必不可少的。本文概述了当前ADHD的药物治疗方案,并探讨了不同欧洲国家治疗指南的差异。结论:儿童和青少年ADHD的药物治疗方案有效且耐受性良好。ADHD的药物治疗始终是多模式方法的一部分。虽然欧洲关于ADHD药物治疗的指南有相当大的共识,存在显著差异,特别是关于各种药物的选择和排序。已知:•对于儿童和青少年中的ADHD,存在药物治疗的重要证据基础。•儿科医生经常参与评估,儿童多动症的诊断和治疗。新增内容:•我们对不同欧洲指南的概述揭示了在儿童和青少年ADHD药物治疗方面的重要共识。•差异主要存在于不同药物的选择和排序方面。
    Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by a persistent pattern of inattention, hyperactivity, and impulsivity. It is the most common neurodevelopmental disorder presenting to pediatric services, and pediatricians are often involved in the early assessment, diagnosis, and treatment of children with ADHD. The treatment of ADHD typically involves a multimodal approach that encompasses a combination of psychoeducation, parent/teacher training, psychosocial/psychotherapeutic interventions, and pharmacotherapy. Concerning pharmacotherapy, guidelines vary in drug choice and sequencing, with psychostimulants, such as methylphenidate and (lis)dexamfetamine, generally being the favored initial treatment. Alternatives include atomoxetine and guanfacine. Pharmacotherapy has been proven effective, but close follow-up focusing on physical growth, cardiovascular monitoring, and the surveillance of potential side effects including tics, mood fluctuations, and psychotic symptoms, is essential. This paper presents an overview of current pharmacological treatment options for ADHD and explores disparities in treatment guidelines across different European countries.   Conclusion: Pharmacological treatment options for ADHD in children and adolescents are effective and generally well-tolerated. Pharmacotherapy for ADHD is always part of a multimodal approach. While there is a considerable consensus among European guidelines on pharmacotherapy for ADHD, notable differences exist, particularly concerning the selection and sequencing of various medications. What is Known: • There is a significant base of evidence for pharmacological treatment for ADHD in children and adolescents. • Pediatricians are often involved in assessment, diagnosis and management of children with ADHD. What is New: • Our overview of different European guidelines reveals significant agreement in the context of pharmacotherapy for ADHD in children and adolescents. • Discrepancies exist primarily in terms of selection and sequencing of different medications.
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  • 文章类型: Journal Article
    注意缺陷多动障碍(ADHD)的特征是持续的注意力不集中症状,多动症,和冲动。两者,兴奋剂和非兴奋剂药物已被批准用于治疗这种疾病。一些西方指南建议使用规定的食品和药物管理局(FDA)批准的ADHD药物以及父母在行为管理和行为课堂干预方面的培训。2022年,日本发布了新的ADHD指南,它建议学校环境管理和社会心理治疗作为一线治疗,添加药物治疗作为二线治疗。虽然日本的指导方针,包括药物治疗,已经建立,亚洲地区ADHD药物的指南和使用情况尚不清楚.因此,适当评估药物治疗多动症的策略,我们调查了亚洲地区儿童ADHD药物治疗指南.我们还审查了马来西亚的指导方针,新加坡,印度,和大韩民国,发现这些准则与西方准则不同。
    Attention-deficit hyperactivity disorder (ADHD) is characterized by persistent symptoms of inattention, hyperactivity, and impulsivity. Both, stimulant and nonstimulant medications have been approved for the treatment of this disorder. Several Western guidelines recommend the use of prescribed Food and Drug Administration (FDA)-approved medications for ADHD along with parental training in behavior management and behavioral classroom intervention. In 2022, new Japanese guidelines for ADHD were issued, which recommended school environment management and psychosocial treatment as the first-line treatment, with pharmacological treatment added as the second-line treatment. Although Japanese guidelines, including pharmacological treatments, have been established, the guidelines and utilization of ADHD medications across Asian regions are unclear. Therefore, to appropriately evaluate the strategy of pharmacological treatments for ADHD, we investigated Asian regional guidelines for ADHD medication in children. We also reviewed the guidelines in Malaysia, Singapore, India, and the Republic of Korea and found that these guidelines differ from Western guidelines.
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  • 文章类型: English Abstract
    Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in school-age children, with 30%-50% persisting into adulthood. In addition, adult ADHD patients have more comorbidities, are more difficult to identify, and have a wider range of impairments on individual function, thereby leading to more serious adverse effects on medical care, economy and society. This consensus establishes the diagnose of adult ADHD based on the 11th edition of International Classification of Diseases (ICD-11), determines the treatment plans based on the etiology and pathogenesis of the disease, recommends psycho-stimulants as the first-line pharmacotherapy for adult ADHD and selective noradrenalin reuptake inhibitors (NARIs) as the second-line pharmacotherapy to reduce the core symptoms, and combines non-pharmacological treatments, such as cognitive behavioral therapy, health education and lifestyle training, aiming to improve patients\' functioning and quality of life to the utmost.
    注意缺陷多动障碍(ADHD)是一种学龄期儿童常见的神经发育障碍,30%~50%可持续到成年期,且成人ADHD共病更多、更难以识别,对个体功能损害范围更广。因此,具有更大的医学、经济和社会影响。本共识基于国际疾病诊断分类第11版(ICD-11)确定本病的诊断,依据病因和发病机制确定治疗方案,推荐中枢兴奋剂作为本病的一线药物治疗,选择性去甲肾上腺素再摄取抑制剂作为二线药物治疗以减轻核心症状,联合认知行为治疗、健康教育、生活方式训练等非药物干预以最大限度地改善患者的功能损害,提升生活质量。.
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  • 文章类型: Journal Article
    背景:指南依从性对于确保对患有注意力缺陷/多动障碍(ADHD)的儿童和青少年的哌醋甲酯的最佳和安全使用很重要。我们调查了荷兰关于在儿童和青少年精神卫生保健和儿科治疗环境中使用哌醋甲酯的剂量和监测指南的依从性。方法:对2015年和2016年的儿童和青少年病历进行调查。我们评估了对以下指南建议的遵守情况:(1)在剂量发现阶段至少进行四次访问;(2)此后至少每6个月进行一次监测;(3)至少每年测量身高和体重;(4)使用经过验证的问卷评估治疗反应。Pearson的卡方检验统计量用于检查设置之间的差异。结果:在剂量发现阶段,只有一小部分患者至少有四次就诊(前4周为5.1%,前6周为12.4%)。此外,不到一半的患者(48.4%)至少每6个月就诊一次.42.0%的患者至少每年记录身高,重量在44.9%,两者都录得19.5%的增长图。评估治疗反应的问卷调查仅用于所有访视的2.3%。比较这两种设置时,更多的儿科患者每6个月就诊一次,尽管在精神健康护理机构中更经常记录身高和体重。结论:总体而言,指南依从性低。对临床医生进行培训并在电子病历模板中添加指南建议可能会提高依从性。此外,我们应该通过批判性地看待指南的可行性来缩小指南与临床实践之间的差距。
    Background: Guideline adherence is important to ensure optimal and safe use of methylphenidate for children and adolescents with attention-deficit/hyperactivity disorder (ADHD). We investigated adherence to Dutch guidelines regarding dosing and monitoring of methylphenidate in child and adolescent mental health care and pediatric treatment settings. Methods: Five hundred six medical records of children and adolescents were investigated in 2015 and 2016. We assessed adherence to the following guideline recommendations: (1) at least four visits during the dose-finding phase; (2) monitoring thereafter at least every 6 months; (3) measuring height and weight at least annually; and (4) the use of validated questionnaires to assess treatment response. Pearson\'s chi-squared test statistics were used to examine differences between settings. Results: Only a small portion of patients had at least four visits during the dose-finding phase (5.1% in the first 4 weeks to 12.4% in the first 6 weeks). Also, less than half of the patients (48.4%) were seen at least every 6 months. Height was recorded at least annually in 42.0% of patients, weight in 44.9%, and both recorded in a growth chart in 19.5%. Questionnaires to assess treatment response were only used in 2.3% of all visits. When comparing both settings, more patients in the pediatric settings were seen every 6 months, although height and weight were recorded more often in the mental health care setting. Conclusion: Overall, guideline adherence was low. Training of clinicians and adding guideline recommendations to electronic medical records templates may improve adherence. Additionally, we should aim to close the gap between guidelines and clinical practice by looking critically at the feasibility of guidelines.
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  • 文章类型: Journal Article
    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年首次发布了有关ADHD的临床实践指南,该指南于2011年进行了修订,并与随附的护理过程算法一起重新发布。最近,2019年临床实践指南修订版发布.自2011年指南以来,精神疾病诊断和统计手册,第五版(DSM-5),被释放了。此外,发育和行为儿科学会(SDBP)最近发布了另一项复杂多动症的临床实践指南.尽管这些更新中反映了不必要的变化,仍有一些变化;例如,DSM-5标准降低了老年青少年和成人ADHD的诊断阈值.此外,修订了标准,以方便应用于年龄较大的青少年和成年人,现在允许与自闭症谱系障碍共病诊断。同时,2019年AAP指南增加了与多动症合并症相关的建议.最后,SDBP制定了一个复杂的多动症指南,涵盖共病条件等领域,中度至重度损伤,治疗失败,诊断的不确定性。此外,其他国家多动症指南已经公布,欧洲在新冠肺炎大流行期间管理多动症的指导方针也是如此。为了促进初级保健中的多动症管理,提供和审查临床指南和最新更新非常重要.在这篇文章中,我们将回顾和总结最近的临床指南及其更新。
    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.
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  • 文章类型: Journal Article
    本文的目的是概述澳大利亚基于证据的注意缺陷多动障碍(ADHD)临床实践指南的发展和建议。该指南旨在促进准确和及时的识别和诊断,和多动症的最佳和一致的治疗。
    开发将现有的最佳证据与多学科临床专业知识以及有经验的人的偏好相结合,以建议分级为基础,评估,发展,和评估(等级)框架。23个指南发展小组成员包括精神科医生,儿科医生,全科医生,心理学家,言语病理学家,职业治疗师,教育工作者,土著心理学家,和有生活经验的人;有两个独立的椅子和一个方法学家。在适当的情况下,美国国家健康与护理卓越研究所(NICE)2018年的“注意力缺陷多动障碍:诊断和管理”指南的证据综述已更新.在14项系统评价(NICE2018年新增和更新)和28项叙述性评价中解决了50个优先临床问题。
    113项临床建议适用于幼儿(5岁及以下),孩子们,青少年和成年人。他们为临床医生提供识别指导,筛选,诊断,多模式治疗和支持,包括药物和非药物干预措施。指南和支持信息可在线获得:https://adhdguideline。aadpa.com.au/.
    该指南得到了澳大利亚国家卫生与医学研究委员会(NHMRC)以及相关医学和相关卫生专业协会的批准。预计组织将成功实施和采纳该指南,医疗保健提供者和其他专业人员将增加循证治疗的交付,并改善80多万患有ADHD的澳大利亚人的健康结果。
    The objective of this article was to provide an overview of the development and recommendations from the Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). The guideline aims to promote accurate and timely identification and diagnosis, and optimal and consistent treatment of ADHD.
    Development integrated the best available evidence with multidisciplinary clinical expertise and the preferences of those with lived experience, underpinned by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The 23 guideline development group members included psychiatrists, paediatricians, general practitioners, psychologists, speech pathologists, occupational therapists, educators, Indigenous psychologists, and people with a lived experience; with two independent chairs and a methodologist. Where appropriate, evidence reviews from the National Institute for Health and Care Excellence (NICE) 2018 \'Attention Deficit Hyperactivity Disorder: Diagnosis and Management\' guideline were updated. Fifty prioritised clinical questions were addressed in 14 systematic reviews (new and updated from NICE 2018) and 28 narrative reviews.
    The 113 clinical recommendations apply to young children (5 years and under), children, adolescents and adults. They provide guidance for clinicians on identification, screening, diagnosis, multimodal treatment and support, including pharmacological and non-pharmacological interventions. The guideline and supporting information are available online: https://adhdguideline.aadpa.com.au/.
    The guideline was approved by the National Health and Medical Research Council (NHMRC) of Australia and relevant medical and allied health professional associations. It is anticipated that successful implementation and uptake of the guideline by organisations, health care providers and other professionals will increase delivery of evidence-based treatment and improve health outcomes for the more than 800,000 Australians with ADHD.
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