Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
复制标题
儿童和青少年注意力缺陷/多动障碍的诊断、评估和治疗临床实践指南
DOI：
10.1542/peds.2019-2528
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发表时间：
2019-10-01
期刊：
影响因子：
8
通讯作者：
Hagan, Joseph F., Jr.
中科院分区：
文献类型：
--
作者：
Wolraich, Mark L.;Hagan, Joseph F., Jr.;Hagan, Joseph F., Jr.
注意力缺陷/多动障碍 (ADHD) 是儿童期最常见的神经行为障碍之一，可深刻影响儿童的学业成绩、幸福感和社交互动。美国儿科学会于 2000 年首次发布了儿童 ADHD 评估和诊断的临床建议； 2001 年提出了治疗建议。该指南于 2011 年进行了修订，并发布了随附的护理流程算法 (PoCA)，提供了离散且可管理的步骤，临床医生可以通过这些步骤来实现临床指南的建议。自2011年指南发布以来，《精神疾病诊断与统计手册》已修订为第五版，并发表了新的ADHD相关研究。这些出版物不支持对先前的建议进行重大改变。因此，本指南修订仅进行了增量更新，包括添加了与多动症儿童和青少年共病的诊断和治疗相关的关键行动声明。随附的护理流程算法也已更新，以协助实施指南建议。在修订指南和算法的整个过程中，发现了许多系统性障碍，这些障碍限制和/或妨碍儿科临床医生采纳其建议的能力。因此，小组委员会撰写了一篇关于照顾患有多动症的儿童和青少年的系统性障碍的配套文章（可在补充信息中找到），其中确定了主要的系统性障碍并提出了解决这些障碍的建议；在本文中，我们支持临床实践指南和随附的护理流程的建议。
Attention-deficit/hyperactivity disorder (ADHD) is 1 of the most common neurobehavioral disorders of childhood and can profoundly affect children's academic achievement, well-being, and social interactions. The American Academy of Pediatrics first published clinical recommendations for evaluation and diagnosis of pediatric ADHD in 2000; recommendations for treatment followed in 2001. The guidelines were revised in 2011 and published with an accompanying process of care algorithm (PoCA) providing discrete and manageable steps by which clinicians could fulfill the clinical guideline's recommendations. Since the release of the 2011 guideline, the Diagnostic and Statistical Manual of Mental Disorders has been revised to the fifth edition, and new ADHD-related research has been published. These publications do not support dramatic changes to the previous recommendations. Therefore, only incremental updates have been made in this guideline revision, including the addition of a key action statement related to diagnosis and treatment of comorbid conditions in children and adolescents with ADHD. The accompanying process of care algorithm has also been updated to assist in implementing the guideline recommendations. Throughout the process of revising the guideline and algorithm, numerous systemic barriers were identified that restrict and/or hamper pediatric clinicians' ability to adopt their recommendations. Therefore, the subcommittee created a companion article (available in the Supplemental Information) on systemic barriers to the care of children and adolescents with ADHD, which identifies the major systemic-level barriers and presents recommendations to address those barriers; in this article, we support the recommendations of the clinical practice guideline and accompanying process of care algorithm.