目的循证评价儿童和青少年注意缺陷多动障碍（ADHD）临床指南,比较推荐药物的异同,以期为临床使用提供参考。方法计算机检索Pub Med、EMbase、VIP、Wan Fang Data和CNKI数据,以及NGC（National Guideline Clearinghouse）、GIN（Guideli...目的循证评价儿童和青少年注意缺陷多动障碍（ADHD）临床指南,比较推荐药物的异同,以期为临床使用提供参考。方法计算机检索Pub Med、EMbase、VIP、Wan Fang Data和CNKI数据,以及NGC（National Guideline Clearinghouse）、GIN（Guidelines International Network）和NICE（National Institute for Health and Clinical Excellence）网站,纳入儿童和青少年ADHD相关临床指南,检索时限均为建库至2013年12月,而后使用AGREEⅡ工具评价纳入指南的方法学质量,分析比较各指南的异同。结果 1共纳入9个指南,制定时间跨度为2004~2012年,其中美国4个、欧洲3个、英国2个。2纳入指南推荐级别为A级2个、B级7个,在AGREEⅡ各领域得分高低依次为＂清晰性＂、＂范围和目的＂、＂参与人员＂、＂应用性＂、＂制定的严谨性＂及＂编辑的独立性＂,仅在＂清晰性与可读性＂和＂范围与目的＂2个领域平均得分〉60%。3纳入指南中有3个为循证指南,其在制定的严谨性上得分居前三。4各指南推荐意见略有差别。结论不同国家或地区儿童和青少年ADHD临床指南的整体质量不高,AGREEⅡ工具6个领域23个条目评分各有高低,循证指南各领域的得分均较高。今后儿童和青少年ADHD临床指南在制定的严谨性和应用性上要加强,应注意申明利益冲突,并提倡采用循证医学方法制定指南,使用最佳证据。展开更多
Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) ...Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.展开更多
文摘目的循证评价儿童和青少年注意缺陷多动障碍（ADHD）临床指南,比较推荐药物的异同,以期为临床使用提供参考。方法计算机检索Pub Med、EMbase、VIP、Wan Fang Data和CNKI数据,以及NGC（National Guideline Clearinghouse）、GIN（Guidelines International Network）和NICE（National Institute for Health and Clinical Excellence）网站,纳入儿童和青少年ADHD相关临床指南,检索时限均为建库至2013年12月,而后使用AGREEⅡ工具评价纳入指南的方法学质量,分析比较各指南的异同。结果 1共纳入9个指南,制定时间跨度为2004~2012年,其中美国4个、欧洲3个、英国2个。2纳入指南推荐级别为A级2个、B级7个,在AGREEⅡ各领域得分高低依次为＂清晰性＂、＂范围和目的＂、＂参与人员＂、＂应用性＂、＂制定的严谨性＂及＂编辑的独立性＂,仅在＂清晰性与可读性＂和＂范围与目的＂2个领域平均得分〉60%。3纳入指南中有3个为循证指南,其在制定的严谨性上得分居前三。4各指南推荐意见略有差别。结论不同国家或地区儿童和青少年ADHD临床指南的整体质量不高,AGREEⅡ工具6个领域23个条目评分各有高低,循证指南各领域的得分均较高。今后儿童和青少年ADHD临床指南在制定的严谨性和应用性上要加强,应注意申明利益冲突,并提倡采用循证医学方法制定指南,使用最佳证据。
文摘Aims: This study was designed to verify the proportion of Japanese adults with pervasive developmental disorder (PDD) who met the diagnostic criteria (other than E) for attention-deficit/hyperactivity disorder (ADHD) in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Furthermore, we examined to what extent adults with PDD think that they exhibit ADHD symptoms. Methods: We developed an original Japanese self-report questionnaire to determine the presence or absence of 18 symptoms from the diagnostic criteria for ADHD in the DSM-IV-TR. We administered the questionnaire to 64 adults with high-functioning PDD (45 men and 19 women) and 21 adults with ADHD (10 men and 11 women), aged 18 to 59 years, with a full-scale intelligence quotient ≥75. Target patients were evaluated for ADHD by their psychiatrists. Results: Twenty-nine (45.3%) adults with PDD also had ADHD. The percentage of these adults who had over six perceived inattention symptoms from the DSM-IV-TR was 96.6%. The percentage of these adults who had over six perceived hyperactivity-impulsivity symptoms was 65.5%. Thirty-five (55.6%) adults with PDD responded that they were aware of having ADHD symptoms at the level of the relevant diagnostic criteria. Conclusions: The present study is the first to examine the frequency of objective and perceived ADHD symptoms in adults with PDD in Japan. Our results show that both objective and perceived ADHD symptoms frequently appear in a large number of adults with PDD. This suggests that it is necessary to attend to concomitant ADHD symptoms in the medical care of adults with PDD.
