诊断与药物治疗黄宗显医生.ppt

* Notes: Substance abuse onset earlier, last longer and remit more slowly * * Highlights the myths of public towards ADHD If they can concentrate on TV game, they must not have ADHD. Truth- even for people with ADHD, they can still concentrate on something that they like e.g. fishing, TV They oppose with intention Truth- they just cannot follow instruction and not listen to others because of their inattention but not their intention, however some ADHD children develop into ODD (Oppositional Defiant Disorder) if ADHD cannot be detected at the earlier stage 3. It must be related to the parenting skills Truth- the cause is unknown but parenting is not the cause for it. It is an indirect factor for the severity of symptoms. If parents learn effective parenting skills, child’s problem may improve 4. Boys are always like that Truth – Boy: girl = 6:1 clinic referrals Boy: girl = 1:1 in adult clinic (Brown, 2005) Biederman et al.(2005): clinical correlates of ADHD are not influenced by gender and that gender differences reported in groups of subjects seen in clinical settings may be caused by referral biases. Underdiagnose of women in childhood because they did not bring trouble * Educational intent: to represent just one example of many of the relative effectiveness of interventions?? SPEAKERS’ NOTES The Multimodal Treatment study of children with ADHD (MTA study) is the single most important randomised clinical trial of treatment strategies for ADHD. 579 combined-type children, aged 7-9.9 years, were assigned to 14 months of: MED – medication management (titration followed by monthly visits) IBT – intensive behavioural treatment (parent, school and child components) MED+IBT – the two combined, or Community care – standard community care (treatment by community providers). All four groups showed sizable reductions in symptoms over time, but there were significant differences among them in the degree of change. For most ADHD symptoms, children in the com