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Dr. Hallowell on the Today show discussing Adult ADD

While ADD 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 ADD/ADHD who will outgrow it, we now know that the vast majority will not. Listed below are criteria for adult ADD 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 lability, 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 AD/HD or manic depressive illness or depression or substance abuse or other disorders of impulse control or mood. Recognizing and treating ADD is just as important for adults as it is for children, as it has a wide ranging impact in careers, marriages and families. [1]

Embed YouTube Video Trial

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特征和诊断

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诊断ADHD的标准系依据DSM-IV-TR精神疾病诊断与统计手册的标准，可以连结至美国疾病控制与预防中心（CDC）查询。美国疾病管制局强调儿童及成人之ADHD诊断必须由受过专业训练的医疗团队(例如：Pediatric psychiatrist 儿童精神科医师团队)才可，否则容易被误诊与处方，这是相当危险的。

According to the DSM-5, symptoms must be present for six months or more to a degree that is much greater than others of the same age[10] and they must cause significant problems functioning in at least two settings (e.g., social, school/work, or home).[10] The full criteria must have been met prior to age 12 in order to receive a diagnosis of ADHD.[10]
根据最新的DSM-5，以下表列之症状必须持续至少六个月且其程度明显高于多数同年龄层之同侪。除此之外，以下表列之症状必须在至少两种不同的情境下(例如：社交、课业/工作、或家庭)造成显著的问题，且这些条件必须出现在大约十二岁以前。

ADHD is divided into three subtypes: predominantly inattentive, predominantly hyperactive-impulsive, and combined type.[10][35] A child with ADHD inattentive type has most or all of following symptoms, excluding situations where these symptoms are better explained by another psychiatric or medical condition:[10][36] Be easily distracted, miss details, forget things, and frequently switch from one activity to another Have difficulty maintaining focus on one task Become bored with a task after only a few minutes, unless doing something enjoyable Have difficulty focusing attention on organizing and completing a task or learning something new Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities Seem to not be listening when spoken to Daydream, become easily confused, and move slowly Have difficulty processing information as quickly and accurately as others Struggle to follow instructions Have trouble understanding minute details
注意力不足过动症又可细分为以下三种类型：注意力不足为主型、过动-冲动为主型、及注意力不足且过动冲动的混和型。
一个以注意力不足为主的ADHD拥有以下几乎所有的症状，且非由其他医学疾病直接造成。

  • 容易分心、粗心、忘记事情且经常从一件事情切换至另一件事情。
  • 难以持续对于一件事情保持专注。
  • 除非是从事自己有兴趣的事情，否则很容易对从事一件事情感到无聊。
  • 难以对组职事情、完成一个任务或学习新事物保持专注。
  • 难以完成或(如期)缴交家庭作业并且经常丢失一些用以完成任务或活动的必备东西(例如：铅笔、玩具、作业)
  • 当你在跟患者说话时，该患者似乎没在听你说话。
  • 白日梦、容易困惑、且移动迟缓。
  • 难以和其他非ADHD的人一样精确且快速的在脑海中处理接收到的资讯。
  • 难以遵从指示。
  • 难以认知细微的细节。

A child with ADHD hyperactive/impulsive type has most or all of the following symptoms, excluding situations where these symptoms are better explained by another psychiatric or medical condition:[10][36] Fidget and squirm in their seats Talk nonstop Dash around, touching or playing with anything and everything in sight Have trouble sitting still during dinner, school, doing homework, and story time Be constantly in motion Have difficulty doing quiet tasks or activities Be very impatient Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences Have difficulty waiting for things they want or waiting their turns in games Often interrupt conversations or others' activities
一个以过动-冲动为主的ADHD拥有以下几乎所有的症状，且非由其他医学疾病直接造成。

  • 坐在椅子上动来动去
  • 一直讲话
  • 四处东奔西跑、碰触或玩弄视野内的任一或每一个物体。
  • 难以在吃饭时间、学校中、做功课的时间、及故事时间坐著。
  • 一直在移动、动作。
  • 难以从事安静的任务或活动。
  • 非常不耐烦。
  • 脱口说出不恰当的话语、毫无掩饰地直接在表情中流露出心理的想法、不顾后果的豪放不羁。
  • 难以接(忍)受延迟的满足、难耐在游戏中因轮流所产生的等待时间。
  • 经常打断他人的对话或活动。

Symptoms of hyperactivity tend to go away with age and turn into "inner restlessness" in teens and adults with ADHD.[15]
在青少年及成年的注意力不足过动症患者中，过动的症状往往随著社会化及年龄的增长而转变为"内在的不安宁"。

People with ADHD of all ages are more likely to have problems with social skills, such as social interaction and forming and maintaining friendships. This is true for all subtypes. About half of children and adolescents with ADHD experience social rejection by their peers compared to 10–15% of non-ADHD children and adolescents. People with attention deficits are prone to having difficulty processing verbal and nonverbal language which can negatively affect social interaction. They also may drift off during conversations, and miss social cues.[37] Difficulties managing anger are more common in children with ADHD[38] as are poor handwriting[39] and delays in speech, language and motor development.[40][41] Although it causes significant impairment, particularly in modern society, many children with ADHD have a good attention span for tasks they find interesting.[6]
各年龄层的注意力不足过动症患者往往较容易遭遇社交技巧上的问题，例如：社交互动、建立及维持友谊。这个观察在各注意力不足过动症的三种子类型中都是成立的。大约一半(50%)的患有ADHD的儿童及青少年曾经历过社交上的拒绝(排斥)；而其同侪遭遇社交上的拒绝的比率约为10~15%。注意力不足的人比起对照组(非ADHD)更容易遭遇理解口头与非口头言语上的困难，进而对于其社交互动产生负面影响。ADHD也可能在对话的过程中打瞌睡会遗漏他人释放出的社交暗示。
难以管理愤怒情绪的情况则较常在儿童ADHD身上显现。且儿童ADHD通常有写字的困难、言语及行动发展的迟缓。虽然这造成患者在现今社会中很大的障碍，然而许多ADHD在他们有兴趣的事情上都能持续维持专注力。 Associated disorders[edit]
In children, ADHD occurs with other disorders about ⅔ of the time.[6] Some commonly associated conditions include:
Learning disabilities have been found to occur in about 20–30% of children with ADHD. Learning disabilities can include developmental speech and language disorders and academic skills disorders.[42] ADHD, however, is not considered a learning disability, but it very frequently causes academic difficulties.[42]
Tourette syndrome has been found to occur more commonly in the ADHD population.[43]
Oppositional defiant disorder (ODD) and conduct disorder (CD), which occur with ADHD in about 50% and 20% of cases respectively.[44] They are characterized by antisocial behaviors such as stubbornness, aggression, frequent temper tantrums, deceitfulness, lying, and stealing.[45] About half of those with hyperactivity and ODD or CD develop antisocial personality disorder in adulthood.[46] Brain imaging supports that conduct disorder and ADHD are separate conditions.[47]
Primary disorder of vigilance, which is characterized by poor attention and concentration, as well as difficulties staying awake. These children tend to fidget, yawn and stretch and appear to be hyperactive in order to remain alert and active.[45] Mood disorders (especially bipolar disorder and major depressive disorder). Boys diagnosed with the combined ADHD subtype are more likely to have a mood disorder.[48] Adults with ADHD sometimes also have bipolar disorder, which requires careful assessment to accurately diagnose and treat both conditions.[49] Anxiety disorders have been found to occur more commonly in the ADHD population.[48] Obsessive-compulsive disorder (OCD) can co-occur with ADHD and shares many of its characteristics.[45] Substance use disorders. Adolescents and adults with ADHD are at increased risk of substance abuse.[15] This is most commonly seen with alcohol or cannabis.[15] The reason for this may be an altered reward pathway in the brains of ADHD individuals.[15] This makes the evaluation and treatment of ADHD more difficult, with serious substance misuse problems usually treated first due to their greater risks.[18][50] Restless legs syndrome has been found to be more common in those with ADHD and is often due to iron deficiency anaemia.[51][52] However, restless legs can simply be a part of ADHD and requires careful assessment to differentiate between the two disorders.[53] Sleep disorders and ADHD commonly co-exist. They can also occur as a side effect of medications used to treat ADHD. In children with ADHD, insomnia is the most common sleep disorder with behavioral therapy the preferred treatment.[54][55] Problems with sleep initiation are common among individuals with ADHD but often they will be deep sleepers and have significant difficulty getting up in the morning.[56] Melatonin is sometimes used in children who have sleep onset insomnia.[57] People with ADHD have an increased risk of persistent bed wetting.[58] A 2016 systematic review found a well established association between ADHD and obesity, asthma and sleep disorders, and tentative evidence for association with celiac disease and migraine,[59] while another 2016 systematic review did not support a clear link between celiac disease and ADHD, and stated that routine screening for celiac disease in people with ADHD is discouraged.[60]

治疗方式的争议

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即便目前ADHD的治疗策略(涵盖药物既非药物治疗)皆通过世界各国政府机关及世界卫生组织的安全及临床试验认可，少部分台湾的中国医学科医师(中医师)仍对此不以为然，认为西药有毒又有副作用。坊间亦有人宣传“保健食品”、花精皂(宣称多搭配此香皂洗手可治疗ADHD)、“人造磁铁”、“自然疗法”、“营养处方”等试验者、提倡者、成分、短中长期之安全性、有效性、科学根据、官方认证、......皆不明的疗法。

对此，台湾儿童青少年精神医学会理事长、国立台湾大学医学院附设医院精神科主治医师高淑芬回应指出，对ADHD治疗想法可以很多元，但介入方式必需要有科学证据及严谨的研究设计，包括对象治疗多久，都应受到密切监督.[2] 台湾儿童青少年精神医学会并在其官方公告中发布以标题各为孩子和家长接受专业医疗协助的权利，是需要被维护的、20160728公听会-台湾儿童青少年精神医学会新闻稿为首的数份新闻稿，其内容涵盖对于当前治疗策略的明确释疑外，亦重申有科学根据、通过临床试验、获得政府安全许可的把关才是一个疗法对患者人生负责任的体现。

Further agendas: Refer to ADHD page English version to seek for inspiration to optimize the Chinese version of ADHD. Refer to Obsessive Compulsive Disorder talk page written in Chinese characters to see whether or not to get involved in listed activities over there. :D 11/20/2016 20:18

完善医疗环境之展望

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当前之医疗环境仍有许多值得改善之处。 包括：

因此台湾精神医学会指出

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Myth or frequently asked questions
Question:
“ADHD在台湾被过度诊断、过度治疗根本是药物滥用！”

Answer:
台湾儿童“注意力不足过动症（ADHD）”盛行率约7%~7.5%。全世界平均值约7.2%。
根据健保资料库，小于18岁之“注意力不足过动症（ADHD）”患者求诊率约2.3％~2.5%，用药率约1.6％。因此“ADHD台湾被过度诊断、过度治疗根本是药物滥用！”是不成立的。[3]

Question:

Answer:


Reference coverages: ADHD用药争议 立法院上演大对决

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A. Consider to write a paragraph to include most of the links.
For instance,
B. 格式手册的目的是为了提供一些准则、方针，使得所有条目的编辑风格变得一致。以下的规则并没有声明不能变动，也不暗示这些规则比其他方式都要好，但如果所有人的编辑方式都一致，维基百科会更易于阅读和使用，并让撰写和编辑变得更加方便。《芝加哥格式手册》里面的话应得到注意： 格式手册的目的是为了提供一些准则、方针，使得所有条目的编辑风格变得一致。以下的规则并没有声明不能变动，也不暗示这些规则比其他方式都要好，但如果所有人的编辑方式都一致，维基百科会更易于阅读和使用，并让撰写和编辑变得更加方便。《芝加哥格式手册》里面的话应得到注意： “规章制度，本质上，并非永恒不变的定律。它们仅针对一般案例，必须在某程度的弹性下应用。 （Rules and regulations such as these, in the nature of the case, cannot be endowed with the fixity of rock-ribbed law. They are meant for the average case, and must be applied with a certain degree of elasticity.）”

“当然，编写内容清晰、有内涵、无偏见的条目，比任何的文章编排格式来得更重要。只要您能做到这一点，其实无须过分在意任何指引：编辑维基的乐趣在于未必凡事都要做到最完美。”

其他维基参与者在编辑维基百科的时候，会按照这个指引修正不规范格式的条目，条目会渐渐地符合指引内容。 https://zh.wikipedia.org/wiki/Wikipedia:格式手册 Wikipedia:格式手册
C. 将连结数目减至最少[edit source] 尽量只放置一个官方连结；若放置多于一个官方连结，请确保各连结提供不同的内容，而且连结之间没有联系。例如，一位作者的官网有其微博和网志连结，则无须放置3个外部链接，放置官网就足够。请以最少的连结提供最多的资讯。请谨记，维基百科不是纯粹的外部链接收集处或网站列表。https://zh.wikipedia.org/wiki/Wikipedia:外部链接#.E5.B0.87.E9.80.A3.E7.B5.90.E6.95.B8.E7.9B.AE.E6.B8.9B.E8.87.B3.E6.9C.80.E5.B0.91 Wikipedia:外部链接
D. No rule was found with respect to limitation of number of external link can be added.
E. Many outdated/obsolete external links were hidden upon the addition of External Link Issue template on the top of the page.

For instance 间接医疗协助 (社会资源协助)

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台湾

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除了在医疗场所接受直接的医疗照护外，中华民国政府亦附设许多相关机构，例如：......。以便让这些患者能

除了在医疗场所接受直接的医疗照护外，中华民国中央政府及地方政府亦下辖卫生福利部-社会及家庭署[4]及社会局[5]等，汇整对于弱势者社会支持的资源，以便让这些患者能在接受直接医疗协助时无后顾之忧。

  1. ^ Dr. Hallowell on the Today show discussing Adult ADD
  2. ^ ADHD用药争议 立法院上演大对决, 2016年8月
  3. ^ [www.healthnews.com.tw/news/article/30113/三人成虎 三人成虎_ADHD过动症须正视勿轻信谣传]
  4. ^ 中华民国卫生福利部-社会及家庭署
  5. ^ 中华民国高雄市政府社会局
检索自“https://zh.wikipedia.org/w/index.php?title=User:It%27s_gonna_be_awesome/沙盒&oldid=42625667”