成人注意力不足過動症：修订间差异

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===健康與社會領域的障礙===
===健康與社會領域的障礙===

成人注意力不足過動症患者與''非'' 成人注意力不足過動症患者相比，成人ADHD患者遭遇職業困難（occupational difficulties）、交通事故、從事犯罪、物質濫用的比例較高<ref name="Jerome Habinski Segal 2006 pp. 416–26">{{cite journal | last=Jerome | first=L | last2=Habinski | first2=L | last3=Segal | first3=A | title=Attention-deficit/hyperactivity disorder (ADHD) and driving risk: a review of the literature and a methodological critique. | journal=Current psychiatry reports | volume=8 | issue=5 | year=2006 | issn=1523-3812 | pmid=16968625 | pages=416–26}}</ref><ref name="Biederman Faraone Spencer Mick 2006 pp. 524–40">{{cite journal | last=Biederman | first=J | last2=Faraone | first2=SV | last3=Spencer | first3=TJ | last4=Mick | first4=E | last5=Monuteaux | first5=MC | last6=Aleardi | first6=M | title=Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community. | journal=The Journal of clinical psychiatry | volume=67 | issue=4 | year=2006 | issn=0160-6689 | pmid=16669717 | pages=524–40}}</ref><ref name="Hodgkins Arnold Shaw Caci 2012 p. ">{{cite journal | last=Hodgkins | first=Paul | last2=Arnold | first2=L. Eugene | last3=Shaw | first3=Monica | last4=Caci | first4=Hervé | last5=Kahle | first5=Jennifer | last6=Woods | first6=Alisa G | last7=Young | first7=Susan | title=A Systematic Review of Global Publication Trends Regarding Long-Term Outcomes of ADHD | journal=Frontiers in psychiatry | publisher=Frontiers Media SA | volume=2 | year=2012 | issn=1664-0640 | pmid=22279437 | pmc=3260478 | doi=10.3389/fpsyt.2011.00084 | page=}}</ref>。


====職場====
====職場====

2019年1月28日 (一) 13:16的版本

成人注意力不足過動症
Adult Attention deficit hyperactivity disorder
fMRI[1]
分类和外部资源
醫學專科精神医学
OMIM143465
[编辑此条目的维基数据]
维基百科中的醫學内容仅供参考，並不能視作專業意見。如需獲取醫療幫助或意見，请咨询专业人士。詳見醫學聲明。
成人注意力不足過動症
类型注意力不足過動症
分类和外部资源
醫學專科精神医学
OMIM143465
[编辑此条目的维基数据]
参见：注意力不足過動症 § 成年注意力不足過動症患者

成人注意力不足過動症（英語：Adult attention deficit hyperactivity disorder、adult ADHD、adult with ADHD、ADHD in adults、或AADD）是持續到成年的注意力不足過動症，是一種神經生理（英语：clinical neuroscience）病症。大約有三分之一到三分之二的兒童青少年ADHD的症狀會持續到成年乃至終身。[2]（p. 44）[3]


特徵與症狀

患者往往有組織規劃上的困難，且容易感到挫折。[9]

注意力缺陷

成人注意力不足過動症患者之注意力缺陷的症狀表現為難以長時間把專注力維持在一件事情上。患者有組織、規劃、安排事情的困難而且難以分辨事情的緩急輕重以及難以長期追蹤任務並完成任務[10]。患者不僅健忘而且時間管理能力明顯有問題[10]。患者總是在截止期限前一刻才完成作業或根本還沒動手開始做作業、遲交作業[10]。注意力缺陷也影響患者的駕駛型態，患者常在行駛中粗心大意、收到罰單、超速。[10]

過動

從青春期開始直到往後的人生，過動-衝動的症狀將漸漸不再頻繁以外部的肢體表現出來，轉而傾向以「內在的不安寧（inner restlessness）」等內在型式或以多話或插嘴打斷他人等外在形式表現。[2]（p. 44）[11]

衝動

過度參與具有相當高的機率會讓參與者付出代價的活動；過度（過於頻繁、用詞過重或語氣過於直接）說出那些具有相當高可能性會讓他最終付出代價的言論[12]。成年時期的衝動後果往往重於童年時期的衝動。除此之外，患者可能會在時機未成熟的情況下貿然中斷關係、或是在找到其他工作之前就辭職。[12] 衝動的問題同樣會導致患者的駕駛行為出狀況[12]。

情緒不穩

成人注意力不足過動症患者通常已衍生出情感障礙、焦慮症、物質濫用或經常突然暴怒（英语：Intermittent explosive disorder）等共病[13]。

心情不穩（英语：mood liability）、容易激動、容易暴怒、低挫折容忍度以及缺乏動機（擺爛）等都是成人注意力不足過動症患者的常見特徵。雖然這些特徵也常見於某些心理疾病。[14][15]患者通常難以應場合需要而控制自己的情緒（特別是那些負面的情緒），這讓患者常難以維繫工作與人際關係[16]。

憤怒管理

[17][18][19][20]

缺乏動機

執行功能缺損

健康與社會領域的障礙

成人注意力不足過動症患者與非 成人注意力不足過動症患者相比，成人ADHD患者遭遇職業困難（occupational difficulties）、交通事故、從事犯罪、物質濫用的比例較高[21][22][23]。

職場

意外事故

行為障礙

物質濫用

成人注意力不足過動症患者中約有五分之一到四分之一的人帶有物質濫用的情況。[24]

人際關係

婚姻等親密關係

成人注意力不足過動症（尤其是「過動-衝動」、「混合型」）可能增加其做出令眾人感到無法接受的犯罪行為（包含與熟識的人的互動中使用暴力（英语：intimate partner violence）（IPV）：家庭暴力、酒精成癮）的風險。若成人注意力不足過動症合併行為障礙（英语：conduct disorder），則上述風險將顯著提升。然而許多成人注意力不足過動症患者也遭受緊密關係暴力（IPV）。[25][26][27][28][29][30][31][32][33][34][35][36][37]

置身於存在緊密關係暴力的環境將增加孩子罹患ADHD的機會。具有憂慮傾向的父母，其養育小孩的能力與經濟能力通常有限，將導致孩子的健康較差且發育不良並增加罹患注意力不足過動症的機率。[38][39][40][41] [42][43]成長於婚後暴力的家庭中的孩子，其未來將有較高機率出現行為問題。[44]

治療

Enkele verkrijgbare merken methylfenidaat
参见：注意力不足過動症的治療

成人注意力不足過動症的治療包含藥物並結合行為治療、認知治療、或職能醫學介入（英语：occupational medicine）。[45]治療往往從以藥物治療ADHD的症狀及可能存在的共病（英语：comorbid）開始。

單獨使用藥物治療雖然能有效的改善ADHD的生理症狀，但藥物並不會返還成人患者在ADHD的抑制之下沒能隨著年齡成長而後天習得的一些能力。舉例而言：一個成人ADHD患者可能在服藥後重新獲得專注 的能力，然而像是做計畫、分辨事情的緩急輕重（英语：piroritize）、和有效的與人溝通等後天習得的能力則需要花時間學習、培養。[46]

流行病學

成人注意力不足過動症的的流行率和組成（過動/衝動為主=2.5%；注意力缺陷為主型=1.3%；混合型=0.9%；總和=4.7%）[47]

成人注意力不足過動症的流行率約落在3%-5%之間[48][13]。

美國的成人注意力不足過動症的流行率為4.4%左右。[13]

社會與文化

有ADHD的公眾人物

L'actrice Emma Watson, connue principalement pour le rôle d'Hermione Granger dans la saga Harry Potter, est atteinte d'un trouble déficitaire de l'attention avec hyperactivité. Elle prend ouvertement un médicament depuis l'enfance.
衛報、Clin d'Oiel 雜誌（法语：Clin_d%27œil_(magazine)）、IMDB、費加洛報及Gara（英语：Gara）等媒體曾報導，在哈利波特電影版中飾演妙麗的演員艾瑪·華森即為成人注意力不足過動症患者，自幼即開始服藥治療[53][54][55][56][57][58]。

許多公眾人物都患有注意力不足過動症，包括但不限於下列人士：

公眾意識

Rick Green（英语：Rick Green） (左側) 和 Patrick McKenna（英语：Patrick McKenna），拍攝於2009年，Rick Green致力於倡導成人注意力不足過動症的相關知識 [90][91][92]

文獻與來源

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  22. ^ Biederman, J; Faraone, SV; Spencer, TJ; Mick, E; Monuteaux, MC; Aleardi, M. Functional impairments in adults with self-reports of diagnosed ADHD: A controlled study of 1001 adults in the community.. The Journal of clinical psychiatry. 2006, 67 (4): 524–40. ISSN 0160-6689. PMID 16669717. 
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