18世纪起的医学文献中就有描述过类似注意缺陷多动障碍的症状[34]。自1970年起,就有出现有关注意缺陷多动障碍疾病本身、其诊断及治疗方式的争议[35],争议和临床医师、教师、政策订定者、家长及媒体有关。争议焦点包括ADHD的病因,以及是否要用兴奋剂来治疗ADHD[36]。目前大部分的医疗人员都接受ADHD是儿童及成人的遗传性疾病,科学界的争议点则是在其诊断方式及治疗方式[37][38][39]。此疾病在1980年至1987年的正式名称是注意力缺失症(attention-deficit disorder,简称ADD),在更早期的名称是儿童过度活跃的反应(hyperkinetic reaction of childhood)[40][41]。
演化也可能是造成ADHD高比率的原因,特别是男性过动以及冲动的倾向[112],有人曾提出假说,认为女性比较容易被会冒险的男性所吸引,因此增加了基因库中爱好冲动及冒险的基因的比率[113]。其他人则认为这种倾向有助于男性面对有压力或是危险的环境(例如更有冲劲,从事探究行为)[112][113]。在特定情境下,ADHD倾向虽然对个体是有害的,但是对群体是有益的[112][113][114]。ADHD虽然对个体可能不利,但其高比例以及异质性也有利于群体的生殖健康,并且可以增加基因库的多样性,对群体有益[114]。在特定环境下,ADHD也可能对个体有利,例如对捕食者的反应更快,以及较好的狩猎技巧(英语:Hunter vs. farmer hypothesis)等[115]。
ADHD的社会建构理论(英语:social construct theory of ADHD)认为评断正常及异常的标准是社会建构的(是由社会中的所有人建立并且使其有效的,特别是医生、病患、家长、教师等),然后再主观的评估及判断要使用哪一种判据,以及有多少人会因此受到影响[134]。他们认为这是依DSM-IV标准诊断到的ADHD人数会是由ICD-10标准所诊断人数三至四倍的原因[22]。汤玛士·萨斯是ADHD社会建构理论的支持者,他认为ADHD是“发明出来的,之后取了这个名字”[135]。
不同的时期,描述注意缺陷多动障碍的名词也有所不同:在1952年的DSM-I称为微细脑功能失常,在1968年的DSM-II则称为儿童活动亢进,在1980年的DSM-III称为注意力不足症(可能伴随过动,也可能没有)英文为 attention-deficit disorder (ADD) with or without hyperactivity[224],在1987年的DSM-III-R更名为注意缺陷多动障碍,在1994年的DSM-IV将注意缺陷多动障碍分为注意力散涣主导型(英语:Attention deficit hyperactivity disorder predominantly inattentive)、活动量过多型以及混合型[230],在2013年的DSM-5仍延用此一分类[12]。其他的名词有在1930年代使用的微细脑创伤[231],但因为不少病童都没有发觉有受过任何创伤,因此后来改名为微细脑功能失常。
ADHD药物能改善(非治愈)患者在生活中许多方面的功能性损伤(functional impairment ;可理解为应对能力的损伤)和生活品质(英语:Quality of life (healthcare))(例如:发生意外事故的风险)。但是ADHD患者的学习障碍和执行功能缺损(例如时间管理、生活秩序以及组织能力[237])等症状,即便在服用ADHD药物后,这些症状的改善程度极其有限或几乎没有效果。[238]
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Ertürk E, Wouters S, Imeraj L, Lampo A. Association of ADHD and Celiac Disease: What Is the Evidence? A Systematic Review of the Literature. Journal of Attention Disorders (Review). 2016-01: 108705471561149. PMID 26825336. doi:10.1177/1087054715611493. Up till now, there is no conclusive evidence for a relationship between ADHD and CD. Therefore, it is not advised to perform routine screening of CD when assessing ADHD (and vice versa) or to implement GFD as a standard treatment in ADHD. Nevertheless, the possibility of untreated CD predisposing to ADHD-like behavior should be kept in mind. ... It is possible that in untreated patients with CD, neurologic symptoms such as chronic fatigue, inattention, pain, and headache could predispose patients to ADHD-like behavior (mainly symptoms of inattentive type), which may be alleviated after GFD treatment. (CD: celiac disease; GFD: gluten-free diet)
Faraone, Stephen V.; Ghirardi, Laura; Kuja-Halkola, Ralf; Lichtenstein, Paul; Larsson, Henrik. The Familial Co-Aggregation of Attention-Deficit/Hyperactivity Disorder and Intellectual Disability: A Register-Based Family Study. Journal of the American Academy of Child & Adolescent Psychiatry. 2017. doi:10.1016/j.jaac.2016.11.011. 使用|accessdate=需要含有|url= (帮助)
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Hyperactivity: MedlinePlus Medical Encyclopedia. MedlinePlus. 2018-07-09 [2018-07-15]. (原始内容存档于2017-07-15). Hyperactivity is often considered more of a problem for schools and parents than it is for the child. But many hyperactive children are unhappy, or even depressed. Hyperactive behavior may make a child a target for bullying, or make it harder to connect with other children. Schoolwork may be more difficult. Kids who are hyperactive are frequently punished for their behavior. Excessive movement (hyperkinetic behavior) often decreases as the child grows older. It may disappear entirely by adolescence.
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Maturation of the brain, as reflected in the age at which a cortex area attains peak thickness, in ADHD (above) and normal development (below). Lighter areas are thinner, darker areas thicker. Light blue in the ADHD sequence corresponds to the same thickness as light purple in the normal development sequence. The darkest areas in the lower part of the brain, which are not associated with ADHD, had either already peaked in thickness by the start of the study, or, for statistical reasons, were not amenable to defining an age of peak cortex thickness. Movie of same data below. Source: NIMH Child Psychiatry Branch
Berry MD. The potential of trace amines and their receptors for treating neurological and psychiatric diseases. Reviews on Recent Clinical Trials. 2007-01, 2 (1): 3–19 [2021-02-06]. CiteSeerX 10.1.1.329.563. PMID 18473983. doi:10.2174/157488707779318107. (原始内容存档于2017-02-01). Although there is little direct evidence, changes in trace amines, in particular PE, have been identified as a possible factor for the onset of attention deficit/hyperactivity disorder (ADHD). … Further, amphetamines, which have clinical utility in ADHD, are good ligands at trace amine receptors. Of possible relevance in this aspect is modafanil, which has shown beneficial effects in ADHD patients and has been reported to enhance the activity of PE at TAAR1. Conversely, methylphenidate, …showed poor efficacy at the TAAR1 receptor. In this respect it is worth noting that the enhancement of functioning at TAAR1 seen with modafanil was not a result of a direct interaction with TAAR1.
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Nigg JT, Holton K. Restriction and elimination diets in ADHD treatment. Child and Adolescent Psychiatric Clinics of North America (Review). 2014-10, 23 (4): 937–53. PMC 4322780. PMID 25220094. doi:10.1016/j.chc.2014.05.010. an elimination diet produces a small aggregate effect but may have greater benefit among some children. Very few studies enable proper evaluation of the likelihood of response in children with ADHD who are not already preselected based on prior diet response.
Malenka RC, Nestler EJ, Hyman SE. Chapters 10 and 13. Sydor A, Brown RY (编). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 266, 315, 318–323. ISBN 978-0-07-148127-4. Early results with structural MRI show thinning of the cerebral cortex in ADHD subjects compared with age-matched controls in prefrontal cortex and posterior parietal cortex, areas involved in working memory and attention.
Malenka RC, Nestler EJ, Hyman SE. Chapter 6: Widely Projecting Systems: Monoamines, Acetylcholine, and Orexin. Sydor A, Brown RY (编). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 148, 154–157. ISBN 9780071481274. NOTE: DA: dopamine, LC: locus coeruleus, VTA: ventral tegmental area, 5HT: serotonin (5-hydroxytryptamine)
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Faraone, Stephen V. The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neuroscience and biobehavioral reviews (Elsevier BV). 2018, 87: 255–270. ISSN 0149-7634. PMID 29428394. doi:10.1016/j.neubiorev.2018.02.001. Although a substantial amount of research has focused on dopamine (DA) and norepinephrine (NE), ADHD has also been linked to dysfunction in serotonin (5hydroxytryptamine [5-HT]), acetylcholine (ACH), opioid, and glutamate (GLU) pathways (Cortese, 2012; Maltezos et al., 2014; Blum et al., 2008; Potter et al., 2014; Elia et al., 2011). The alterations in these neurotransmitter systems affect the function of brain structures that moderate executive function, working memory, emotional regulation, and reward processing (Fig. 1) (Faraone et al., 2015).
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Lesch KP, Merker S, Reif A, Novak M. Dances with black widow spiders: dysregulation of glutamate signalling enters centre stage in ADHD. European Neuropsychopharmacology. 2013-06, 23 (6): 479–91. PMID 22939004. doi:10.1016/j.euroneuro.2012.07.013.
Modesto-Lowe V, Chaplin M, Soovajian V, Meyer A. Are motivation deficits underestimated in patients with ADHD? A review of the literature. Postgraduate Medicine. 2013-07, 125 (4): 47–52. PMID 23933893. doi:10.3810/pgm.2013.07.2677. Behavioral studies show altered processing of reinforcement and incentives in children with ADHD. These children respond more impulsively to rewards and choose small, immediate rewards over larger, delayed incentives. Interestingly, a high intensity of reinforcement is effective in improving task performance in children with ADHD. Pharmacotherapy may also improve task persistence in these children. ... Previous studies suggest that a clinical approach using interventions to improve motivational processes in patients with ADHD may improve outcomes as children with ADHD transition into adolescence and adulthood.
Arns M, de Ridder S, Strehl U, Breteler M, Coenen A. Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis. Clinical EEG and Neuroscience. 2009-07, 40 (3): 180–9. PMID 19715181. doi:10.1177/155005940904000311.
Cortese S, Ferrin M, Brandeis D, Holtmann M, Aggensteiner P, Daley D, Santosh P, Simonoff E, Stevenson J, Stringaris A, Sonuga-Barke EJ. Neurofeedback for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials. Journal of the American Academy of Child and Adolescent Psychiatry. 2016-06, 55 (6): 444–55. PMID 27238063. doi:10.1016/j.jaac.2016.03.007. hdl:1854/LU-8123796.
Bjornstad G, Montgomery P. Bjornstad GJ , 编. Family therapy for attention-deficit disorder or attention-deficit/hyperactivity disorder in children and adolescents. The Cochrane Database of Systematic Reviews. 2005-04, (2): CD005042. PMID 15846741. doi:10.1002/14651858.CD005042.pub2.
Kamp CF, Sperlich B, Holmberg HC. Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters. Acta Paediatrica. 2014-07, 103 (7): 709–14. PMID 24612421. doi:10.1111/apa.12628. We may conclude that all different types of exercise ... attenuate the characteristic symptoms of ADHD and improve social behaviour, motor skills, strength and neuropsychological parameters without any undesirable side effects. Available reports do not reveal which type, intensity, duration and frequency of exercise is most effective
Wigal SB. Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults. CNS Drugs. 2009,. 23 Suppl 1: 21–31. PMID 19621975. doi:10.2165/00023210-200923000-00004.
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Prasad V, Brogan E, Mulvaney C, Grainge M, Stanton W, Sayal K. How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis. European Child & Adolescent Psychiatry. 2013-04, 22 (4): 203–16. PMID 23179416. doi:10.1007/s00787-012-0346-x.
Kiely B, Adesman A. What we do not know about ADHD… yet. Current Opinion in Pediatrics. 2015-06, 27 (3): 395–404. PMID 25888152. doi:10.1097/MOP.0000000000000229. In addition, a consensus has not been reached on the optimal diagnostic criteria for ADHD. Moreover, the benefits and long-term effects of medical and complementary therapies for this disorder continue to be debated. These gaps in knowledge hinder the ability of clinicians to effectively recognize and treat ADHD.
Hazell P. The challenges to demonstrating long-term effects of psychostimulant treatment for attention-deficit/hyperactivity disorder. Current Opinion in Psychiatry. 2011-07, 24 (4): 286–90. PMID 21519262. doi:10.1097/YCO.0b013e32834742db.
Frodl T, Skokauskas N. Meta-analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects. Acta Psychiatrica Scandinavica. 2012-02, 125 (2): 114–26. PMID 22118249. doi:10.1111/j.1600-0447.2011.01786.x. Basal ganglia regions like the right globus pallidus, the right putamen, and the nucleus caudatus are structurally affected in children with ADHD. These changes and alterations in limbic regions like ACC and amygdala are more pronounced in non-treated populations and seem to diminish over time from child to adulthood. Treatment seems to have positive effects on brain structure.
Biederman, Joseph. New-Generation Long-Acting Stimulants for the Treatment of Attention-Deficit/Hyperactivity Disorder. Medscape. 2003 [2016-06-19]. (原始内容存档于2003-12-07). As most treatment guidelines and prescribing information for stimulant medications relate to experience in school-aged children, prescribed doses for older patients are lacking. Emerging evidence for both methylphenidate and Adderall indicate that when weight-corrected daily doses, equipotent with those used in the treatment of younger patients, are used to treat adults with ADHD, these patients show a very robust clinical response consistent with that observed in pediatric studies. These data suggest that older patients may require a more aggressive approach in terms of dosing, based on the same target dosage ranges that have already been established – for methylphenidate, 1–1.5–2 mg/kg/day, and for D,L-amphetamine, 0.5–0.75–1 mg/kg/day.... In particular, adolescents and adults are vulnerable to underdosing, and are thus at potential risk of failing to receive adequate dosage levels. As with all therapeutic agents, the efficacy and safety of stimulant medications should always guide prescribing behavior: careful dosage titration of the selected stimulant product should help to ensure that each patient with ADHD receives an adequate dose, so that the clinical benefits of therapy can be fully attained.
Storebø OJ, Pedersen N, Ramstad E, Kielsholm ML, Nielsen SS, Krogh HB, Moreira-Maia CR, Magnusson FL, Holmskov M, Gerner T, Skoog M, Rosendal S, Groth C, Gillies D, Buch Rasmussen K, Gauci D, Zwi M, Kirubakaran R, Håkonsen SJ, Aagaard L, Simonsen E, Gluud C. Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of adverse events in non-randomised studies. The Cochrane Database of Systematic Reviews. 2018-05, 5: CD012069. PMID 29744873. doi:10.1002/14651858.CD012069.pub2.
Shoptaw SJ, Kao U, Ling W. Shoptaw SJ, Ali R , 编. Treatment for amphetamine psychosis. The Cochrane Database of Systematic Reviews. 2009-01, (1): CD003026. PMID 19160215. doi:10.1002/14651858.CD003026.pub3. A minority of individuals who use amphetamines develop full-blown psychosis requiring care at emergency departments or psychiatric hospitals. In such cases, symptoms of amphetamine psychosis commonly include paranoid and persecutory delusions as well as auditory and visual hallucinations in the presence of extreme agitation. More common (about 18%) is for frequent amphetamine users to report psychotic symptoms that are sub-clinical and that do not require high-intensity intervention ... About 5–15% of the users who develop an amphetamine psychosis fail to recover completely (Hofmann 1983) ... Findings from one trial indicate use of antipsychotic medications effectively resolves symptoms of acute amphetamine psychosis.
Adderall XR Prescribing Information(PDF). United States Food and Drug Administration. Shire US Inc. 2013-12 [2013-12-30]. (原始内容存档(PDF)于2013-12-30). Treatment-emergent psychotic or manic symptoms, e.g., hallucinations, delusional thinking, or mania in children and adolescents without prior history of psychotic illness or mania can be caused by stimulants at usual doses. ... In a pooled analysis of multiple short-term, placebo controlled studies, such symptoms occurred in about 0.1% (4 patients with events out of 3482 exposed to methylphenidate or amphetamine for several weeks at usual doses) of stimulant-treated patients compared to 0 in placebo-treated patients.
Mosholder AD, Gelperin K, Hammad TA, Phelan K, Johann-Liang R. Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children. Pediatrics. 2009-02, 123 (2): 611–6. PMID 19171629. doi:10.1542/peds.2008-0185.
Kraemer M, Uekermann J, Wiltfang J, Kis B. Methylphenidate-induced psychosis in adult attention-deficit/hyperactivity disorder: report of 3 new cases and review of the literature. Clinical Neuropharmacology. 2010-07, 33 (4): 204–6. PMID 20571380. doi:10.1097/WNF.0b013e3181e29174.
van de Loo-Neus GH, Rommelse N, Buitelaar JK. To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended?. European Neuropsychopharmacology. 2011-08, 21 (8): 584–99. PMID 21530185. doi:10.1016/j.euroneuro.2011.03.008.
Malenka RC, Nestler EJ, Hyman SE. Sydor A, Brown RY , 编. Molecular Neuropharmacology: A Foundation for Clinical Neuroscience 2nd. New York: McGraw-Hill Medical. 2009: 323, 368. ISBN 978-0-07-148127-4. supervised use of stimulants at therapeutic doses may decrease risk of experimentation with drugs to self-medicate symptoms. Second, untreated ADHD may lead to school failure, peer rejection, and subsequent association with deviant peer groups that encourage drug misuse. ... amphetamines and methylphenidate are used in low doses to treat attention deficit hyperactivity disorder and in higher doses to treat narcolepsy (Chapter 12). Despite their clinical uses, these drugs are strongly reinforcing, and their long-term use at high doses is linked with potential addiction
Konikowska K, Regulska-Ilow B, Rózańska D. The influence of components of diet on the symptoms of ADHD in children. Roczniki Panstwowego Zakladu Higieny. 2012, 63 (2): 127–34. PMID 22928358.
Krause J. SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder. Expert Review of Neurotherapeutics. 2008-04, 8 (4): 611–25. PMID 18416663. doi:10.1586/14737175.8.4.611. Zinc binds at ... extracellular sites of the DAT [103], serving as a DAT inhibitor. In this context, controlled double-blind studies in children are of interest, which showed positive effects of zinc [supplementation] on symptoms of ADHD [105,106]. It should be stated that at this time [supplementation] with zinc is not integrated in any ADHD treatment algorithm.
Lipkin, Paul H.; Mostofsky, Stewart. Attention-Deficit Hyperactivity Disorder. Neurobiology of Disease. Elsevier. 2007: 631–639. ISBN 978-0-12-088592-3. doi:10.1016/b978-012088592-3/50059-1. Attention-deficit hyperactivity disorder (ADHD) is the most common developmental disorder of childhood, affecting approximately 3–9% of schoolchildren [1,2].
Park, Subin; Cho, Maeng Je; Chang, Sung Man; Jeon, Hong Jin; Cho, Seong-Jin; Kim, Byung-Soo; Bae, Jae Nam; Wang, Hee-Ryung; Ahn, Joon Ho; Hong, Jin Pyo. Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: Results of the Korean epidemiologic catchment area study. Psychiatry Research (Elsevier BV). 2011, 186 (2-3): 378–383 [2017-04-21]. doi:10.1016/j.psychres.2010.07.047. In the National Comorbidity Survey Replication, 4.4% of 3199 subjects aged 18 to 44 years met the DSM-IV criteria for ADHD (Kessler et al., 2006). The acceptance of ADHD symptoms in adults, because the prevalence rates of ADHD in Korean school-age children are similar to the rates reported in Western countries (Kim, 2002).
Pham, Hoai Danh; Nguyen, Huu Bao Han; Tran, Diep Tuan. Prevalence of ADHD in primary school children in Vinh Long, Vietnam. Pediatrics international : official journal of the Japan Pediatric Society (Wiley). 2015-08-19, 57 (5): 856–859. ISSN 1328-8067. PMID 25864909. doi:10.1111/ped.12656.
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An Early Description of ADHD (Inattentive Subtype): Dr Alexander Crichton and `Mental Restlessness'(1798)Child and Adolescent Mental Health[dead link],Volume 6, Number 2, May 2001 , pp. 66–73 (8)
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RICHTERS, JOHN E.; ARNOLD, L. EUGENE; JENSEN, PETER S.; ABIKOFF, HOWARD; CONNERS, C. KEITH; GREENHILL, LAURENCE L.; HECHTMAN, LILY; HINSHAW, STEPHEN P.; PELHAM, WILLIAM E.; SWANSON, JAMES M. NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD: I. Background and Rationale. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 1995, 34 (8): 987–1000. ISSN 0890-8567. PMID 7665456. doi:10.1097/00004583-199508000-00008.
NIH awards nearly $100 million for Autism Centers of Excellence program. National Institutes of Health (NIH). 2017-09-06 [2017-11-08]. (原始内容存档于2017-11-09). Duke University, Durham, North Carolina – Understanding and potentially treating ASD-ADHD combination. An estimated 40 to 60 percent of people with ASD have attention deficit hyperactivity disorder (ADHD), which encompasses such symptoms as difficulty paying attention, problems controlling behavior and hyperactivity. Co-investigators Geraldine Dawson, Ph.D., and Scott Kollins, Ph.D., aim to learn how ADHD may influence the diagnosis and treatment of autism and plan to observe children who have ASD alone, ASD and ADHD, and ADHD alone and compare them to typically developing children. They will also test whether the stimulant medication used to treat ADHD will help children with both conditions.