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注意力不足過動症：修订间差异

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{{Expand language|en|date=2024年4月}}
{{Expert needed}}
{{Redirect2|過動症|膀胱的疾病|膀胱過動症}}
{{Medical}}
{{NoteTA
{{NoteTA
| G1=Medicine
| G1=Medicine
| G2=Lifesciences
| G2=Lifesciences
| G3=物理學
| T= zh-cn:注意（力）缺陷多动障碍; zh-tw:注意力不足過動症; zh-hk:專注力失調（或）過度活躍症;
| G4=Psychology
| 1= zh-cn:注意力缺陷多动障碍; zh-tw:注意力不足過動症; zh-hk:專注力失調或過度活躍症;
| 2= zh:醫師; zh-cn:医生; zh-tw:醫師; zh-hk:醫生;
| T= zh-cn:注意缺陷多动障碍; zh-tw:注意力不足過動症; zh-hk:專注力失調或過度活躍症;
| 2= zh-cn:程序性記忆; zh-hk:程序性記憶; zh-tw:程序性記憶;
| 3= zh-cn:自闭症谱系; zh-tw:自閉症光譜;
| 5=zh-hans:电动机;zh-hk:摩打;zh-tw:馬達;
}}
}}
{{Infobox medical condition (new)

| name = 注意力不足過動症（ADHD）<br/> attention deficit hyperactivity disorder
{{Medical}}
| synonyms = 注意力缺失症、注意力缺陷過動症、過度活躍症、hyperkinetic disorder (ICD-10)
{{Infobox_Disease
| image = Proposed_Symptoms_of_ADHD.PNG
| Name = 注意力不足過動症（ADHD） <br>Attention Deficit Hyperactivity Disorder | synonyms = 注意力缺失症、過度活躍症=Hyperkinetic disorder (ICD-10)
| width = 300px
| Image= Primary Laos2.jpg
| Caption= 注意力不足過動症兒童患者可能比較難以專注在學校的作業，因此也不容易在期限內完成作業
| caption = 注意力不足過動症的常見症狀
| alt = 注意力不足過動症的常見症狀
| alt= An image of children
| field = [[精神醫學]]、[[兒童與青少年精神醫學]]
| DiseasesDB = 6158
| symptoms = {{tsl|en|attentional shift|注意力轉移|容易分心}}（難以把專注力放對地方）、過度的活動、 [[衝動 (心理學)|難以控制行為和衝動]]<ref name=NIH2016/><ref name="DSM5 for navigation box">{{cite book | author=American Psychiatric Association | title=Diagnostic and Statistical Manual of Mental Disorders | year=2013 | publisher=American Psychiatric Publishing | location=Arlington | isbn=978-0-89042-555-8 | pages=59–65 | edition=5th}}</ref>
| ICD10 = {{ICD10|F|90||f|90}}
| complications =
| ICD9 = {{ICD9|314.00}}，{{ICD9|314.01}}
| onset = 6 - 12歲左右<ref name=CDC/><ref name=Lake2011/>
| OMIM = 143465
| duration = 多於6個月<ref name=CDC/>
| MedlinePlus = 001551
| causes = 遗传因素（[[遗传]]、{{le|新生變異|De novo mutation}}），較小程度是环境因素（怀孕期间接触生物危害、[[创伤性脑损伤]]）
| eMedicineSubj = med
| eMedicineTopic = 3103
| risks =
| diagnosis = 根據症狀並排除其他可能的致病原因。<ref name=NIH2016/>
| eMedicine_mult = {{eMedicine2|ped|177}}
| differential = [[品行障碍]]、[[對立反抗症]]、[[學習障礙]]、[[躁鬱症]]<ref>{{cite book|last1=Ferri|first1=Fred F.|title=Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders|date=2010|publisher=Elsevier/Mosby|location=Philadelphia, PA|isbn=0323076998|page=Chapter A|edition=2nd ed.}}</ref>、[[自閉症光譜]]、[[睡眠障礙]]<ref name="CDC 2017 differential diagnosis">{{cite web | author=CDC | title=ADHD Symptoms and Diagnosis | website=Centers for Disease Control and Prevention | date=2017-08-31 | url=https://www.cdc.gov/ncbddd/adhd/diagnosis.html | accessdate=2018-07-15 | quote=Deciding if a child has ADHD is a several-step process. This page gives you an overview of how ADHD is diagnosed. There is no single test to diagnose ADHD, and many other problems, like sleep disorders, anxiety, depression, and certain types of learning disabilities, can have similar symptoms. | deadurl=no | archiveurl=https://web.archive.org/web/20141107202516/http://www.cdc.gov/ncbddd/adhd/diagnosis.html | archivedate=2014-11-07 }}</ref>、[[焦慮症]]<ref name="CDC 2017 differential diagnosis"/>、[[憂鬱症]]<ref name="CDC 2017 differential diagnosis"/>
| MeshID = D001289
| prevention =
| treatment = [[心理治療]]、改變生活方式、藥物<ref name=NIH2016/>
| medication = [[兴奋剂|中樞神經刺激劑]]、[[阿托莫西汀]]、[[胍法辛]]<ref>{{cite journal | vauthors = Coghill DR, Banaschewski T, Soutullo C, Cottingham MG, Zuddas A | title = Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder | journal = European Child & Adolescent Psychiatry | volume = 26 | issue = 11 | pages = 1283–1307 | date = 2017-11 | pmid = 28429134 | pmc = 5656703 | doi = 10.1007/s00787-017-0986-y | issn = 1018-8827}}</ref><ref>{{cite journal | vauthors = Jain R, Katic A | title = Current and Investigational Medication Delivery Systems for Treating Attention-Deficit/Hyperactivity Disorder | journal = The Primary Care Companion for CNS Disorders | volume = 18 | issue = 4 | date = 2016-08 | pmid = 27828696 | doi = 10.4088/PCC.16r01979 }}</ref>
| prognosis =
| frequency = 5,110萬（2015年）<ref name=GBD2015Pre>{{cite journal|last1=GBD 2015 Disease and Injury Incidence and Prevalence|first1=Collaborators.|title=Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.|journal=Lancet|date=2016-10-08|volume=388|issue=10053|pages=1545–1602|pmid=27733282|doi=10.1016/S0140-6736(16)31678-6|pmc=5055577}}</ref>
| deaths =
}}
}}
{{各地中文名
{{各地中文名
| t = 1
| t = 1
| name = ADHD
| name = ADHD
| cn = 注意力缺陷多动障碍
| cn = 注意缺陷多动障碍
| tw = 注意力不足過動症
| tw = 注意力不足過動症
| hk = 專注力失調/過度活躍症
| hk = 專注力失調/過度活躍症
| mo = 專注力失調/過度活躍症
| mo = 專注力失調/過度活躍症
| where = 日本
| where = 日本
| other = 注意欠陥・多動性障害
| other = 注意欠陥・多動性障害
| where2 = 大韓民國
| where2 = 大韓民國
| other2 = 注意力缺乏過多行動障礙
| other2 = 注意力缺乏過多行動障礙<br/>注意力缺乏 過剩行動 症候群
| where3 = 越南
| where3 = 越南
| other3 = 𦇒亂增動減注意
| other3 = 𦇒亂增動減注意
}}
}}
'''注意力不足過動症'''（{{lang-en|attention deficit hyperactivity disorder}}，縮寫为{{nowrap|'''ADHD'''}}），是一种[[神經發展障礙]]<ref name="pmid23299717">{{cite journal | vauthors = Sroubek A, Kelly M, Li X | title = Inattentiveness in attention-deficit/hyperactivity disorder | journal = Neuroscience Bulletin | volume = 29 | issue = 1 | pages = 103–10 | date = 2013-02 | pmid = 23299717 | pmc = 4440572 | doi = 10.1007/s12264-012-1295-6 }}</ref><ref name=Caroline2010>{{cite book | veditors=Caroline SC | title=Encyclopedia of Cross-Cultural School Psychology | year=2010 | publisher=Springer Science & Business Media | isbn=9780387717982 | pages=133 | url=https://books.google.com/books?id=PaO3jsaGkeYC&pg=PA133 | access-date=2017-11-02 | archive-date=2020-12-22 | archive-url=https://web.archive.org/web/20201222193428/https://books.google.com/books?id=PaO3jsaGkeYC&pg=PA133 | dead-url=no }}</ref>。主要表现为難以專注、過度活躍、做事不考慮後果等。除此之外，还存在不合年紀的行為且存在注意力缺失问题的患者也可能表現出情緒調節困難或執行功能方面的問題<ref name=NIH2016/><ref name=DSM5/>。對於診斷來說，症狀應在患者12歲之前出現、持續超過六個月、至少發生於兩種情境下（如學校、家中、[[休閒活動]]等）<ref name=CDC>{{cite web |work=Attention-Deficit / Hyperactivity Disorder (ADHD) |title=Symptoms and Diagnosis |url=https://www.cdc.gov/ncbddd/adhd/diagnosis.html |publisher=Division of Human Development, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention |date=2014-09-29 |access-date=2014-11-03 |deadurl=no |archive-url=https://web.archive.org/web/20141107202516/http://www.cdc.gov/ncbddd/adhd/diagnosis.html |archive-date=2014-11-07 }}</ref><ref name=Lake2011>{{cite book |last1= Dulcan |first1= Mina K. |last2= Lake |first2= MaryBeth | name-list-format = vanc |chapter=Axis I Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence: Attention-Deficit and Disruptive Behavior Disorders |chapter-url={{google books|HvTa2nArhOsC|pages=23|plainurl=yes}} | title=Concise Guide to Child and Adolescent Psychiatry |url={{google books|HvTa2nArhOsC|plainurl=yes}} |via=Google Books | edition=4th illustrated | publisher=American Psychiatric Publishing | isbn=978-1-58562-416-4 | date=2011 | pages= [https://books.google.com/books?id=HvTa2nArhOsC&pg=PA34 34] }}</ref>。兒童患者注意力不集中的問題可能導致學習成績不佳<ref name=NIH2016 />，此外，此病症也跟其他心智障礙或藥物濫用有關<ref>{{cite journal | vauthors = Erskine HE, Norman RE, Ferrari AJ, Chan GC, Copeland WE, Whiteford HA, Scott JG | title = Long-Term Outcomes of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder: A Systematic Review and Meta-Analysis | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 55 | issue = 10 | pages = 841–50 | date = 2016-10 | pmid = 27663939 | doi = 10.1016/j.jaac.2016.06.016 }}</ref>。雖然此病症（特別是在現代社會中）會造成一些「障礙」，但很多過動症者會對他們感興趣或認為有價值的任務保持持續的專注，此狀況被稱為[[過度專注]]<ref name=Koo2019>{{cite journal |last1=Kooij |first1=J.J.S. |last2=Bijlenga |first2=D. |title=Updated European Consensus Statement on diagnosis and treatment of adult ADHD |journal=European Psychiatry |date=2019-02 |volume=56 |pages=14–34 |doi=10.1016/j.eurpsy.2018.11.001|pmid=30453134}}</ref><ref name=Wal2012>{{cite journal | vauthors = Walitza S, Drechsler R, Ball J | title = [The school child with ADHD] | language = DE | journal = Therapeutische Umschau. Revue Therapeutique | volume = 69 | issue = 8 | pages = 467–73 | date = 2012-08 | pmid = 22851461 | doi = 10.1024/0040-5930/a000316 | trans-title = The school child with ADHD }}</ref>。
'''注意力不足過動症'''（{{lang-en|Attention Deficit Hyperactivity Disorder}}，縮寫为ADHD、或AD/HD）並涵蓋'''注意力缺失症'''（{{lang|en|Attention Deficit Disorder}}，縮寫为ADD）。[[世界衛生組織]]的《[[國際疾病傷害及死因分類標準第十版]]》稱此症為'''過度活躍症'''（Hyperkinetic Disorder），分類編號為F90，一般又俗稱為'''多動症'''、'''心動兒'''<ref>{{cite web|url=http://www.tc-adhd.com/?page_id=957 |title=台灣心動家族兒童青少年關懷協會理事長陳錦宏醫師 敬上|author=嘉義長庚精神科副教授級主治醫師、教育部部定副教授 陳錦宏 醫師|publisher=Tc-adhd.com|language =zh-tw |date=2015-04-18 |accessdate=2016-12-09|quote=理事長的話：在這場演講，協會提出第一個主張，我們主張將ADHD原本"過動兒"的中文稱呼改為"心動兒"，因為ADHD包含沒有過動症狀的不專心兒童，"過動兒"常令人混淆，另外過動兒文字本身即包含負面意涵，而心動兒無此字義上的問題。}}</ref>、'''過動兒'''、'''多動障礙'''。


<!--診斷及流行病學 -->
注意力不足過動症是一種常見的[[腦|腦部]]發展障礙，主要症狀是注意力散渙或集中困難、活動量過多且自制力弱。
儘管此病症在小孩與青年的範圍中被大量的研究以及診斷，多數的例子中，仍然找不到精確的病因，他們認為基因的原因占了75%，在懷孕期間尼古丁的接觸也可能是一個導致病因的外部風險，似乎跟自律以及家庭風格沒有關係<ref name="nimh">{{cite web|author=NIMH|title=Attention Deficit Hyperactivity Disorder (Easy-to-Read)|url=http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-easy-to-read/index.shtml|publisher=National Institute of Mental Health|year=2013|access-date=2016-04-17|deadurl=no|archive-url=https://web.archive.org/web/20160414031036/http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-easy-to-read/index.shtml|archive-date=2016-04-14}}</ref>。依照《[[精神障碍诊断与统计手册]]》第四版（DSM-IV）的準則，約有5–7%的兒童確診<ref name=DSM5/><ref name="pmid22976615"/>，若依照《[[国际疾病分类]]》第十版[[ICD-10]]的準則，則有1–2%確診<ref name="Cowen2012"/>。2015年估計全球有5110萬人受到注意力不足過動症的影響<ref name=GBD2015Pre/>。盛行率主要會受到診斷方式及判斷基準不同所影響<!-- Rates are similar between countries and depend mostly on how it is diagnosed.--><ref name=Jones2011>{{cite book |editor1-last= Tsuang |editor1-first= MT |editor2-last= Tohen |editor2-first= M |editor3-last= Jones |editor3-first= P |title= Textbook of Psychiatric Epidemiology |publisher= John Wiley & Sons |isbn= 9780470977408 |chapter= Ch. 25: Epidemiology of Attention Deficit Hyperactivity Disorder |vauthors= Faraone SV |pages= 450 |edition= 3rd |year= 2011 |chapter-url= https://books.google.com/books?id=fOc4pdXe43EC&pg=PA450 |access-date= 2018-09-16 |archive-date= 2020-12-22 |archive-url= https://web.archive.org/web/20201222193454/https://books.google.com/books?id=fOc4pdXe43EC&pg=PA450 |dead-url= no }}</ref>，男孩確診的比例是女孩的二倍以上<ref name=DSM5/>，不過因為女孩的症狀和男孩不同，因此常被忽略<ref>{{cite journal |last=Crawford |first=Nicole |date=2003-02 |title=ADHD: a women's issue |journal=Monitor on Psychology |volume=34 |issue=2 |pages=28 |url=http://www.apa.org/monitor/feb03/adhd.aspx |deadurl=no |archive-url=https://web.archive.org/web/20170409110923/http://www.apa.org/monitor/feb03/adhd.aspx |archive-date=2017-04-09 |access-date=2019-11-21 }}</ref><ref name="pmid19393378">{{cite journal | vauthors = Emond V, Joyal C, Poissant H | title = [Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)] | language = FR | journal = L'Encephale | volume = 35 | issue = 2 | pages = 107–14 | date = 2009-04 | pmid = 19393378 | doi = 10.1016/j.encep.2008.01.005 | trans-title = Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD) }}</ref><ref name="Singh">{{cite journal | vauthors = Singh I | title = Beyond polemics: science and ethics of ADHD | journal = Nature Reviews. Neuroscience | volume = 9 | issue = 12 | pages = 957–64 | date = 2008-12 | pmid = 19020513 | doi = 10.1038/nrn2514 }}</ref>。兒童期診斷到的注意力不足過動症，約到30–50%會[[成人注意力不足過動症|持續到成年]]，成年人約有2–5%會有成人注意力不足過動症<ref name="Kooij-2010">{{cite journal | vauthors = Kooij SJ, Bejerot S, Blackwell A, Caci H, Casas-Brugué M, Carpentier PJ, Edvinsson D, Fayyad J, Foeken K, Fitzgerald M, Gaillac V, Ginsberg Y, Henry C, Krause J, Lensing MB, Manor I, Niederhofer H, Nunes-Filipe C, Ohlmeier MD, Oswald P, Pallanti S, Pehlivanidis A, Ramos-Quiroga JA, Rastam M, Ryffel-Rawak D, Stes S, Asherson P | display-authors = 6 | title = European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD | journal = BMC Psychiatry | volume = 10 | issue = | pages = 67 | date = 2010-09 | pmid = 20815868 | pmc = 2942810 | doi = 10.1186/1471-244X-10-67 }}</ref><ref name=Balint2008>{{cite journal | vauthors = Bálint S, Czobor P, Mészáros A, Simon V, Bitter I | title = [Neuropsychological impairments in adult attention deficit hyperactivity disorder: a literature review] | language = hu | journal = Psychiatria Hungarica | volume = 23 | issue = 5 | pages = 324–35 | year = 2008 | pmid = 19129549 | trans-title = Neuropsychological impairments in adult attention deficit hyperactivity disorder: A literature review }}</ref><ref name="underdiagnosed">{{cite journal | vauthors = Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP | title = Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature | journal = The Primary Care Companion for CNS Disorders | volume = 16 | issue = 3 | year = 2014 | pmid = 25317367 | pmc = 4195639 | doi = 10.4088/PCC.13r01600 | quote = Reports indicate that ADHD affects 2.5%–5% of adults in the general population,<sup>5–8</sup> compared with 5%–7% of children.<sup>9,10</sup>&nbsp;... However, fewer than 20% of adults with ADHD are currently diagnosed and/or treated by psychiatrists.<sup>7,15,16</sup> }}</ref>。在成人注意力不足過動症中，過動的情形可能會被「內在的不安寧」所取代<ref>{{Cite book|title=Attention deficit hyperactivity disorder : diagnosis and management of ADHD in children, young people, and adults|url=https://archive.org/details/attentiondeficit0000unse_l2x5|date=2009|publisher=British Psychological Society|others=National Collaborating Centre for Mental Health (Great Britain), National Institute for Health and Clinical Excellence (Great Britain), British Psychological Society., Royal College of Psychiatrists.|isbn=9781854334718|location=Leicester|oclc=244314955|pmid=22420012|page=[https://archive.org/details/attentiondeficit0000unse_l2x5/page/17 17]|author1 = National Collaborating Centre for Mental Health (UK)}}</ref>。ADHD的症狀可能不太容易和其他疾病的症狀區分，也不太容易區分正常範圍的活力充沛以及過動的分界點在哪裡<ref name=Lake2011/>。
<ref name="Tc_ADHD">{{cite web
| url =http://www.tc-adhd.com/?p=1850#more-1850
| title =心動家族:注意力不足過動症ＡＤＨＤ的第三條路
| date =2016-12-13
| website =台灣心動家族兒童青少年關懷協會
| publisher =Tc-adhd.com
|language =zh-tw
| access-date =February 2017
|author= 嘉義長庚精神科副教授級主治醫師、教育部部定副教授 陳錦宏 醫師
| quote = 典型症狀包括忘東忘西，粗心大意，寫作業很久，吃飯很久，常恍神，媽媽交代的事一下就忘，東西不會收，今天念的書明天就忘掉大半，怎麼教都沒用。且有明顯的焦慮症狀，咬手指甲，連所有的腳趾甲都咬光。...注意力不足過動症（ADHD），長期追蹤研究顯示主要是腦部發育較慢（平均慢了三年），因此比同一年紀的人有較慢發展的認知功能（包括注意，記憶，結構，組織，學習，反應及解決事情能力），及自我動作及情緒控制能力表現，表現出來被簡要描述的症狀就是注意力不足，衝動及過動表現。因現代研究發展，逐漸了解大多數是生理的問題，症狀起源無關教養及教育環境，但表現嚴重度及後續後遺症會受到教養及教育環境的影響。 其診斷並非根據症狀有無而已，還包含持續長時間，症狀嚴重度，要對功能造成影響及排除其他疾病。每一個部分均需有經驗的專家評估，而非症狀學字面上的意義。ADHD經多年研究，治療改善率至少80%，比許多內外科疾病治療效果要好。治療主要是整合性模式，包括藥物治療、（認知）行為治療及學校特教環境，也是少數做過上百個對照研究的疾病。}} </ref>


<!--管理及預後 -->
過去普遍認為注意力不足過動症是只會發生在兒童身上的腦部發展障礙，但近年發現確診的注意力不足過動症患者以及應接受診斷卻未接受診斷的注意力不足過動症兒童及青少年患者中的60%，其注意力不足過動症癥狀會持續至成人時期，而這60%患者中的41%，其注意力不足過動症仍對生活造成明顯的影響。<ref name="SibleySwanson2016">{{cite journal|last1=Sibley|first1=Margaret H.|last2=Swanson|first2=James M.|last3=Arnold|first3=L. Eugene|last4=Hechtman|first4=Lily T.|last5=Owens|first5=Elizabeth B.|last6=Stehli|first6=Annamarie|last7=Abikoff|first7=Howard|last8=Hinshaw|first8=Stephen P.|last9=Molina|first9=Brooke S. G.|last10=Mitchell|first10=John T.|last11=Jensen|first11=Peter S.|last12=Howard|first12=Andrea L.|last13=Lakes|first13=Kimberley D.|last14=Pelham|first14=William E.|title=Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity|journal=Journal of Child Psychology and Psychiatry|year=2016|issn=00219630|doi=10.1111/jcpp.12620}}</ref><ref>{{Cite journal
建議[[注意力不足過動症的治療|治療]]的方法依國家不同而有所差異，一般都會以[[心理治療]]、生活方式調整以及藥物，這三種中的一種或多種方式來進行治療<ref name=NIH2016>{{cite web|title=Attention Deficit Hyperactivity Disorder|date=2016-03|url=http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml|website=National Institute of Mental Health|access-date=2016-03-05|deadurl=no|archive-url=https://web.archive.org/web/20160723192735/http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml|archive-date=2016-07-23}}</ref>。英國的醫學指南建議針對兒童，只有在症狀嚴重時，才建議使用藥物為第一線的療法，若兒童拒絕接受心理治療，或是接受治療後進展不大，需考慮用藥物進行治療，若針對成人，藥物為第一線的治療方式<ref name=NICE2009-PharmRec>{{cite book |title=Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults |author=National Collaborating Centre for Mental Health |series=NICE Clinical Guidelines |volume=72 |publisher=British Psychological Society |location=Leicester |isbn=978-1-85433-471-8 |date=2009 |url=https://www.ncbi.nlm.nih.gov/books/NBK53652/ |chapter=Pharmacological Treatment |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK53654/ |pages=[https://www.ncbi.nlm.nih.gov/books/NBK53654/#ch10.s92 303–307] |via=NCBI Bookshelf |deadurl=no |archive-url=https://web.archive.org/web/20160113133612/http://www.ncbi.nlm.nih.gov/books/NBK53652/ |archive-date=2016-01-13 |access-date=2017-06-22 }}</ref>。加拿大及美國則是建議第一線的治療應該是合併藥物治療及行為治療，只有一些學齡前的兒童例外<ref name="CADDRA">{{cite web|title=Canadian ADHD Practice Guidelines|url=http://www.caddra.ca/cms4/pdfs/caddraGuidelines2011Introduction.pdf|work=Canadian ADHD Alliance|access-date=2011-02-04|archive-date=2021-01-21|archive-url=https://web.archive.org/web/20210121222344/https://www.caddra.ca/cms4/pdfs/caddraGuidelines2011Introduction.pdf|dead-url=no}}</ref><ref name="CDC guideline">{{cite web|title=Attention-Deficit / Hyperactivity Disorder (ADHD): Recommendations|url=https://www.cdc.gov/ncbddd/adhd/guidelines.html|publisher=Centers for Disease Control and Prevention|access-date=2015-07-13|date=2015-06-24|deadurl=no|archive-url=https://web.archive.org/web/20150707181535/http://www.cdc.gov/ncbddd/adhd/guidelines.html|archive-date=2015-07-07}}</ref>。在所有的醫學指南中，都不建議針對學齡前的兒童用興奮劑作為第一線的治療方式<ref name=NICE2009-PharmRec/><ref name="CDC guideline" />。用興奮劑治療，在前十四個月的療效有研究資料可供佐證，不過不確定長期使用的療效<ref>{{cite web | title=NIMH » The Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study (MTA):Questions and Answers | website=NIMH » Home | url=https://www.nimh.nih.gov/funding/clinical-research/practical/mta/the-multimodal-treatment-of-attention-deficit-hyperactivity-disorder-study-mta-questions-and-answers.shtml | access-date=2019-01-01 | quote=Why were the MTA medication treatments more effective than community treatments that also usually included medication? Answer: There were substantial differences in quality and intensity between the study-provided medication treatments and those provided in the community care group. | archive-date=2021-01-30 | archive-url=https://web.archive.org/web/20210130184640/https://www.nimh.nih.gov/funding/clinical-research/practical/mta/the-multimodal-treatment-of-attention-deficit-hyperactivity-disorder-study-mta-questions-and-answers.shtml | dead-url=no }}</ref><ref name="Long-Term Outcomes Medications">{{cite journal | vauthors = Huang YS, Tsai MH | title = Long-term outcomes with medications for attention-deficit hyperactivity disorder: current status of knowledge | journal = CNS Drugs | volume = 25 | issue = 7 | pages = 539–54 | date = 2011-07 | pmid = 21699268 | doi = 10.2165/11589380-000000000-00000 }}</ref><ref name="Long-term 2015">{{cite journal | vauthors = Arnold LE, Hodgkins P, Caci H, Kahle J, Young S | title = Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder: a systematic review | journal = PLOS One | volume = 10 | issue = 2 | pages = e0116407 | date = 2015-02 | pmid = 25714373 | pmc = 4340791 | doi = 10.1371/journal.pone.0116407 | displayauthors = 4 }}</ref>。患有ADHD的成人可能會發展出{{le|處理 (心理學)|Coping_(psychology)|應對方法}}，來處理症狀造成的部份或所有影響<ref name="Art.218"/>。
| author = Margaret H. Sibley, James M. Swanson, L. Eugene Arnold, Lily T. Hechtman, Elizabeth B. Owens, Annamarie Stehli, Howard Abikoff, Stephen P. Hinshaw, Brooke S. G. Molina, John T. Mitchell, Peter S. Jensen, Andrea L. Howard, Kimberley D. Lakes & William E. Pelham
| title = Defining ADHD symptom persistence in adulthood: optimizing sensitivity and specificity
| journal = Journal of child psychology and psychiatry, and allied disciplines
| doi = 10.1111/jcpp.12620
| pmid = 27642116
|quote=CONCLUSION:The interview format optimizes young adult self-reporting when parent reports are not available. However, the combination of parent and self-reports from rating scales, using an 'or' rule and a NB threshold optimized the balance between sensitivity and specificity. With this definition, 60% of the ADHD group demonstrated symptom persistence and 41% met both symptom and impairment criteria in adulthood.
| date=September 2016}}</ref><ref>{{cite web
| url =https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
| title =Signs and symptoms of Attention Deficit Hyperactivity Disorder, National Institute of Mental Health.
| date =March 2013
| website =nimh.nih.gov
| publisher=National Institute of mental health
|language =en
| access-date = January 2017
| quote = Many adolescents with ADHD also struggle with relationships and antisocial behaviors. Inattention, restlessness, and impulsivity tend to persist into adulthood. Symptoms of ADHD can be mistaken for emotional or disciplinary problems or missed entirely in quiet, well-behaved children, leading to a delay in diagnosis. Adults with undiagnosed ADHD may have a history of poor academic performance, problems at work, or difficult or failed relationships.}}</ref><ref name="Collaboration">{{cite book
| author-link = 國立臺灣大學醫學院附設醫院精神醫學部
| title = 注意力不足過動症
| publisher = 衛生福利部
| series = 衛生福利部精神疾病衛教叢書
| volume = 02
| edition = First
| location = Taipei
| language = zh-tw
| date = June, 2015.
| page = 19-20
| doi =
| isbn = 9789860454154
| quote=藉由成人 ADHD 的回顧性研究或是長期追蹤 研究可發現，孩童時期的 ADHD 患者，在成年後 僅有 2 成左右的人完全沒有症狀、另外有 2 成有輕 微不致干擾的症狀，其餘近 6 成的人雖然症狀較孩 童時期有所減輕，但仍達到生活顯著困擾程度。不 只是ADHD的核心症狀，許多次發症狀或是共病， 並不會隨著年紀增長而減少或是消失，甚至產生長 久的負面影響（物質濫用依賴、慢性焦慮憂鬱 等）。除了再度說明 ADHD 是一個長期慢性的神經發展疾病以外，也讓我們發現，如果早期了解 ADHD，給予合適的治療介入時，孩童長期的預後 將會大有不同。 }}</ref>


<!--歷史、社會及文化 -->
注意力不足過動症在[[嬰兒]]期和[[幼兒]]期，因為正在學走路和說話，所以症狀通常不易發覺，往往要等到進入幼稚園或小學之後，透過遵守教室、課堂的規範及跟同學們的相處，才會漸漸注意到症狀。學校[[教師|老師]]往往是最容易發現孩童注意力不足過動症症狀的人，因為在學校有明確的[[對照組]]。社會環境（如學校[[制度]]、[[法律]]規範）或[[家庭教育]]、家庭心理因素（如父母的管教方式）並不會導致注意力不足過動症。然而需要特別注意的是，這些後天因素會影響注意力不足過動症症狀的嚴重度、持續度、短期[[預後]]{{efn|短期預後即短期治療效果（short-term outcomes）}}、長期預後{{efn|長期預後即長期治療效果（long-term outcomes）}}、以及是否會合併引起其他的[[情緒]]及[[行為]]問題。<ref name="Tc_ADHD" />
18世紀起的醫學文獻中就有描述過類似注意力不足過動症的症狀<ref name="Lange Reichl 2010">{{cite journal | vauthors = Lange KW, Reichl S, Lange KM, Tucha L, Tucha O | title = The history of attention deficit hyperactivity disorder | journal = Attention Deficit and Hyperactivity Disorders | volume = 2 | issue = 4 | pages = 241–55 | date = 2010-12 | pmid = 21258430 | pmc = 3000907 | doi = 10.1007/s12402-010-0045-8 <!--| doi-access=free--> }}</ref>。自1970年起，就有出現有關[[注意力不足過動症的爭議|注意力不足過動症疾病本身、其診斷及治療方式的爭議]]<ref name="Parrillo 2008 63">{{Cite book | title=Encyclopedia of Social Problems | vauthors = Parrillo VN | year=2008 | publisher=SAGE | isbn=9781412941655 | pages=63 | url=https://books.google.com/?id=mRGr_B4Y1CEC | access-date=2009-05-02 }}</ref>，爭議和臨床醫師、教師、政策訂定者、家長及媒體有關。爭議焦點包括ADHD的病因，以及是否要用興奮劑來治療ADHD<ref name=May2008>{{cite journal | vauthors = Mayes R, Bagwell C, Erkulwater J | title = ADHD and the rise in stimulant use among children | journal = Harvard Review of Psychiatry | volume = 16 | issue = 3 | pages = 151–66 | date = 2008 | pmid = 18569037 | doi = 10.1080/10673220802167782 }}</ref>。目前大部份的醫療人員都接受ADHD是兒童及成人的遺傳性疾病，科學界的爭議點則是在其診斷方式及治療方式<ref name="Sim">{{cite journal | vauthors = Sim MG, Hulse G, Khong E | title = When the child with ADHD grows up | journal = Australian Family Physician | volume = 33 | issue = 8 | pages = 615–8 | date = 2004-08 | pmid = 15373378 | doi = | url = http://www.racgp.org.au/afp/200408/20040803sim.pdf | format = PDF | archive-url = https://web.archive.org/web/20150924083931/http://www.racgp.org.au/afp/200408/20040803sim.pdf | deadurl = no | archive-date = 2015-09-24 | access-date = 2019-01-01 }}</ref><ref name="Online">{{cite book| vauthors = Silver LB |title=Attention-deficit/hyperactivity disorder | publisher=American Psychiatric Publishing | edition=3rd | year=2004 | isbn=978-1-58562-131-6 | pages=4–7 }}</ref><ref name="Schonwald">{{cite journal | vauthors = Schonwald A, Lechner E | title = Attention deficit/hyperactivity disorder: complexities and controversies | journal = Current Opinion in Pediatrics | volume = 18 | issue = 2 | pages = 189–95 | date = 2006-04 | pmid = 16601502 | doi = 10.1097/01.mop.0000193302.70882.70 }}</ref>。此疾病在1980年至1987年的正式名稱是'''注意力缺失症'''（attention-deficit disorder，簡稱ADD），在更早期的名稱是'''兒童過度活躍的反應'''（hyperkinetic reaction of childhood）<ref name=We2005>{{cite book|last1=Weiss|first1=Lawrence G.|name-list-format=vanc|title=WISC-IV clinical use and interpretation scientist-practitioner perspectives|date=2005|publisher=Elsevier Academic Press|location=Amsterdam|isbn=978-0-12-564931-5|pages=237|edition=1st|url=https://books.google.com/books?id=Eg9U9e_ICr8C&pg=PA237|access-date=2019-01-01|archive-date=2021-01-16|archive-url=https://web.archive.org/web/20210116095548/https://books.google.com/books?id=Eg9U9e_ICr8C&pg=PA237|dead-url=no}}</ref><ref>{{cite news|title=ADHD: The Diagnostic Criteria|url=https://www.pbs.org/wgbh/pages/frontline/shows/medicating/adhd/diagnostic.html|access-date=2016-03-05|agency=Frontline|publisher=PBS|deadurl=no|archive-url=https://web.archive.org/web/20160420080026/http://www.pbs.org/wgbh/pages/frontline/shows/medicating/adhd/diagnostic.html|archive-date=2016-04-20}}</ref>。


{{TOC limit|3}}
不少注意力不足過動症患者（尤其是女性）並無過動症狀，甚至是非常安靜、沒有破壞性的，而過去對此症的認識總是集中在過動{{efn|即多動、過度活躍}}症狀上，使得這類不過動患者甚少能診斷出來。端視注意力不足過動症患者其腦部發展的程度與其所在環境對其執行功能要求的程度的比例，因此有些注意力不足過動症患者可能直到青少年時期甚至是成年初期才開始顯露出注意力不足過動症的症狀。<ref name="Brown-2008" /><ref name="Tc_ADHD" />
{{clear}} <!-- This code controls section formatting and prevents next section from starting early.-->


== 名稱 ==
注意力不足過動症患者甚至其家屬可能對自身或患者的問題存有[[否認心理]]。<ref>{{cite web
注意力不足過動症也译作注意力不集中/過動症（{{lang-en|Attention Deficit/Hyperactivity Disorder}}，簡稱{{nowrap|AD/HD}}）、過度活躍症（{{lang-en|Hyperkinetic Disorder}}；於[[國際疾病傷害及死因分類標準第十版|ICD 10]]中的名稱），俗称有多動症、多動障礙及[[大雄·胖虎症候群]]（日本）等。此病患的兒童習稱過動兒，也有醫療人士建議改稱為心動兒<ref name="IV">{{cite web|url=http://www.tc-adhd.com/?page_id=957|title=台灣心動家族兒童青少年關懷協會理事長陳錦宏醫師 敬上|author=陳錦宏|publisher=Tc-adhd.com|language=zh-tw|date=2015-04-18|accessdate=2016-12-09|quote=理事長的話：在這場演講，協會提出第一個主張，我們主張將ADHD原本「過動兒」的中文稱呼改為「心動兒」，因為ADHD包含沒有過動症狀的不專心兒童，「過動兒」常令人混淆，另外過動兒文字本身即包含負面意涵，而心動兒無此字義上的問題。|deadurl=no|archiveurl=https://web.archive.org/web/20180224050902/http://www.tc-adhd.com/?page_id=957|archivedate=2018-02-24}}</ref><ref name="WWW.COMMONHEALW 2017">{{cite web| title=過動兒現象如何避免被以偏概全| website=[[康健雜誌]]| date=2017-01-25| url=//m.commonhealth.com.tw/article/article.action?nid=72375| language=zh| author=陳錦宏| accessdate=2018-04-14| archiveurl=https://web.archive.org/web/20170924045255/https://m.commonhealth.com.tw/article/article.action?nid=72375| archivedate=2017-09-24| dead-url=no}}</ref>。
| url =https://www.sciencedaily.com/releases/2016/08/160801093232.htm
| title =ADHD symptom persistence into adulthood estimated
| date =2016-10-20
| website =Science News
| archive-url=http://onlinelibrary.wiley.com/doi/10.1111/jcpp.12620/abstract?systemMessage=WOL+Usage+report+download+page+will+be+unavailable+on+Friday+27th+January+2017+at+23%3A00+GMT%2F+18%3A00+EST%2F+07%3A00+SGT+%28Saturday+28th+Jan+for+SGT%29++for+up+to+2+hours+due+to+essential+server+maintenance.+Apologies+for+the+inconvenience.
| archive-date=2016-09-19
| publisher =Journal of Child Psychology and Psychiatry, 2016
|language =en
| access-date =January 2017
| quote = "There has been a lot of recent controversy over whether children with ADHD continue to experience symptoms into adulthood," said Dr. Margaret Sibley, lead author of the Journal of Child Psychology and Psychiatry study. "This study found that the way you diagnose ADHD can lead to different conclusions about whether or not an adult still has the disorder that started in childhood. First, if you ask the adult about their continued symptoms, they will often be unaware of them; however, family members or others who know them well often confirm that they still observe significant symptoms in the adult." Dr. Sibley added that if the classic childhood definition of ADHD is used when diagnosing adults, many cases will be missed because symptom presentation changes in adulthood. "By asking a family member about the adult's symptoms and using adult-based definitions of the disorder, you typically find that around half of children with moderate to severe ADHD still show significant signs of the disorder in adulthood."}} </ref><ref name="找回專注力's section in regard to diagnosis of adults with ADHD">
{{cite book|author=高淑芬 |title=找回專注力：成人ADHD全方位自助手冊 |year=2016年 |publisher=心靈工坊|language =zh-tw|location=台北 |isbn=9789863570592 |date=2016-05-09 |accessdate=2016-12-12|url=http://www.books.com.tw/products/0010714786 |quote=from section of 成人ADHD的診斷}}</ref>


==症狀及體徵==
國際ADHD[[流行率]]{{efn|就是 盛行率、患(罹)病率}}[[中位數]]，兒童為5-8%，成人為3-5%。研究顯示美國一年因注意力不足過動症損失高達近40億美金，其中即包括父母的工作損失。
{| class="wikitable" style = "float: right; margin-left:15px; text-align:center"

! colspan="2" style="background-color: #CCEEEE;" |ADHD的症狀<ref name="CDC2">{{cite web|url=https://www.cdc.gov/ncbddd/adhd/diagnosis.html|title=ADHD: Symptoms and Diagnosis|last=|first=|date=2017-08-31|website=|publisher=Centers for Disease Control and Prevention (2017)|access-date=|archive-date=2014-11-07|archive-url=https://web.archive.org/web/20141107202516/http://www.cdc.gov/ncbddd/adhd/diagnosis.html|dead-url=no}}</ref>
注意力不足過動症患者的智力與不是注意力不足過動症患者相仿，然而因為注意力不足過動症的症狀，使得其[[智力測驗]]結果可能產生較大的[[誤差]]。<ref name="neuropsychology2004">Frazier, TW; Demaree, HA; Youngstrom, EA (July 2004). "Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder.". Neuropsychology. 18 (3): 543–55. doi:10.1037/0894-4105.18.3.543. PMID 15291732.</ref><ref>Mackenzie, GB; Wonders, E (2016). "Rethinking Intelligence Quotient Exclusion Criteria Practices in the Study of Attention Deficit Hyperactivity Disorder.". Frontiers in psychology. 7: 794. doi:10.3389/fpsyg.2016.00794. PMC 4886698Freely accessible. PMID 27303350.</ref>

現時沒有任何確切證據證實任何一個或多個因素決定性地導致這種病症。研究顯示注意力不足過動症與腦部的[[額葉]]及其他構造發展相關，但詳細成因仍未被了解。注意力不足過動症可能具有相當高的[[遺傳]]率。

根據[[美國疾病控制及防禦中心]]的研究，注意力不足過動症是一個症狀群的交集。因此，要正確診斷這一病症，不能依靠單一測試去確定，而必須同時採用多種臨床方法配合去確認。因此，要正確診斷這一病症，不能依靠單一測試去確定，而必須同時採用多種測試配合去確認。注意力不足過動症的診斷係依據《[[精神疾病診斷與統計手冊]]》的標準、門診病人的{{tsl|en|chief complaint|主訴}}、患者的歷史經歷及[[心理測驗]]等。<ref name="Tc_ADHD"/>

[[注意力不足過動症#医药治疗|藥物治療]]合併[[注意力不足過動症#行為治療|行為治療]]是目前被證實最有效的治療方式<ref name="ChanFogler2016_findings"/><ref name="ChanFogler2016"/><ref name="auto"/><ref name="tscap1"/><ref name="Yen"/><ref name="tscap2"/><ref name="Tc_ADHD"/>。學齡前的患者，通常僅需接受行為治療，除非症狀達到嚴重的程度且拒絕接受行為治療或無法從行為治療中獲得改善，才需考慮加入藥物治療。<ref name="Guidelines_May_Have_Helped_Curb_ADHD_Diagnoses_in_Preschoolers"/>

注意力不足過動症的治療並非是要將孩子們[[標準化]]{{efn|即為一致化}}，而是一本[[教育]]的初衷，協助每一位孩子發掘、發揚自己的優點、並避免缺點。<ref name="找回專注力_Adult with ADHD">{{cite book|author=高淑芬 |title=找回專注力：成人ADHD全方位自助手冊 |year=2016年 |publisher=心靈工坊|language =zh-tw|location=台北 |isbn=9789863570592 |date=2016-05-09 |accessdate=2016-12-12|url=http://www.books.com.tw/products/0010714786 }}</ref><ref name="幫助ADHD孩子快樂成長"/><ref name="books2000"/><ref name="分心也有好成績"/>

== 簡介<!-- § Brief introduction --> ==
[[File:Ian Mackenzie High School Classroom.jpg|thumb|upright=1.6|把握年紀還小、症狀較為單純時治療，可以避免病情複雜化並且在早期建立良好的學習及生活習慣，培養自信心及責任感，這對患者的未來將有深遠的影響。<ref name="找回專注力">{{cite book|author=高淑芬 |title=找回專注力：成人ADHD全方位自助手冊 |year=2016年 |publisher=心靈工坊 |location=台北 |isbn=9789863570592 |date=2016-05-09 |accessdate=2016-12-12|url=http://www.books.com.tw/products/0010714786 }}</ref><ref name="幫助ADHD孩子快樂成長">{{cite book|author=高淑芬 |title=家有過動兒：幫助ADHD孩子快樂成長 |year=2013 |publisher=心靈工坊 |location=台北 |isbn=9789866112805 |date=2013-08-28 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010597713 }}</ref> 圖片為南非教室內的學生]]
注意力不足過動症屬於早發型的兒童精神疾病。若能在大約九、十歲以前把握年紀還小、症狀較為單純時治療，可以避免病情複雜化（衍生共病），並且在早期建立良好的學習及生活習慣，培養自信心及責任感，這對注意力不足過動症患者的未來將有深遠的影響。&nbsp;&nbsp;然而，對於成人注意力不足過動症患者而言，上述的兒童黃金治療期已經過去，不過疑似注意力不足過動症患者、注意力不足過動症患者本身及其家屬不用過於擔心，因為注意力不足過動症是一個治癒率高的疾病，因此即便患者是從哪一個年紀開始治療，都可以見到相當不錯的改善效果。
<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/><ref name="Collaboration"/>

注意力不足過動症患者甚至其家屬可能對自身或患者的問題存有否認心理，包括：高估自己的能力及低估自己的困難、並因此做出不合理的決定（為反對而反對地否認診斷、拒絕接受學習及醫療上的協助、排斥旁人包括醫師、老師、父母與家人的幫忙，即便確實有需要等）。鼓勵患者甚至其家屬勇於面對注意力不足過動症將使-注意力不足過動症長期預後變得更為樂觀。<ref name="auto">{{cite web|author=TSCAP |url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=8&hidNewsID=125 |title=青少年ADHD的治療-一系統性回顧 |doi=10.1001/jama.2016.5453 |publisher=Tscap.org.tw |date= |accessdate=2016-12-27}}</ref>

=== 名稱 ===
<!-- 通常而言，'''注意力不足過動症'''（Attention Deficit Hyperactivity Disorder）意指包含過動（多動、過度活躍）症狀在內的所有注意力不足過動症類型，包含'''注意力缺失症'''（Attention Deficit Disorder）<ref>{{cite web|url=http://www.tc-adhd.com/?page_id=957 |title=台灣心動家族兒童青少年關懷協會理事長陳錦宏醫師 敬上|author=嘉義長庚精神科副教授級主治醫師、教育部部定副教授 陳錦宏 醫師|publisher=Tc-adhd.com |date=2015-04-18 |accessdate=2016-12-09|quote=理事長的話：在這場演講，協會提出第一個主張，我們主張將ADHD原本"過動兒"的中文稱呼改為"心動兒"，因為ADHD包含沒有過動症狀的不專心兒童，"過動兒"常令人混淆。}}</ref>，詳見下節[[注意力不足過動症#.E5.AE.9A.E7.BE.A9|定義]]。 --><!--Reference for the subsequent table. Thus, do not remove this paragraph note. Thank you! =)-->
{| class="wikitable" style="text-align:center;"
|-
|-
!專注力失調
| style="background:#fef; vertical-align:top;" colspan="5"| 注意力不足過動症<br/><u>A</u>ttention <u>D</u>eficit <u>H</u>yperactivity <u>D</u>isorder
!過動-衝動
|-
|-
|
| style="background:#ffebd2;" colspan="2"|'''子類型\核心症狀''' || #ffffe6;|注意力不足（分心）|| #ffffe6;|過動 || #ffffe6;| 衝動
* 很難注意事情的細節
|-
* 不容易專注在一件事情上
| style="background:honeyDew;" colspan="2"|'''過動-衝動'''為主型 || - || &#10004; || &#10004;
* 不容易針對事物或是活動進行規劃組織
|-
* 會遺忘一些需要的物品
| style="background:honeyDew;" colspan="2"|'''注意力不足'''為主型<br>又稱為'''注意力缺失症'''（<u>A</u>ttention <u>D</u>eficit <u>D</u>isorder）|| &#10004; || - || -
* 在日常活動中比較健忘
|-
* 注意力持續時間較短，較容易分心
| style="background:honeyDew;" colspan="2"|'''混和'''型 || &#10004;|| &#10004; || &#10004;
* 不容易處理較具結構性的學校功課
* 難以完成繁瑣或需要花時間的任務
|
* 沒辦法好好坐著
* 在座位上坐立不安、動來動去
* 會在不適當的時間點離開座位
* 從事具風險性的事物，不太考慮後果
* 時常處於活躍狀態<!--on the go-->、精力充沛、停不下來<!--driven by a motor-->
* 說話的頻率及時間會比其他人要多
* 問題未說完就搶著說答案
* 不容易輪流等候
* 在對話中常常插嘴或是打斷別人說話
|}
|}


注意力不足過動症的常見情形有不專心、過動（在成人則會以不安來表現）、破壞行為及衝動<ref name=ICSI2012>{{cite journal | vauthors=Dobie C | title=Diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents | year=2012 | pages=79 | url=http://guidelines.gov/content.aspx?f=rss&id=36812 | deadurl=yes | archive-url=https://web.archive.org/web/20130301124247/http://guidelines.gov/content.aspx?f=rss&id=36812 | archive-date=2013-03-01 | journal= | access-date=2012-10-10 }}</ref><ref name=cdc2016facts/>。在人際關係及學業上都容易出現問題<ref name=ICSI2012/>，不過其症狀不容易定義，因為很難介定一般情形下的不專心、過動及衝動會到什麼程度，到什麼情形下才需要介入治療<ref name =Ramsay25>{{cite book | vauthors = Ramsay JR | title=Cognitive behavioral therapy for adult ADHD | url = https://archive.org/details/cognitivebehavio00rams | publisher=Routledge | year=2007 | isbn=978-0-415-95501-0 | pages=[https://archive.org/details/cognitivebehavio00rams/page/4 4], 25–26}}</ref>。
<!-- '''注意力缺失症'''（Attention Deficit Disorder）則是純粹涵蓋'''注意力不足'''（專注力失調、注意力缺失）的症狀；不含'''過動-衝動'''（多動、過度活躍）症狀（即下節[[注意力不足過動症#.E5.AE.9A.E7.BE.A9|定義]]所述的'''活動量過多或{{tsl|en|self-control|自制力}}{{efn|又做自我管理能力}}弱主導型'''）的注意力不足過動症。-->'''注意力缺失症'''（Attention Deficit Disorder）在學生時期的特徵包含：上課時看上去是在靜靜地聽講，但對教師所說的茫然不知，只是看著教師。<ref>{{cite encyclopedia
| title = 注意缺陷與多動障礙
| encyclopedia = 醫學百科
| pages = #4 疾病概述
| location = Mainland China
| language = zh-tw
| url=http://big5.wiki8.com/zhuyiquexianyuduodongzhangai_38884/#4
| access-date= January, 2017. }}</ref>
<ref name="books2000">{{cite web|url=http://www.books.com.tw/products/0010687149 |title=Edward M. Hallowell, M.D. & John J. Ratey, M.D.著，丁凡譯，《分心不是我的錯》， 台北：遠流出版社，初版：2000， 增訂版：2015 |publisher=Books.com.tw |isbn=9789573277002 |date=2015-08-28 |accessdate=2016-12-09}}</ref>


依照《[[精神疾病診斷與統計手冊]]》（DSM）第五版（[[DSM-5]]）的定義，注意力不足過動症的症狀需出現超過六個月，或是其情形要比同年齡的要明顯很多<ref name=DSM5/>，而且其症狀已造成至少二個情境（例如社交、學校/工作、家庭）的問題<ref name=DSM5/>，這些條件需在12歲以前就出現<ref name=DSM5/>，若是17歲以下者，在專注力失調或是過動/衝動上的症狀，至少需要有六項符合，17歲以上者則需要至少五項符合<!--and more than 4 for those over 16 years old.--><ref name=DSM5/>。
[[世界衛生組織]]出版的《[[世界通用疾病分類手冊]]》第十版（ICD-10, International Classification of Disease-10，又稱為國際通用的疾病分類表）, '''過度活躍症'''（Hyperkinetic Disorder）的症狀等同於DSM-5中注意力不足過動症的症狀。意旨在ICD-10中注意力不足過動症被稱為'''過度活躍症'''Hyperkinetic Disorder<ref name=ICD10>{{citation |title=International Statistical Classification of Diseases and Related Health Problems 10th Revision | year=2010 | publisher=World Health Organisation | accessdate=2014-11-02 | url=http://apps.who.int/classifications/icd10/browse/2010/en#/F90 |chapter=F90 Hyperkinetic disorders }}</ref>


=== 子類型 ===
<!--本症一般稱為'''注意力不足過動症'''，但過去一些[[精神科]]醫師會使用'''注意力缺失症'''（ADD）的名稱{{efn|例如ADD專家{{le|愛德華·哈洛威爾|Edward Hallowell (psychiatrist)}}醫師（Edward Hallowell）即經常在其著作使用ADD的稱呼。}}，這個名詞首先於1980年出版的DSM第三版出現。在1987年出版的修訂本中，才改用現在的名稱。--><!-- 這個病症在[[中國大陸]]稱為'''注意力缺陷多動症（障礙）'''，在[[中華民國]]（[[臺灣]]）稱為'''注意力不足過動症'''，在[[香港]]稱為'''專注力失調過度活躍症'''，而在[[日本]]則稱為'''注意欠陷多動性障害'''（{{jpn|j=注意欠陥・多動性障害|hg=ちゅういけっかん・たどうせいしょうがい|link=no}}）。在[[大韓民國]]（韓國）則稱為'''注意力缺乏過多行動障礙'''（{{lang|ko|주의력결핍 과다행동장애}}）。在[[越南]]則稱為{{vie|qn=Rối loạn tăng động giảm chú ý|hn=𦇒亂增動減注意|link=no}}。 --> <!-- Citations incorporated, thus, do not remove this note. It's not relative to the number of readable prose. =) -->
注意力不足過動症可分為三個子類型<ref name=DSM5/><ref name="Ramsay25"/>:
<!-- 除了注意力不足過動症或注意力缺乏症（ADD）以外，過去也曾採用過度活躍症或多動症候群（{{lang|en|Hyperkinetic Syndrome，英文缩写HKS}}）；微細腦損傷、微細腦機能障礙（{{lang|en|Minimal Cerebral Dysfunction}}，英文缩写MCD）等各種名稱。此外，外國出版物有時為了迴避“disorder”這一個比較負面的詞語，會改稱為{{lang|en|''Attention-Deficit Syndrome''}}（''注意力不足症候群''，英文缩写''ADS''）。<ref>{{cite web|url=http://www.rcpsych.ac.uk/mentalhealthinfo/mentalhealthandgrowingup/adhdhyperkineticdisorder.aspx|title=Not found|author=|date=|publisher=}}</ref>
*{{link-en|ADHD注意力不足為主型|Attention deficit hyperactivity disorder predominantly inattentive}}（ADHD-PI或ADHD-I）
-->=== 定義 ===
*ADHD過動為主型（ADHD-PH或ADHD-HI）
*混合型（ADHD-C）


若是以注意力不足（專注力失調）為主的兒童或青少年，會有以下大部份甚至全部的症狀，且非由其他醫學疾病或藥物直接造成<ref name=DSM5/><ref name="NIMH1">{{cite web |url=http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml |title=Attention Deficit Hyperactivity Disorder (ADHD) |author=National Institute of Mental Health |year=2008 |publisher=National Institutes of Health |deadurl=no |archive-url=https://web.archive.org/web/20130119030917/http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml |archive-date=2013-01-19 |accessdate=2019-12-03 }}</ref>：
[[File:Attention deficit hyperactivity disorder video.webm|upright=1.4|thumb|讲解注意力不足過動症的影片（英文）]]


* 容易分心、粗心、忘記事情、且經常從一件事情切換至另一件事情。
對注意力不足過動症比較確切的定義，記載於[[美國精神醫學會]]（APA{{efn|APA, American Psychiatry Association}}）出版的《[[精神疾病診斷與統計手冊]]》第四版文本修改版<ref name="Association2000">{{cite book|author=American Psychiatric Association|title=Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®|url=https://books.google.com/books?id=3SQrtpnHb9MC|year=2000|publisher=American Psychiatric Association|isbn=978-0-89042-025-6}}</ref>。注意力不足過動症的主要病徵是：
* 很難持續專注在同一件事情上。
* 除非進行自身有興趣的事務，不然進行幾分鐘後就覺得無聊。
* 難以對組織（規劃）事情、完成一個任務保持專注。
* 很難完成回家作業，或是如期繳交，常會遺失一些要完成作業或是其他活動需要的東西（例如鉛筆、玩具、作業等）*
* 當別人在和患者說話時，似乎沒有在聽對方說話。
* 作白日夢、很感到困惑、動作緩慢。
* 不容易像其他非注意力不足過動症患者一樣，快速且準確的處理資訊。
* 難以遵從指示
* 不容易認知細節，常忽略細節。


若是以過動為主的兒童或青少年，會有以下大部份甚至全部的症狀且非由其他醫學疾病或藥物直接造成<ref name=DSM5/><ref name="NIMH1"/>：
# '''注意力散渙或集中困難''' = 專注力失調 = 注意力缺陷 = inattentive or Attention-deficit
* 常常煩躁及坐立不安
# '''活動量過多''' = 過度活躍 = 多動 = hyperactive/hyperkinetic
* 不停地講話
# '''{{tsl|en|self-control|自制力}}{{efn|又做自我管理能力}}弱''' = [[衝動]] = impulsive {{efn|P.S 心理學上的所說的某種突發的願望或渴望。Sudden strong desire.}}
* 四處東奔西跑、碰觸或玩弄視野內的任一或每一個物體。
* 難以在上課時間、吃飯時間、做功課的時間乖乖坐好。
* 不停的動來動去。
* 不容易進行安靜的活動或是工作。
* 沒有耐心
* 脫口說出不恰當的話語、毫無掩飾地流露內心的想法，且行事不顧後果。
* 難耐在遊戲中因輪流所產生的等待時間。
* 經常打斷他人的對話或活動。


基於以上三種病徵<!-- 出現的優勢 -->，再把注意力不足過動症細分為以下三個分類：
若注意力不足過動症患者的症狀符合上述二類，則屬於合併型的注意力不足過動症。


ADHD的女性比較不會有過動及衝動的症狀，比較會有注意力不集中及分心的症狀<ref>{{cite journal | vauthors = Gershon J | title = A meta-analytic review of gender differences in ADHD | journal = Journal of Attention Disorders | volume = 5 | issue = 3 | pages = 143–54 | date = 2002-01 | pmid = 11911007 | doi = 10.1177/108705470200500302 }}</ref>。注意力不足過動症中有關過動的症狀，可能會隨著年齡增長而漸漸消退，而轉變為青少年及成人階段的「內在不安寧」<ref name="Kooij-2010"/>。
# 注意力散渙主導型（predominantly inattentive type）<br/>又稱為'''注意力不足'''（專注力失調）為主型
# 活動量過多或自制力弱主導型（mainly hyperactive-impulsive type）<br/>又稱為'''過動-衝動'''（過度活躍、多動障礙）為主型
# 混合型（combination/combined type）<br/>又稱為'''注意力不足'''（專注力失調）、'''過動-衝動'''（過度活躍、多動障礙）混和型


注意力不足過動症的兒童、青少年及成年比較容易有[[社交技巧]]上的問題，例如社交互動、發展友誼及建立友誼。<!---This is true for all subtypes.--->有半數的注意力不足過動症患者曾受到同儕社會排斥的情形，而沒有注意力不足過動症的人被社會排斥的比例約為10%至15%。患有注意力不足過動症的人比較不容易處理口語及非語言的訊息，比較容易在社交互動上有負面的影響，也比較容易在對話時離題、忽略到一些社交的資訊、也比較不容易學習社交技能<ref>{{cite journal | vauthors = Coleman WL | title = Social competence and friendship formation in adolescents with attention-deficit/hyperactivity disorder | journal = Adolescent Medicine | volume = 19 | issue = 2 | pages = 278–99, x | date = 2008-08 | pmid = 18822833 }}</ref>。
近期的研究發現，注意力不足過動症是由一種發生於腦[[前額葉]]的[[遺傳]]性的[[多巴胺]]新陳代謝失常引致。更近期的研究認為[[正腎上腺素]]（norepinephrine）的[[新陳代謝]]亦會對病情有所影響。<ref>Krause, Dresel, Krause in Psycho 26/2000 p.199ff</ref>
<ref name="Bymaster 2002 pp. 699–711">{{cite journal | last=Bymaster | first=F | title=Atomoxetine Increases Extracellular Levels of Norepinephrine and Dopamine in Prefrontal Cortex of Rat A Potential Mechanism for Efficacy in Attention Deficit/Hyperactivity Disorder | journal=Neuropsychopharmacology | publisher=Springer Nature | volume=27 | issue=5 | year=2002 | pages=699–711 | url=https://doi.org/10.1016%2Fs0893-133x%2802%2900346-9 | doi=10.1016/s0893-133x(02)00346-9 | accessdate=2017-02-17|quote=The selective norepinephrine (NE) transporter inhibitor atomoxetine (formerly called tomoxetine or LY139603) has been shown to alleviate symptoms in Attention Deficit/Hyperactivity Disorder (ADHD).}}</ref>。


注意力不足過動症的兒童比較常有不容易控制情緒的問題<ref>{{cite web |url=http://www.webmd.com/add-adhd/adhd-anger-management-directory |title=ADHD Anger Management Directory |publisher=Webmd.com |access-date=2014-01-17 |deadurl=no |archive-url=https://web.archive.org/web/20131105032151/http://www.webmd.com/add-adhd/adhd-anger-management-directory |archive-date=2013-11-05 }}</ref>，其{{link-en|手寫|handwriting|寫字}}能力也比較弱<ref name="Racine-2008">{{cite journal | vauthors = Racine MB, Majnemer A, Shevell M, Snider L | title = Handwriting performance in children with attention deficit hyperactivity disorder (ADHD) | journal = Journal of Child Neurology | volume = 23 | issue = 4 | pages = 399–406 | date = 2008-04 | pmid = 18401033 | doi = 10.1177/0883073807309244 }}</ref>，在語言、說話及運動上的發展都比較晚<ref name=ICD10>{{citation | title=International Statistical Classification of Diseases and Related Health Problems 10th Revision | year=2010 | publisher=World Health Organisation | access-date=2014-11-02 | chapter-url=http://apps.who.int/classifications/icd10/browse/2010/en#/F90 | chapter=F90 Hyperkinetic disorders | deadurl=no | archive-url=https://web.archive.org/web/20141102133725/http://apps.who.int/classifications/icd10/browse/2010/en#/F90 | archive-date=2014-11-02 }}</ref><ref name="pmid22201208">{{cite journal | vauthors = Bellani M, Moretti A, Perlini C, Brambilla P | title = Language disturbances in ADHD | journal = Epidemiology and Psychiatric Sciences | volume = 20 | issue = 4 | pages = 311–5 | date = 2011-12 | pmid = 22201208 | doi = 10.1017/S2045796011000527 }}</ref>。雖然注意力不足過動症會造成許多的不便，不過若注意力不足過動症的兒童針對有興趣的主題及事物，其專注力持續時間和其他兒童相當，甚至比其他兒童要好<ref name=Wal2012/>。
各年齡層的注意力不足過動症患者往往較容易遭遇社交技巧上的問題，例如：社交互動、建立及維持友誼。這個觀察在各注意力不足過動症的三種子類型中都是成立的。大約一半（50%）的患有注意力不足過動症的兒童及青少年曾經歷過社交上的拒絕（排斥）；而其同儕遭遇社交上的拒絕的比率約為10~15%。注意力不足的人比起對照組（非注意力不足過動症患者）更容易遭遇理解口頭與非口頭言語上的困難，進而對於其社交互動產生負面影響。注意力不足過動症患者也可能在對話的過程中打瞌睡並遺漏他人釋放出的社交暗示。<ref>Coleman WL (August 2008). "Social competence and friendship formation in adolescents with attention-deficit/hyperactivity disorder". Adolesc Med State Art Rev. 19 (2): 278–99, x. PMID 18822833.</ref>


=== 可能有關的疾病===
難以管理憤怒情緒的情況則較常在兒童注意力不足過動症患者身上顯現。<ref>"ADHD Anger Management Directory". Webmd.com. Retrieved 17 January 2014.</ref>且兒童注意力不足過動症患者通常有寫字的困難、言語及行動發展的遲緩。雖然這造成患者在現今社會中很大的障礙<ref>"F90 Hyperkinetic disorders", International Statistical Classification of Diseases and Related Health Problems 10th Revision, World Health Organisation, 2010, retrieved 2 November 2014</ref><ref>Bellani M, Moretti A, Perlini C, Brambilla P (December 2011). "Language disturbances in ADHD". Epidemiol Psychiatr Sci. 20 (4): 311–315. doi:10.1017/S2045796011000527. PMID 22201208.</ref>，然而許多注意力不足過動症患者在他們有興趣的事情上都能持續維持專注力。<ref name="autogenerated2">Walitza, S; Drechsler, R; Ball, J (August 2012). "Das schulkind mit ADHS" [The school child with ADHD]. Ther Umsch (in German). 69 (8): 467–73. doi:10.1024/0040-5930/a000316. PMID 22851461.</ref><ref name="找回專注力"/>
在注意力不足過動症患者中，大約會有三分之二的機率會伴隨其他的疾病或特徵<ref name=Wal2012/>。常見的共病或特徵如下：


* [[癫痫]]<ref name=NHS2018>{{cite web|title=ADHD Symptoms|url=https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/#related-conditions-in-children-and-teenagers|website=nhs.uk|access-date=2018-05-15|date=2017-10-20|archive-date=2021-02-01|archive-url=https://web.archive.org/web/20210201015023/https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/#related-conditions-in-children-and-teenagers|dead-url=no}}</ref>
注意力不足過動症患者遇到需要保持長時間專注的事情，比如說：讀書、寫功課、或閱讀，就容易出現不適應的情況。<ref name="找回專注力"/>[[File:Stofa i hradbraut.jpg|thumb|upright=1.6|待在圖書館、餐館、上課、聽演講、開會等需要長時間保持靜態的場合，對患者來說可能不太容易。<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/> 圖片為冰島教室內的學生Stofa i hradbraut]]
* [[妥瑞症]]<ref name=NHS2018/>
* [[自閉症光譜]]（ASD）：此疾病會影響社交技巧、溝通能力，也會出現固定興趣和重複行為<ref name=NHS2018/>。
* 在注意力不足過動症患者中，較常出現有[[焦虑症]]的情形<ref name="Wilens-2010"/>。
*[[間歇性暴怒症]]<ref name=DSM5 />
* 在注意力不足過動症的兒童中，有20%至30%有[[學習障礙]]的情形。學習障礙可能包括發展障礙、語言障礙以及學習技巧的障礙<ref name=BaileyHC>{{cite web|last=Bailey|first=Eileen|title=ADHD and Learning Disabilities: How can you help your child cope with ADHD and subsequent Learning Difficulties? There is a way.|url=http://www.healthcentral.com/adhd/education-159625-5.html|publisher=Remedy Health Media, LLC.|access-date=2013-11-15|deadurl=no|archive-url=https://web.archive.org/web/20131203092339/http://www.healthcentral.com/adhd/education-159625-5.html|archive-date=2013-12-03}}</ref>。注意力不足過動症本身不是一種學習障礙，不過常常會造成其他學業上的困難<ref name=BaileyHC/>。
* [[强迫症]]（OCD）常和注意力不足過動症一起出現，其中也有許多相同的特徵<ref name="UTP2008" />。
* [[智能障礙]]<ref name=DSM5 />
* {{link-en|反應性依附疾患|Reactive attachment disorder}}<ref name=DSM5 />
* [[物質使用疾患]]。注意力不足過動症的兒童及成人在[[物質濫用]]上的風險較高<ref name="Kooij-2010"/>。最常見的是酒或是大麻<ref name="Kooij-2010"/>。物質使用疾患的原因可能和注意力不足過動症造成的大腦{{tsl|en|reward pathway|回饋酬賞迴路}}改變有關<ref name="Kooij-2010"/>。若注意力不足過動症和物質使用疾患一起出現，這會讓注意力不足過動症的評估及治療更加困難。如果ADHD合併「嚴重的」物質濫用問題，基於往後衍生的風險大小之考量，會優先治療物質濫用問題<ref name=NICE2009-part2>{{cite book |title=Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults |author=National Collaborating Centre for Mental Health |series=NICE Clinical Guidelines |volume=72 |publisher=British Psychological Society |location=Leicester |isbn=978-1-85433-471-8 |date=2009 |url=https://www.ncbi.nlm.nih.gov/books/NBK53652/ |chapter=Attention Deficit Hyperactivity Disorder |pages=[https://www.ncbi.nlm.nih.gov/books/NBK53663/#ch2.s8 18–26], [https://www.ncbi.nlm.nih.gov/books/NBK53663/#ch2.s41 38] |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK53663/ |via=NCBI Bookshelf |deadurl=no |archive-url=https://web.archive.org/web/20160113133612/http://www.ncbi.nlm.nih.gov/books/NBK53652/ |archive-date=2016-01-13 |access-date=2017-06-22 }}</ref><ref name="Wilens-2011">{{cite journal | vauthors = Wilens TE, Morrison NR | title = The intersection of attention-deficit/hyperactivity disorder and substance abuse | journal = Current Opinion in Psychiatry | volume = 24 | issue = 4 | pages = 280–5 | date = 2011-07 | pmid = 21483267 | pmc = 3435098 | doi = 10.1097/YCO.0b013e328345c956 }}</ref>。
*[[睡眠障碍]]常和ADHD一起出現。這也可能是治療ADHD的副作用。對於注意力不足過動症的兒童而言，[[失眠]]是最常見的睡眠障碍，一般會用行為療法來進行治療<ref name="pmid21600348">{{cite journal | vauthors = Corkum P, Davidson F, Macpherson M | title = A framework for the assessment and treatment of sleep problems in children with attention-deficit/hyperactivity disorder | url = https://archive.org/details/sim_pediatric-clinics-of-north-america_2011-06_58_3/page/667 | journal = Pediatric Clinics of North America | volume = 58 | issue = 3 | pages = 667–83 | date = 2011-06 | pmid = 21600348 | doi = 10.1016/j.pcl.2011.03.004 }}</ref><ref name="pmid20451036">{{cite journal | vauthors = Tsai MH, Huang YS | title = Attention-deficit/hyperactivity disorder and sleep disorders in children | url = https://archive.org/details/sim_medical-clinics-of-north-america_2010-05_94_3/page/615 | journal = The Medical Clinics of North America | volume = 94 | issue = 3 | pages = 615–32 | date = 2010-05 | pmid = 20451036 | doi = 10.1016/j.mcna.2010.03.008 }}</ref>。 ADHD患者常伴隨著不容易入睡的問題，而他們也會睡的比較熟，因此早上不容易起床<ref name="Brown-2008">{{cite journal | vauthors = Brown TE | title = ADD/ADHD and Impaired Executive Function in Clinical Practice | journal = Current Psychiatry Reports | volume = 10 | issue = 5 | pages = 407–11 | date = 2008-10 | pmid = 18803914 | doi = 10.1007/s11920-008-0065-7 }}</ref>，有時會針對不容易入睡的兒童用[[褪黑素]]治療<ref name="pmid20028959">{{cite journal | vauthors = Bendz LM, Scates AC | title = Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder | url = https://archive.org/details/sim_annals-of-pharmacotherapy_2010-01_44_1/page/185 | journal = The Annals of Pharmacotherapy | volume = 44 | issue = 1 | pages = 185–91 | date = 2010-01 | pmid = 20028959 | doi = 10.1345/aph.1M365 }}</ref>。
*ADHD的患者約有50%有[[對立反抗症]]（ODD），有20%有[[品行障碍|行為規範障礙]]（CD）<ref name="pmid19940426">{{cite journal | vauthors = McBurnett K, Pfiffner LJ | title = Treatment of aggressive ADHD in children and adolescents: conceptualization and treatment of comorbid behavior disorders | journal = Postgraduate Medicine | volume = 121 | issue = 6 | pages = 158–65 | date = 2009-11 | pmid = 19940426 | doi = 10.3810/pgm.2009.11.2084 }}</ref>，其特性是反社會的行為，例如心態固執、有攻擊性、常常{{link-en|鬧脾氣|temper tantrums}}、<!--deceitfulness、-->說謊和偷竊等<ref name=UTP2008>{{cite web | url=http://www.uptodate.com/online/content/topic.do?topicKey=behavior/8293#5 | last=Krull | first=KR | title=Evaluation and diagnosis of attention deficit hyperactivity disorder in children | subscription=yes | access-date=2008-09-12 | work=Uptodate | publisher=Wolters Kluwer Health | date=2007-12-05 | deadurl=no | archive-url=https://web.archive.org/web/20090605040744/http://www.uptodate.com/online/content/topic.do?topicKey=behavior%2F8293#5 | archive-date=2009-06-05 }}</ref>。若有對立反抗症或行為規範障礙的ADHD患者，長大成人後出現[[反社会人格障碍]]的機率約有一半<ref name="pmid19428109">{{cite journal | vauthors = Hofvander B, Ossowski D, Lundström S, Anckarsäter H | title = Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition | journal = International Journal of Law and Psychiatry | volume = 32 | issue = 4 | pages = 224–34 | year = 2009 | pmid = 19428109 | doi = 10.1016/j.ijlp.2009.04.004 | url = http://lup.lub.lu.se/search/ws/files/5190474/1430656.pdf | access-date = 2019-12-03 | archive-date = 2020-11-28 | archive-url = https://web.archive.org/web/20201128115309/https://lup.lub.lu.se/search/ws/files/5190474/1430656.pdf | dead-url = no }}</ref>。根據腦部造影，可確認ADHD和行為規範障礙是兩種不同的疾病<ref name="pmid21094938">{{cite journal | vauthors = Rubia K | title = "Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review | journal = Biological Psychiatry | volume = 69 | issue = 12 | pages = e69–87 | date = 2011-06 | pmid = 21094938 | doi = 10.1016/j.biopsych.2010.09.023 }}</ref>。
* 有關注意力的原發型疾病，其症狀是注意力不佳，不容易專注，也不容易維持清醒。這類兒童常會坐立不安、打呵欠及伸展身體，這些動作看似過動，但其實是為了讓自己維持警覺以及有活力的狀態<ref>{{cite journal | vauthors = Weinberg WA, Brumback RA | title = Primary disorder of vigilance: a novel explanation of inattentiveness, daydreaming, boredom, restlessness, and sleepiness | url = https://archive.org/details/sim_journal-of-pediatrics_1990-05_116_5/page/720 | journal = The Journal of Pediatrics | volume = 116 | issue = 5 | pages = 720–5 | date = 1990-05 | pmid = 2329420 | doi = 10.1016/s0022-3476(05)82654-x }}</ref>。
* {{link-en|遲緩的認知速率|Sluggish cognitive tempo}}（SCT）是許多症狀的總稱，其中不少症狀可能也包括了注意力不足的問題。在ADHD的個案中，不論其子類型如何，有30%至50%符合這些症狀<ref name="Barkley, R. A. 2014">{{cite journal | vauthors = Barkley RA | title = Sluggish cognitive tempo (concentration deficit disorder?): current status, future directions, and a plea to change the name | journal = Journal of Abnormal Child Psychology | volume = 42 | issue = 1 | pages = 117–25 | date = 2014-01 | pmid = 24234590 | doi = 10.1007/s10802-013-9824-y | url = https://psychology.uiowa.edu/sites/psychology.uiowa.edu/files/groups/nikolas/files/Barkley,%202014.pdf | archive-url = https://web.archive.org/web/20170809102631/https://psychology.uiowa.edu/sites/psychology.uiowa.edu/files/groups/nikolas/files/Barkley%2C%202014.pdf | deadurl = no | archive-date = 2017-08-09 | access-date = 2018-03-12 }}</ref>。
*{{link-en|刻板的慣性動作症|Stereotypic movement disorder}}<ref name=DSM5 />
* [[情感障礙]]（特別是[[躁鬱症]]及[[重度抑郁症]]）。診斷患有混合子類型ADHD的男孩較容易有情感障礙<ref name="Wilens-2010">{{cite journal | vauthors = Wilens TE, Spencer TJ | title = Understanding attention-deficit/hyperactivity disorder from childhood to adulthood | journal = Postgraduate Medicine | volume = 122 | issue = 5 | pages = 97–109 | date = 2010-09 | pmid = 20861593 | pmc = 3724232 | doi = 10.3810/pgm.2010.09.2206 }}</ref>。有ADHD的成人有時也會有躁鬱症，需要很仔細的評估來診斷及治療這兩種疾病<ref name="pmid21717696">{{cite journal | vauthors = Baud P, Perroud N, Aubry JM | title = [Bipolar disorder and attention deficit/hyperactivity disorder in adults: differential diagnosis or comorbidity] | language = fr | journal = Revue Medicale Suisse | volume = 7 | issue = 297 | pages = 1219–22 | date = 2011-06 | pmid = 21717696 }}</ref>。
*注意力不足過動症的患者較常有[[不寧腿綜合症]]，一般是因為[[缺鐵性貧血]]所造成<ref name="pmid21365608">{{cite journal | vauthors = Merino-Andreu M | title = [Attention deficit hyperactivity disorder and restless legs syndrome in children] | language = es| journal = Revista de Neurologia | volume = 52 Suppl 1 | issue = | pages = S85–95 | date = 2011-03 | pmid = 21365608 | trans-title = Attention deficit hyperactivity disorder and restless legs syndrome in children }}</ref><ref name="pmid20620105">{{cite journal | vauthors = Picchietti MA, Picchietti DL | title = Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment | journal = Sleep Medicine | volume = 11 | issue = 7 | pages = 643–51 | date = 2010-08 | pmid = 20620105 | doi = 10.1016/j.sleep.2009.11.014 }}</ref>。不過不寧腿綜合症也可能是注意力不足過動症症狀的一部份，因此需要進行詳細的診斷，區分不寧腿綜合症和注意力不足過動症<ref name="pmid18656214">{{cite journal | vauthors = Karroum E, Konofal E, Arnulf I | title = [Restless-legs syndrome] | language =fr | journal = Revue Neurologique | volume = 164 | issue = 8–9 | pages = 701–21 | year = 2008 | pmid = 18656214 | doi = 10.1016/j.neurol.2008.06.006 }}</ref>。
*注意力不足過動症的患者出現[[夜遺尿]]的風險較高<ref name="pmid19096296">{{cite journal | vauthors = Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR | title = Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: results from a nationally representative study | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 48 | issue = 1 | pages = 35–41 | date = 2009-01 | pmid = 19096296 | pmc = 2794242 | doi = 10.1097/CHI.0b013e318190045c }}</ref>。


有一個2016年的系統回顧發現注意力不足過動症和肥胖、[[哮喘]]及睡眠障礙有有著直接的關聯，和[[乳糜泻]]和[[偏頭痛]]也有一些關係<ref name="pmid27664125">{{cite journal | vauthors = Instanes JT, Klungsøyr K, Halmøy A, Fasmer OB, Haavik J | title = Adult ADHD and Comorbid Somatic Disease: A Systematic Literature Review | journal = Journal of Attention Disorders | volume = 22 | issue = 3 | pages = 203–228 | date = 2018-02 | pmid = 27664125 | pmc = 5987989 | doi = 10.1177/1087054716669589 | url = https://www.researchgate.net/publication/308535417 | archive-url = https://web.archive.org/web/20170207035945/https://www.researchgate.net/publication/308535417_Adult_ADHD_and_Comorbid_Somatic_Disease_A_Systematic_Literature_Review | deadurl = no | archive-date = 2017-02-07 | type = Systematic Review | access-date = 2021-02-06 }}{{open access}}</ref>。不過同一年的另一篇系統回顧認為注意力不足過動症和乳糜泻沒有明確關係<ref name="pmid26825336">{{cite journal | vauthors = Ertürk E, Wouters S, Imeraj L, Lampo A | title = Association of ADHD and Celiac Disease: What Is the Evidence? A Systematic Review of the Literature | journal = Journal of Attention Disorders | pages = 108705471561149 | date = 2016-01 | pmid = 26825336 | doi = 10.1177/1087054715611493 | quote = 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.&nbsp;... 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)'' | type = Review }}</ref>。


===智力===
待在圖書館、餐館、上課、聽演講、開會等需要長時間保持靜態的場合，對注意力不足過動症患者來說可能不太容易，除非他們在圖書館裡看有興趣的書、對上課內容有興趣。與靜態場合相比，注意力不足過動症患者可能更偏愛動態的、節奏快的、短時間內就完結的活動，當然若能在活動過程中四處走動更好，不然他們會想趕快去做別的事情以排解心中的不耐煩。當周遭的人都保持安靜時，注意力不足過動症患者往往顯得靜不下來。一直動來動去，給人一種充滿能量的印象。由於健忘和生活組織（規劃）能力不足以應付日常所需，於是常表現出一副沒事做、事情都做完了、無聊的樣子。由於不知道自己要做什麼（生活組織力不足、健忘）但又靜不下來，於是發展出樂於沒事找事做等涵蓋：樂於幫助他人消耗體力的活動，例如：跑腿、拿東西。因此，注意力不足過動症患者可能帶給人熱情活潑的印象。而部分注意力不足過動症患者的運動協調性不佳，肢體動作較大，有時候也可能讓人留下粗魯的形象。<ref name="找回專注力"/>
有研究發現患有注意力不足過動症的人其[[智商]]（IQ）測試的結果會比沒有注意力不足過動症的人要低<ref name="ReferenceA">{{cite journal | vauthors = Frazier TW, Demaree HA, Youngstrom EA | title = Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder | url = https://archive.org/details/sim_neuropsychology_2004-07_18_3/page/543 | journal = Neuropsychology | volume = 18 | issue = 3 | pages = 543–55 | date = 2004-07 | pmid = 15291732 | doi = 10.1037/0894-4105.18.3.543 }}</ref>，不過有關此研究結果的重要性，目前仍有爭議，因為很難區分影響是因為ADHD的症狀（例如分心）所造成還是ADHD本身對於智力有影響<ref name="ReferenceA" />。<!--In studies of ADHD, higher IQs may be over represented because many studies exclude individuals who have lower IQs despite those with ADHD scoring on average nine points lower on standardized intelligence measures.<ref name="Mac2016">{{cite journal | vauthors = Mackenzie GB, Wonders E | title = Rethinking Intelligence Quotient Exclusion Criteria Practices in the Study of Attention Deficit Hyperactivity Disorder | journal = Frontiers in Psychology | volume = 7 | pages = 794 | date = 2016 | pmid = 27303350 | pmc = 4886698 | doi = 10.3389/fpsyg.2016.00794 }}</ref>-->


有一份成人ADHD的研究指出有關ADHD患者在智力上的差異，沒有統計上的意義，也可以用其他相關的疾病來解釋<ref>{{cite journal | vauthors = Bridgett DJ, Walker ME | title = Intellectual functioning in adults with ADHD: a meta-analytic examination of full scale IQ differences between adults with and without ADHD | url = https://archive.org/details/sim_psychological-assessment_2006-03_18_1/page/n4 | journal = Psychological Assessment | volume = 18 | issue = 1 | pages = 1–14 | date = 2006-03 | pmid = 16594807 | doi = 10.1037/1040-3590.18.1.1 }}</ref>。


有一份最新的研究報告指出，智能障礙的病患罹患ADHD的機率相比其他人較為提高；而若親屬中有人為智能障礙者的話，家族中其他成員罹患ADHD的機率（相比於親屬中沒有智能障礙者）也較高。根據擬和模型的分析，造成這種情況的原因有91%的可能性與基因有關。<ref>{{cite journal |title=The Familial Co-Aggregation of Attention-Deficit/Hyperactivity Disorder and Intellectual Disability: A Register-Based Family Study |journal=Journal of the American Academy of Child & Adolescent Psychiatry |year=2017 |last=Faraone |first=Stephen V. |last2=Ghirardi |first2=Laura |last3=Kuja-Halkola |first3=Ralf |last4=Lichtenstein |first4=Paul |last5=Larsson |first5=Henrik |doi=10.1016/j.jaac.2016.11.011 |accessdate=2020-12-30 }}</ref>
{{border |因為不少注意力不足過動症患者（尤其女性）並無過動症狀，甚至是非常安靜、沒有破壞性的，而過去對此症的認識總是集中在過動（多動、過度活躍）症狀上，使得這類不過動患者甚少能診斷出來。<ref name="pmid19393378"/><ref name="Singh"/>|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

==== 注意力不足（失調/缺陷） ====

<!-- 參照用，盡量不要移除。:D
以下數字條列之解釋整理自[[國立臺灣大學醫學院附設醫院]]精神醫學部、基因醫學部主任高淑芬醫師之著作<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/> -->
<!-- 以下表格中條列之解釋整理自[[國立臺灣大學醫學院附設醫院]]精神醫學部、基因醫學部主任高淑芬醫師之著作<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/> -->
注意力（專注力）包含了四個面向。<ref name="找回專注力" /><ref name="幫助ADHD孩子快樂成長" />
<!-- 參照用，請勿移除。:D

# 選擇性（Selective）注意力：能夠將注意力凝聚於某一個重要目標，而忽略其他不相干的訊息，所以就不會分心。
# 分開性（Divided）注意力：能夠同時接收多個指令，或者同時進行好幾件事情而不會搞混或忘記。
# 轉移性（Shifting）注意力：專注力可以迅速從一件事切換到另一件事，果斷地處理完眼前的事物、再隨時切換回去，不會遲疑不決或慌張混亂。
# 持續性（Sustained）注意力：可以讓專注力保持一段較長的時間，不會一下子就恍神或散漫。

-->

{| class="wikitable sortable"
|-
! 面向 !! 解釋
|-
| 選擇性（Selective）注意力 || 能夠將注意力凝聚於某一個重要目標，而忽略其他不相干的訊息，所以就不會分心。
|-
| 分開性（Divided）注意力 || 能夠同時接收多個指令，或者同時進行好幾件事情而不會搞混或忘記。
|-
| 轉移性（Shifting）注意力 || 專注力可以迅速從一件事切換到另一件事，果斷地處理完眼前的事物、再隨時切換回去，不會遲疑不決或慌張混亂。
|-
| 持續性（Sustained）注意力 || 可以讓專注力保持一段較長的時間，不會一下子就恍神或散漫。
|}

=== 成年注意力不足過動症患者 ===
{{prose|章節|date=2017-02-28}}

成人注意力不足過動症其實是注意力不足過動症的症狀從幼年延續到成年期，並不是成年後才出現的疾病。其症狀基本上仍未脫離分心、過動-衝動的核心概念，只是表現方式有很多（比起幼年期更為多樣），一般大眾不一定能將這些多樣的表現型式與ADHD的核心症狀相連結。

研究發現，兒童青少年時期的ADHD症狀若未經治療，約有六成進入成年期後仍有明顯症狀。

有鑑於目前臺灣社會對於成人ADHD的認識有限，不少成人ADHD患者在生活中經歷了可能比別人更多的困難和挫折且在迷糊和混亂中度過了不少歲月，卻不知其問題的根源，於是只能不斷的自我批判欲藉此改善現況，然而卻反而使自己變得更負面以及精神狀況每況愈下。因此下表主要乃根據[[國立臺灣大學醫學院附設醫院]]精神醫學部、基因醫學部主任高淑芬醫師之著作摘要整理出成人ADHD的特徵，幫助疑似患者自我察覺。<ref name="找回專注力"/><ref name="Tc_ADHD"/>

* 經常天馬行空地想東想西，腦海中不斷迸發出新的點子，興致勃勃地告訴別人後卻鮮少具體實踐，讓美麗的夢想成真。即便興沖沖開始執行，通常也只是三分鐘熱度。
* 喜歡熱心主動的幫助別人或提供別人各式各樣的建議，不過與此同時，對自己的事卻顯得吊兒啷噹，拖拖拉拉，好像沒有作完的一天。
* 喜歡說話，無論是在會議中或是上課的場合中，仍會忍不住一直跟旁邊的人聊天。經常吵到人而不自知。
* 對注意力不足過動症患者來說，跟別人好好聊天可能不是一件容易的事，因為不耐於傾聽，經常插嘴或岔（離）題。
* 對於時間這個東西沒什麼概念，常常無法準時赴約，不是遲到，就是根本把這件事拋到九雲通宵外，把這件事情給忘了。（缺乏時間觀念）
* 粗心、忽略細節、因為不耐煩而便宜行事。只想求快的結果就是做事的品質令人不敢恭維。
* 因為注意力不足過動症的緣故，患者顯得容易衝動又沒耐心，例如：開快車，搶黃燈或闖紅燈、插嘴、插隊、搶話、發生交通事故、收到罰單或與人起衝突。
* 注意力不足過動症患者常挨批評像長不大的人、迷迷糊糊、懶懶散散、不用心、說說哥、說說姊、不負責任、白目、生活習慣不好、以自己為中心等。
* 患者每當遭受到類似的批判，往往覺得無奈又委屈並為此而焦慮。因為患者本身也不想這樣，但就是心有餘而力不足，無法自我控制。
* ADHD患者的言行舉止往往令周遭的親友感到納悶，一來是他們的表現有時候很不錯、學習力也不差，但為何就是需要旁人再三提醒專心把事情做好，還需周遭親友們不時替患者操心。
* 一心只講求快速、效率，卻未顧及到做事的品質，以至於語焉不詳、字跡潦草、漏洞百出。像是剛拿到一樣新東西，連看說明書都不耐煩，便直接動手安裝或使用，導致事倍功半，或是不小心就把東西給弄壞了。
* 對於金錢和財務不太有概念、粗心大意，因此在收支上維持平衡對於成人ADHD患者來說，可能不是一件輕鬆的事情。
* 對於ADHD-患者來說，時間通常只有『現在』沒有『未來』，所以常會把很多事情都擠在同一個時間。ADHD患者的[[空間|空間能力]]也不太好，家中的桌子、地上、床鋪、和櫃子經常堆滿東西。書桌上的東西堆積成了一座小山坡，沒有歸類，然而其抽屜可能空空的，只裝了點小紙屑。
* 當ADHD患者想要或需要某些人、事、物時，他們可能會立馬插嘴或打斷別人，無論別人是不是正在忙、談話中。ADHD可能就會要對方放下正在做的事，立即回應他們。ADHD患者之所以會急性子，除了是肇因於衝動的核心症狀外，他們也擔心如果不現在說出來，未來可能就會忘記啦。
* 為了找東西而浪費很多寶貴的時間，甚至為此進出家門多次而遲到。
* 分辨事情緩急輕重的能力不好。例如：明明人家急著要一份資料，ADHD患者卻因為別人的一句話或一個動作而分心，轉而關注其他的人事時地物，於是原本正在進行的事情全拋諸腦後。對於ADHD來說，一旦應該做的事被打斷，就很難再回來持續做完。
* 常常會從ADHD患者身上觀察到一些好似不安、不安穩的小動作，例如：摸東摸西、拉扯衣服、碰碰文具、在椅子上旋轉、剝指甲、在紙上塗鴉等。
* 常覺得靜不下來。
* 丟三落四的，不是找不到手機、錢包、鑰匙、帳單就是忘了帶應該記得帶的重要東西。
* 說話的時候常常更換主題，使得別人不易釐清重點。
* 因為衝動的特質，ADHD患者經常不假思索就脫口而出不得體的話。（常講錯話）
* 不耐於傾聽他人，往往對方的話還沒講完，他們就插嘴或急著接話：「我知道，我知道，我告訴你⋯⋯」。但別人要說的並不一定與ADHD患者預測的相同。
* 可能會藉由超車、闖紅燈來擺脫等待停等紅燈、堵車時的不耐煩。因此容易出車禍和吃罰單。
* 排隊、等待火車對於ADHD來說可能是件非常煩人的事情。
* 可能因為肢體容易碰撞到別人而引起人際衝突。（肢體協調性可能不足）
* 遇到稍微比較複雜的指令，就容易亂掉。即便是每天的例行公事，也需要不斷地叮嚀。
* 倘若沒有明確嚴格的時間限制，ADHD可能會把他應該做的事、應該繳交的作業、......，無限期的延後，沒有完成的一天。
* 經常從一件事情切換至另一件事情的結果可能是每一件事情都沒做完或花很長的時間才能做完。
* 做事欠缺規劃、分辨事情緩急輕重的能力有待加強、缺乏時間觀念可能帶給人不可靠、不守信的感覺。
* ADHD患者們也不太容易與別人維持長時間的對話和互動、或者看電視（鎖定同一個節目）。總之就是很難持續，還沒有到一個段落，就中斷離開了。<ref name="找回專注力"/>
* 是一個熱心的人，點子很多也很好動，但就是常常恍神、糊裡糊塗、少根筋似的。
* 做事情容易拖拖拉拉，拖延到最後一刻。
* 思考或者做事情上常看起來心不在焉、虎頭蛇尾，講不聽。
* 不耐久坐、才剛坐下看東西、看資料，不到幾分鐘就想站起來找人聊天。
* 各種坐姿，有時候會把腳擱在桌上，或者一直扭動，旁若無人似的。
* 手上的書已經翻開超過半小時，卻因為一直無法專心閱讀，所以書還停留在剛翻開時的那一頁。
* 不擅於整理東西、打理生活，不論是隨身攜帶的包包裡、家裡的房間、抑或是桌子上，基本上都塞著或堆著各種東西。隨著時間的流轉，這些小平原、小丘陵會變成亂亂的大台地和大山坡。
* 忘東忘西的，經常忘記答應別人的事情、東西放在哪裡、安排好的行程規劃、證件、約會的時間地點、資料、應該做到的事、......。注意力不足過動症患者腦部的記憶功能並無缺損，但就是太健忘了，讓自己和周邊的人都感到十分的無奈。
* 易粗心犯錯、工作效率不足、不易與人建立並維持良好的溝通、常常換工作、換老闆、虎頭蛇尾、有始無終、恍神、處事亂無章法、坦率直接、沒有心機、天真、興趣廣泛、少根筋的樂天派、活潑好動、熱心助人、講義氣、喜歡打抱不平、愛講話所以很容易交朋友、創意十足、熱情洋溢、活力充沛、開朗活潑、單純、時間管理能力有待加強、三思而後行的能力不足。

'''同為注意力不足過動症患者之哈洛威爾醫師對於成人注意力不足過動症的觀察'''<ref name="drhallowell1">{{cite web|url=http://www.drhallowell.com/add-adhd/adult-add/ |title=Dr. Hallowell on the Today show discussing Adult ADD |publisher=Drhallowell.com |date=2014-10-16 |accessdate=2016-12-09|quote=Dr. Hallowell on the Today show discussing Adult ADHD\ While ADHD 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 ADHD who will outgrow it, we now know that the vast majority will not. Listed below are criteria for adult ADHD 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 iability, 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 ADHD or manic depressive illness or depression or substance abuse or other disorders of impulse control or mood.Recognizing and treating ADHD is just as important for adults as it is for children, as it has a wide ranging impact in careers, marriages and families.}}</ref>

哈洛威爾：「雖然『注意力不足過動症』常認為是好發於兒童青少年時期，然而到目前為止，我們已經知道，成人『注意力不足過動症』的數量遠多於我們原本的預測。即便有些幼年『注意力不足過動症』患者會在其成年時期擺脫『注意力不足過動症』，但我們已經了解到，其實絕大多數的幼年『注意力不足過動症』患者之症狀會持續至成年時期。」

哈洛威爾：以下表列之特徵為我們歷經數年臨床經驗所得之成人注意力不足過動症患者的特徵：

{{div col|cols=2}}

* 不耐煩。
* 搖擺不定的心情。
* 忽略真實的危機。
* 易怒、容易被激怒。
* 低{{tsl|en|frustration|挫折}}容忍度。
* 不安全感常縈繞在心頭。
* 心理上或身（肢）體上的不安寧。
* 常常追求高度的刺激感。
* 容易不耐煩或感到無聊、難忍無聊的感覺。
* 難以讓自己的人生有組織。
* 長期的（慢性的）低自尊、低自信。
* 衝動。（言語上或是行動上）
* 常有花錢的衝動。（此乃屬行動上的衝動）
* 常帶有高度創意、精確的直覺。十分聰穎。
* 常常杞人憂天，無止盡的、不必要的擔憂。
* 不一定按照既有的管道、尋常的程序行事。
* 慢（慣）性拖延、逃避，不然就是難以開始行動。

{{div col end}}
* 想到什麼就立刻說出來，沒有考慮到時機與場合是否合適。（此乃屬言語上的衝動）
* [[成瘾|成癮]]高危險群。（較負面的解讀。以負面角度觀之。）
* 過度投入有[[興趣]]的事物。（較正面的解讀。以正面角度觀之。）
* 不一定正確的自我觀察。（特別是在盲目的樂觀或悲觀的心境下。）
* ADHD或任何[[情感性疾患]]、衝動控制問題、物質濫用的家庭病史。
* 無論已達成過何種目標/成就，心中一直有種覺得自己沒有發揮應有能力/潛力/實力的感覺。
* 容易分心，難以維持注意力。看似對於一篇文章或是一段對話（交談）不理不睬（或注意力/專注力/心思不知不覺地就飄離了已讀到一半的文章或進行到一半的交談、......）並長期伴隨著難以維持專注力的障礙。
* 計畫常常變來變去，無論在計畫或生涯規劃上都顯得三分鐘熱度。
* 常常用眼睛掃描地平線、水平線等視野範圍去尋找事情來擔心、檢查所擔心的東西（頻繁地反覆檢查）。
* 當（或被迫）離開某人或某事的時候，心情上會有過於重大的負面衝擊及剝奪感。
* 因為難以隨著時間演進有效訂定和掌握各計劃的進度與期程，遂乾脆讓好幾個計畫同時進行。

哈洛威爾：「治療<u>成人</u>ADHD患者與治療<u>兒童青少年</u>ADHD患者，兩者是同等重要的。因為ADHD對於一位成人的衝擊相當廣泛，例如：{{tsl|en|career|生涯}}、[[婚姻]]與[[家庭]]、......等。」
<ref name="drhallowell1"/>
==== 兩性交往與婚姻 ====

ADHD患者活潑開朗、熱心助人、說話風趣、勇於告白的特性對於兩性交往與婚姻來說都具有加分作用。
然而交往一段時間後，ADHD患者的負面特質，例如：沒耐心、容易遲到、無法專心聽人說話、交代的事情老是忘記、需要幫忙的時候找不到人、生活習慣及生活作息不佳、喜歡開快車、個性很迷糊、……，可能就會讓對方萌生退意。

如果順利通過交往，共結連理，則接下來注意力不足過動症患者可能遇到的挑戰為：比起交往時期多了許多柴米油鹽醬醋茶之事，患者可能會因為忘記付帳單、照顧小孩很恍神、做事虎頭蛇尾而引起夫妻間的爭吵，為婚姻生活埋下陰影。

幸運的是，ADHD是可以治療的，只要提升專注力，落實執行力，患者一樣可以活出美好天賦，有著精采陽光的人生。<ref name="找回專注力"/>

=== 雙重特殊，注意力不足過動症和資優的交互關係 ===

[[雙重特殊]]（twice-exceptional）是指兼具資賦優異及身心行為障礙者，身心障礙人口中有3%~5%具有雙重特殊的特質<ref>Yewchuk & Lupark, 1993</ref>。雙重特殊學生是指在學業、智能、創造力、領導能力、視覺、空間或表演藝術等領域中，有一個項目或以上表現優異;而同時也符合顯著明確的知覺溝通障礙（學習障礙）、情緒障礙、肢體障礙、感官障礙、自閉症、或注意力不足過動症等障礙的標準者<ref>Montgomery, 2007</ref>。

資優注意力不足過動症兒童在學校的表現一般是名列前茅，但行為表現卻極不成熟。由於行為問題，通常學校大多數老師不認為資優注意力不足過動症兒童是資優生，也不認為他擁有什麼特殊才藝。反之，學校大部分的老師們都認為他們是暴躁、易怒、叛逆、沒有禮貌的壞學生<ref>Leroux ＆ Levitt-Perlman,2000；引自花敬凱，民93,8頁</ref>他們在感興趣的領域，有亮眼的表現，但在行為或人際關係上卻是常令人頭痛萬分。由於這類負面形象，不符合一般人對資優生的正面期待，往往使得老師常忽略了他們的潛能。臨床上，除了雙重特殊兒童的特質，還歸納出資優注意力不足過動症兒童可能會表現以下的行為<ref>Wolfle ＆ French,1990；引自花敬凱，民93,9頁</ref><ref>{{citation
| author=花敬凱
| series = Wolfle ＆ French
| title = Wolfle ＆ French
| date = 2004
| pages = 9
| archive-date=1990
| access-date=February, 2017.}}</ref>：

{{div col|cols=2}}

* 常在不適當的時機開玩笑或惡作劇。
* 對於重複性的作業感到厭煩或抗拒。
* 高度自我批判，難以接受失敗經驗。
* 霸道。
* 有時寧願獨處。
* 上課時很難專心聽講。
* 經常與人爭吵。
* 情緒敏感。
* 不注重細節，做事草率衝動。
* 拒絕接受權威、不服從、固執。
* 不能和其他人相處

{{div col end}}

資優注意力不足過動症兒童在行為問題上有許多特徵與普通注意力不足過動症兒童相類似，使得注意力不足過動症資優兒童容易因此而誤判，或忽略了其實際擁有的內在潛能。

; 辨別資優注意力不足過動症兒童<ref>{{cite book
| author1= 吳怡慧
| author2= 曾薷瑩
| title = ADHD 資優生的特質與區辨
| series = 國小特殊教育
| volume = 48
| date = June, 2009.
| page = 64-71
| quote=摘要 雙重特殊學生因兼具資賦優異及身心障礙的特質，而導致內在特質的交互作用，左右 了其學校各方面的適應。本文試從環境因素探討 ADHD 與一般資優生的主要區辨因子，並 進一步分析 ADHD 族群中伴隨資優者(AD/GT)的主要特徵。教育工作者及鑑定人員宜清楚 了解此三類學生特質的區辨，並藉由環境分析及行為觀察資料的協助，儘早作好篩選，以 利後續實施相關的鑑定及適性輔導。
| url= http://web.utaipei.edu.tw/~speccen/gifted/article/9801.pdf
| section = 中文關鍵詞：注意力缺陷過動症、過動資優、雙重特殊 英文關鍵詞：Attention Deficit Hyperactivity Disorder (ADHD), ADHD with Giftedness (AD /GT), Twice-Exceptional }}</ref>

{| class="wikitable"
|-
! 比較項目 !! 普通注意力不足過動症兒童 !! 資優注意力不足過動症兒童
|-
| 專注 || 大多數情況下無法集中注意力 || 缺乏興趣的情況下無法集中注意力，但對自己感興趣的事物上卻多數能表現高度專注力
|-
| 工作持續力 || 做事多數虎頭蛇尾，常無法完成指定的工作 || 對有興趣的事物經常表現過人的耐心和持續力
|-
| 衝動行為 || 大多數情況下無法自己控制衝動 || 思考速度太快，思考內容太多，急於分享而無法控制自己的衝動行為
|-
| 遵守規範 || 遵守行為規範與服從指令上有困難 || 遵守行為規範與服從指令上有困難，但會進一步質疑權威（老師/家長）與規範的合理性與正當性，因此叛逆和好辯
|-
| 活動能力 || 顯得精力旺盛，無的放矢的宣洩 || 顯得精力旺盛，但發揮得較有方向，也能計畫自己下一步要做什麼
|}

; 調整方法

資優注意力不足過動症兒童體內由於資賦優異與注意力不足過動症雙重特質交互影響，使得他們不易發現，家長和老師應仔細探究兒童在不同情境下學習與行為表現，不要當兒童出現不當行為時，就予以負面標籤，影響了其潛能發展，或使得他們錯失原本可有的協助與輔導。家長應調整教導方法，給予適度與清楚的期望，也要接納他們不由己的脫軌表現。注意力不足過動症兒童的行為特質，有助於創造力的發展，例如，注意力不足過動症兒童擁有較佳的想像力。只要在發現注意力不足過動症資優兒童後，提供有效、專業的介入與輔導，會因著這不同的特質，而擁有更不一樣的人生。<ref>Hallowell ＆ Ratey,1995；引自花敬凱，民93,12頁</ref>，有些雙重特殊學生可能在逐漸長大後會出現情緒困擾，感覺為社會所孤立，因而發展出攻擊或退縮行為。長期於人際關係上的失敗，也會導致無助感和無望感。最後，在沮喪的情況下，其可能選擇規避最起碼的學習及社會要求，以免讓自己陷入痛苦深淵。

{{border |值得注意的是，國際上通用的注意力不足過動症分類、治療策略及描述並無區分所謂的普通『注意力不足過動症』兒童和資優『注意力不足過動症』兒童<ref>{{cite web|url=http://www.nhs.uk/Conditions/Attention-deficit-hyperactivity-disorder/Pages/Introduction.aspx|title=Attention deficit hyperactivity disorder (ADHD) - NHS Choices|first=NHS|last=Choices|date=|publisher=}}</ref>。|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

=== 可能與注意力不足過動症有關的疾病 ===

在兒童注意力不足過動症患者中，大約有⅔的機率伴隨其他與注意力不足過動症有關的疾病。常見的共病如下：

* [[學習障礙|特殊學習需要]]（舊稱學習障礙、學習困難）在20%~30%的注意力不足過動症患者中被觀察到<ref name="autogenerated2"/>。言語發展遲緩及學習技巧的困難皆涵蓋在學習障礙的範疇中。然而注意力不足過動症本身並不包含在學習障礙中，只不過注意力不足過動症仍經常造成學業上的困難。<ref name=BaileyHC>{{cite web
|last=Bailey
|first=Eileen
|title=ADHD and Learning Disabilities: How can you help your child cope with ADHD and subsequent Learning Difficulties? There is a way.
|url=http://www.healthcentral.com/adhd/education-159625-5.html
|publisher=Remedy Health Media, LLC.
|access-date=2013-11-15}}</ref>
* [[妥瑞氏症]]（Tourette's Syndrome or Tourette's Disease）在注意力不足過動症患者中觀察到的次數越趨頻繁。<ref name="BBDADHD">{{Cite journal
|author1 = Consumer Reports
|author2= Drug Effectiveness Review Project
|date =March 2012
|title = Evaluating Prescription Drugs Used to Treat: Attention Deficit Hyperactivity Disorder (ADHD) Comparing Effectiveness, Safety, and Price
|publisher = Consumer Reports
|work = Best Buy Drugs
|page = 2
|url = http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/ADHDFinal.pdf
|access-date = 2013-04-12
|postscript =. }}</ref>
* {{le|對立反抗症|Oppositional Defiant Disorder}} （Oppositional Defiant Disorder） 以及 [[行為規範障礙]] （Conduct Disorder）：這兩個疾病通常有著[[反社會]]的特徵（但不應與具備獨立思考的批判能力相混淆），例如：抱持只要我喜歡，有什麼不可以的心態且固執守舊、不改變、攻擊性的（防禦心強）、經常突然暴怒、言語隱晦、說謊、和偷竊等。<ref>{{cite web
|location=USA
|url=https://www.ncbi.nlm.nih.gov/pubmed/19940426
|title="Treatment of aggressive ADHD in children and adolescents: Conceptualization and treatment of comorbid behavior disorders".
|author=McBurnett, K; Pfiffner, LJ
|date=November 2009
|journal=Postgraduate Medicine.
|volume=121 (6)
|pages= 158–165
|PMID=19940426
|doi=10.3810/pgm.2009.11.2084
|publisher=Ncbi.nlm.nih.gov
|accessdate=2016-12-09}}</ref><ref name=UTP2008>
{{cite web
| url=http://www.uptodate.com/online/content/topic.do?topicKey=behavior/8293#5
|last= Krull
|first= KR
|title=Evaluation and diagnosis of attention deficit hyperactivity disorder in children
|subscription= yes
| accessdate=2008-09-12
| work=Uptodate
| publisher = Wolters Kluwer Health
| date=2007-12-05 }}</ref><ref name="pmid19428109">
{{cite journal
|vauthors=Hofvander B, Ossowski D, Lundström S, Anckarsäter H
| title = Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition
| journal = International Journal of Law Psychiatry
| volume = 32
| issue = 4
| pages = 224–234
| year = 2009
| pmid = 19428109
| doi = 10.1016/j.ijlp.2009.04.004 }}</ref><ref name="pmid21094938">
{{cite journal
| author=Rubia K
| title="Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review
| type=review
| journal=Biology Psychiatry
| volume=69
| issue=12
| pages=e69–87
| access-date=June 2011
| pmid=21094938
| doi=10.1016/j.biopsych.2010.09.023
| date=2010-09-23 }}</ref>
* [[焦慮症]] （Anxiety Disorder） 越來越頻繁地在注意力不足過動症患者身上觀察到。<ref name="autogenerated3">{{cite
|author=Wilens TE, Spencer TJ
|date=September 2010.
|title="Understanding attention-deficit/hyperactivity disorder from childhood to adulthood".
|journal=Postgraduate Medicine.
|volume=22 (5)
|pages=97–109
|doi=10.3810/pgm.2010.09
|PMC=3724232
|PMID=20861593}}
{{open access}}</ref>
* [[不寧腿症]]（Restless Legs Syndrome） 在注意力不足過動症患者身上觀察到的次數越來越頻繁。此症大多由[[缺鐵性貧血]]（Iron Deficiency Anemia）造成。然而，不寧腿也可能單純僅是注意力不足過動症的一部份。不寧腿的確診需要經過仔細的診斷以與注意力不足過動症區分（細節可再參閱[[人類鐵代謝]]）。<ref>
{{cite journal
|url=https://www.ncbi.nlm.nih.gov/pubmed/21365608
|title=Attention deficit hyperactivity disorder and restless legs syndrome in children
|first=Milagros
|last=Merino-Andreu
|date=2011-03-01
|publisher=
|journal=Rev Neurology
|volume=52 Suppl 1
|pages=S85–95
|via=PubMed
|pmid=21365608}}</ref><ref>
{{cite web
|location=USA
|url=https://www.ncbi.nlm.nih.gov/pubmed/20620105
|title="Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment"
|author=Picchietti MA, Picchietti DL
|date=2009-11-14
|journal=Sleep Medicine.
|volume=11 (7)
|pages= 643–651
|doi=10.1016/j.sleep.2009.11.014
|PMID=20620105
|publisher=Ncbi.nlm.nih.gov
|archive-date=August 2010
|archive-url=https://www.ncbi.nlm.nih.gov/pubmed/20620105
|accessdate=2016-12-09}}</ref><ref>
{{cite web
|url=https://www.ncbi.nlm.nih.gov/pubmed/18656214
|title= "Restless-legs syndrome"
|journal= Rev. Neurology.
|location=Paris
|volume=164 (8–9)
|pages=701–721
|author=Karroum E, Konofal E, Arnulf I
|date=2008-06-06
|PMID=18656214
|doi=10.1016/j.neurol.2008.06.006
|publisher=Ncbi.nlm.nih.gov
|archive-date=2016-11-15
|archive-url=https://www.ncbi.nlm.nih.gov/pubmed/18656214
|accessdate=2016-12-09}}{{法語}}</ref>
* [[強迫症]]（Obsessive Compulsive Disorder）可能與注意力不足過動症併發，且兩者有著許多相同的特徵。<ref name="Krull, KR">{{cite web
|url=http://www.uptodate.com/contents/attention-deficit-hyperactivity-disorder-in-children-and-adolescents-clinical-features-and-diagnosis#5
|title="Evaluation and diagnosis of attention deficit hyperactivity disorder in children".
|subscription =yes
|publisher=Uptodate & Wolters Kluwer Health
|author=Krull, KR
|website=Uptodate.com
|date= 5 December 2007.
|accessdate=2016-12-09}}</ref>
* [[嗜睡症]]（Hypersomnia/Narcolepsy [[猝睡症]]/ Primary Disorder of Vigilance）的患者通常有著專注力上的不足且難以保持醒著的狀態。此症患者通常會在座位上晃動、打哈欠發出聲音、伸展等明顯藉由過動來維繫精神與警覺。<ref name="Krull, KR"/>
* [[睡眠障礙]]（Sleep Disorder）常與注意力不足過動症共伴出現。睡眠障礙症候群也可能是注意力不足過動症用藥的副作用。在兒童注意力不足過動症患者中，[[失眠]]是最常見的睡眠障礙症狀，也是行為治療中較為優先的治療項目。 難以入眠的情況是注意力不足過動症患者們最常面臨的問題。然而，注意力不足過動症患者們也常常是深層（度）[[睡眠]]者，且有難以在上午起床的狀況。[[褪黑素|褪黑激素]]有時用來治療有難以入睡問題的注意力不足過動症患童。<ref name=Owens2008>{{cite journal
| author = Owens JA
| title = Sleep disorders and attention-deficit/hyperactivity disorder
| journal = Current Psychiatry Rep
| volume = 10
| issue = 5
| pages=439–444
| date=October 2008
| pmid = 18803919
| doi = 10.1007/s11920-008-0070-x}}</ref><ref>
{{cite web
|author=Corkum P, Davidson F, Macpherson M
|date=June 2011.
|url=https://www.ncbi.nlm.nih.gov/pubmed/21600348
|title=A framework for the assessment and treatment of sleep problems in children with attention-deficit/hyperactivity disorder.
|journal=Pediatric Clinics North America.
|volume= 58 (3)
|pages=667–683
|PMID=21600348
|doi=10.1016/j.pcl.2011.03.004
|publisher=Ncbi.nlm.nih.gov
|archive-date=2016-11-15
|archive-url=https://www.ncbi.nlm.nih.gov/pubmed/21600348
|accessdate=2016-12-09}}</ref><ref>
{{cite web
|author=Tsai MH, Huang YS
|url=https://www.ncbi.nlm.nih.gov/pubmed/20451036
|date=May 2010.
|title=Attention-deficit/hyperactivity disorder and sleep disorders in children
|journal=Medical Clinics. North America.
|volume=94
|edition=(3)
|pages= 615–632
|PMID=20451036
|doi=10.1016/j.mcna.2010.03.008
|publisher=Ncbi.nlm.nih.gov
|archive-date=2016-11-15
|archive-url=https://www.ncbi.nlm.nih.gov/pubmed/20451036
|accessdate=2016-12-09}}</ref><ref>
{{cite web
|location=USA
|url=https://www.ncbi.nlm.nih.gov/pubmed/18803914
|title=ADD/ADHD and Impaired Executive Function in Clinical Practice
|journal=Curr Psychiatry Rep.
|volume= 10
|issue=5
|pages= 407–411
|doi=10.1007/s11920-008-0065-7
|PMID=18803914
|author=Brown TE
|date=October 2008
|publisher=Ncbi.nlm.nih.gov
|accessdate=2016-12-27}}</ref><ref>
{{cite web
|location=USA
|url=https://www.ncbi.nlm.nih.gov/pubmed/20028959
|author=Bendz LM, Scates AC
|date=January 2010
|title=Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder
|journal=Annals of Pharmacotherapy.
|volume=44
|issue=11
|pages= 185–191
|doi=10.1345/aph.1M365
|PMID=20028959
|publisher=Ncbi.nlm.nih.gov
|accessdate=2016-12-27}}</ref>
* 注意力不足過動症患者相較於其他<u>非</u>注意力不足過動症患者，有著較高的[[夜遺尿]]風險。（[[夜遺尿]] Persistent Bed Wetting）<ref>{{cite web
|location=USA
|author= Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR
|date=January 2009.
|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2794242
|title="Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among United States children: results from a nationally representative study".
|journal= Journal of American Academy of Child and Adolescent Psychiatry.
|volume=48
|issue=1
|pages= 35–41.
|doi=10.1097/CHI.0b013e318190045c
|PMC=2794242
|PMID=19096296
|publisher=Ncbi.nlm.nih.gov
|accessdate=2016-12-27}}
{{open access}}</ref>
* [[情緒障礙|情感性疾患]]（Mood Disorder or Mood Affective Disorder）：特別是[[雙極性症候群]]（Bipolar Disorder）以及[[重性抑郁障碍]]<ref name="autogenerated3"/>。
* [[物質濫用症候群]]（Substance Abused Disorder or Substance Use Disorder） 青少年與成人注意力不足過動症患者皆有相較對照組較高的物質濫用風險。物質濫用的原因之一可能是腦中原有的回饋酬賞迴路（路徑）（reward pathway）因各種因素而由另一回饋酬賞迴路（路徑）取代。<ref>
{{cite web
|author=Kooij, SJ; Bejerot, S; Blackwell, A; Caci, H; et al.
|url=https://www.ncbi.nlm.nih.gov/pubmed/20815868
|title= "European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD".
|date= 2010
|journal=BMC Psychiatry.
|volume=10
|pages= 67
|doi=10.1186/1471-244X-10-67
|PMC=2942810
|PMID=20815868
|publisher=Ncbi.nlm.nih.gov
|accessdate=2016-12-27}}
{{open access}}</ref>
* [[自閉症類群障礙]]（Autism Spectrum Disorder or Pervasive Development Disorder）當[[自閉症]]和注意力不足過動症同時存在時，社交溝通及社會互動障礙會更明顯，且出現固定興趣和重複行為，惟每位患者的嚴重程度不一。<ref name="找回專注力"/>
* [[网络成瘾症]]或3C成癮（Internet or 3C Product Addict）注意力不足過動症患者很容易分心，喜歡新鮮的事物和刺激，一旦進入網路世界，就很容易沉迷於無邊無際的網海。原本是為了要寫報告找資料，但是一看到有趣的訊息就忍不住點進去，然後又連到另一個網站，網網相連到天邊，患者或許知道本身已經分心，然而受限於自制力的缺乏，無法分辨事情的緩急輕重，於是乎很快就把報告和資料的事擱置或根本忘得一乾二淨。<ref name="找回專注力"/>簡單易上手的遊戲，尤其影音畫面一直在變，充滿聲光效果的刺激，不斷破關和不停上升破紀錄的積分，可以輕易吸引他們的注意力，獲得立即的回饋和成就感，忘記日常生活中的挫折感和煩惱，因此網路和3C產品成癮乃注意力不足過動症患者需特別注意的問題。<ref name="找回專注力"/>
* [[睡眠呼吸中止症]]（Sleep Apnea）<ref>
{{Cite journal
| authors = Mark Wolraich, Lawrence Brown,Ronald T. Brown, George DuPaul, Marian Earls, Heidi M. Feldman, Theodore G. Ganiats, Beth Kaplanek, Bruce Meyer, James Perrin, Karen Pierce, Michael Reiff, Martin T. Stein & Susanna Visser
| title = ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents
| journal = [[Pediatrics]]
| volume = 128
| issue = 5
| pages = 1007–1022
| date = November 2011
| doi = 10.1542/peds.2011-2654
| pmid = 22003063}}</ref><ref name="pmid22670023">
{{cite journal
| vauthors=Lal C, Strange C, Bachman D
| title=Neurocognitive impairment in obstructive sleep apnea
| journal=Chest
| volume=141
| issue=6
| pages=1601–1610
| date=June 2012
| pmid=22670023
| doi=10.1378/chest.11-2214 }}</ref>

一個2016年的[[系統性回顧]]發現注意力不足過動症與[[肥胖]]、[[呼吸道]]及[[氣管]][[過敏]]（例如：[[哮喘|氣喘]]、[[過敏性鼻炎]]）、或睡眠障礙有著直接的關聯。<ref name="pmid27664125">{{cite journal
| vauthors=Instanes JT, Klungsøyr K, Halmøy A, Fasmer OB, Haavik J| title=Adult ADHD and Comorbid Somatic Disease: A Systematic Literature Review.
| journal=Journal Attention Deficit Hyperactivity Disorder
| year= 2016
| pmid=27664125
| doi=10.1177/1087054716669589
|url=https://www.researchgate.net/publication/308535417_Adult_ADHD_and_Comorbid_Somatic_Disease_A_Systematic_Literature_Review
| type=Systematic Review }}
{{open access}}</ref>

== 特徵和症狀 <!--signs and symptoms-->==

[[File:Theoretical delay-of-reinforcement normal and ADHD gradients.jpg|thumb|upright=1.5|Theoretical delay-of-reinforcement normal and ADHD gradients <br/>因先天生理因素，<u>未經治療</u>的注意力不足過動症患者通常比<u>治療</u>之注意力不足過動症患者及<u>非</u>注意力不足過動症患者有著對刺激過於延遲的反應（反應包含：緊張、開心等），並造成患者過於不易分辨事情的緩急輕重等症狀。]]

注意力不足過動症的主要症狀包括：<ref name="autogenerated1">{{cite web|url=http://www.adhd.org.hk/ |title=專注不足/過度活躍症(香港)協會 Hong Kong Association For AD/HD |publisher=Adhd.org.hk |date= |accessdate=2016-12-27}}</ref><ref name="Tc_ADHD"/>

# 容易忘記事情。
# 容易分心。
# 囉唆，多話，常打斷別人，且愛辯駁。
# 喜歡到處走動，靜不下來。
# 讀寫困難，包括寫錯字（常多一畫或少一畫、拼字錯誤等）、閱讀時會跳行或無法理解文意等。
# 做事易拖拖拉拉，常拖至最後。
# 工作普遍都做不久，三心兩意，會一直換工作。
# 缺乏組織（規劃）力，無法把自己想說的話、想做的事具體地表達或規劃出來。
# 不了解注意力不足過動症的老師（兒童）或上司（成人）總是視注意力不足過動症」患者為不夠努力或懶惰。
# 逃避需要持續性動腦的工作（例如：家庭作業或學校作業）。
# 缺乏分辨事情緩急輕重的認知。
# 時間管理的認知缺乏。

以上症狀隨患者年齡而有不同表現，有注意力不足過動症的小朋友，其表現通常有上課不專心、無法抑制自己的衝動以及坐立不安的情況；在大人，主要問題則常在於注意力不足過動症患者無法計劃好他們的生活與每日簡單的工作。

但注意力不足過動症患者也有些較為正向的特質：<ref>{{cite web|author1=哈洛威爾|title=淺談ＡＤＤ注意力缺失症|url=http://www.mdnkids.com.tw/specialeducation/detail.asp?sn=450|archiveurl=https://web.archive.org/web/20161005160532/http://www.mdnkids.com.tw/specialeducation/detail.asp?sn=450|archivedate=2016-10-05|website=國語日報社|accessdate=2016-10-05|language=zh-tw}}</ref>

# 具高度創造力，常有特別的新點子（但因組織能力差，常無法將之化為具體行動）。
# 特立獨行、思考不隨俗。
# 對理想保持驚人的堅持度和毅力，甚至可說是頑固。
# 直覺非常強，能單憑直覺深入問題核心，進而發現問題所在（但他通常無法說明如何得知）。


== 診斷 ==
== 診斷 ==
{{main article|注意力不足過動症的診斷}}


注意力不足過動症的診斷是根據患者的行為和心理發展的評鑑並且排除毒品、藥物的影響、或其他生理或心理的可能造成類似ADHD症狀的因素而成。<ref name=NICE2009-part2/>診斷過程通常會將個案的父母意見及師長意見列入考量。<ref name=Lake2011/> 大多數的診斷都是因為個案的教師首先對於孩子的健康提出關切，經轉介後而成。<ref name="Erk2009 II">{{cite book |vauthors=Mayes R, Bagwell C, Erkulwater JL | title=Medicating Children: ADHD and Pediatric Mental Health |url=https://archive.org/details/medicatingchildr0000maye | publisher=Harvard University Press | date=2009 | pages=[https://archive.org/details/medicatingchildr0000maye/page/4 4]–24 | isbn=978-0-674-03163-0 | edition=illustrated }}</ref> 注意力不足過動症的症狀可能會被認為是人類個性光譜的極端或是其中一環而已。<ref name=NICE2009-Diagnosis>{{cite book |title=Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults |author=National Collaborating Centre for Mental Health |series=NICE Clinical Guidelines |volume=72 |publisher=British Psychological Society |location=Leicester |isbn=978-1-85433-471-8 |date=2009 |url=https://www.ncbi.nlm.nih.gov/books/NBK53652/ |chapter=Diagnosis |pages=[https://www.ncbi.nlm.nih.gov/books/NBK53659/#ch5.s40 116–7], [https://www.ncbi.nlm.nih.gov/books/NBK53659/#ch5.s42 119] |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK53659/ |via=NCBI Bookshelf |deadurl=no |archive-url=https://web.archive.org/web/20160113133612/http://www.ncbi.nlm.nih.gov/books/NBK53652/ |archive-date=2016-01-13 |access-date=2017-06-22 }}</ref>
* 成人及兒童青少年的注意力不足過動症診斷標準係依據《DSM-TR精神疾病診斷與統計手冊》的標準。（the Diagnostic and Statistical Manual of Mental Disorders）
對於ADHD的藥物反應結果，無法就此確認診斷或排除診斷。迄今為止ADHD與非ADHD病患腦部構造的差異方面，學界尚未達成一致結論，因此腦部造影只被用於對於複雜的人腦進一步的研究，尚未能應用於診斷ADHD。<ref name="song_yy">{{cite web | url=http://www.merckmedicus.com/pp/us/hcp/diseasemodules/adhd/pathophysiology.jsp | title=MerckMedicus Modules: ADHD&nbsp;–Pathophysiology | archive-url=https://web.archive.org/web/20100501074844/http://www.merckmedicus.com/pp/us/hcp/diseasemodules/adhd/pathophysiology.jsp | archive-date=2010-05-01 | date=2002-08 | accessdate=2018-07-18 | dead-url=no }}</ref>使用{{tsl|en|quantitative electroencephalography||量化腦波}} (QEEG) 診斷ADHD是學界中正在研究的領域之一，然而迄今為止，腦波經過量化後的數值與ADHD之間的關係仍然不明。<ref name=San2013>{{cite journal | vauthors = Sand T, Breivik N, Herigstad A | title = [Assessment of ADHD with EEG] | language = Norwegian | journal = Tidsskrift for Den Norske Laegeforening | volume = 133 | issue = 3 | pages = 312–6 | date = 2013-02 | pmid = 23381169 | doi = 10.4045/tidsskr.12.0224 }}</ref><ref name="pmid21870470">{{cite journal | vauthors = Millichap JG, Millichap JJ, Stack CV | title = Utility of the electroencephalogram in attention deficit hyperactivity disorder | journal = Clinical EEG and Neuroscience | volume = 42 | issue = 3 | pages = 180–4 | date = 2011-07 | pmid = 21870470 | doi = 10.1177/155005941104200307 }}</ref>
* 注意力不足過動症（ADHD）又可細分為以下三種類型：'''注意力不足'''（專注力失調）為主型、'''過動-衝動'''為主型、或'''注意力不足'''（專注力失調）且'''過動-衝動'''的'''混和型'''。


注意力不足過動症又可細分為以下三種類型：注意力不足（專注力失調）為主型、過動-衝動為主型、或注意力不足（專注力失調）且過動-衝動的混合型。<ref name="Association2000">{{cite book|author=American Psychiatric Association|title=Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®|url=https://books.google.com/books?id=3SQrtpnHb9MC|year=2000|publisher=American Psychiatric Association|isbn=978-0-89042-025-6|deadurl=no|archiveurl=https://web.archive.org/web/20200923014600/https://books.google.com/books?id=3SQrtpnHb9MC|archivedate=2020-09-23|access-date=2017-02-17}}</ref>過動，即為「過度」活躍。過度兩字意味著活躍的程度已經對生活造成不良的影響。<ref name="MedlinePlus 2018 Many hyperactive children are unhappy">{{cite web | title=Hyperactivity: MedlinePlus Medical Encyclopedia | website=MedlinePlus | date=2018-07-09 | url=https://medlineplus.gov/ency/article/003256.htm | access-date=2018-07-15 | quote=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. | deadurl=no | archiveurl=https://web.archive.org/web/20170715025355/https://medlineplus.gov/ency/article/003256.htm | archivedate=2017-07-15 }}</ref>即便個案並無上述注意力不足過動症的所有特徵，他仍有可能是ADHD患者，有無全部特徵牽涉到是否有其他共病存在且治療的主要目的在於協助患者避免缺點並發揚優點。<!--引用自本條目多處內容-->成人及兒童青少年的注意力不足過動症的診斷依據《[[精神疾病診斷與統計手冊]]》的標準、患者的歷史經歷（個案史）<ref name="Association2000"/>、門診病人的主訴、[[症狀|症狀學]]、發展史、家族史、共病、生理評估、心理測驗（例如：工作記憶、執行功能：計畫與決策等、視覺記憶、空間記憶、理智等等<ref name="NIMH_ADHD_basic"/>）及各種醫師評估後認為需要進一步的檢查等。<ref name="CDC 2017 differential diagnosis"/><ref name="Tc_ADHD">{{cite web| url =http://www.tc-adhd.com/?p=1850#more-1850| title =心動家族:注意力不足過動症ＡＤＨＤ的第三條路| date =2016-12-13| website =台灣心動家族兒童青少年關懷協會| publisher =Tc-adhd.com| language =zh-tw| accessdate =2017-02| author =陳錦宏| deadurl =no| archiveurl =https://web.archive.org/web/20180224050902/http://www.tc-adhd.com/?p=1850#more-1850| archivedate =2018-02-24}}</ref><ref name="NIMH_ADHD_basic"/>
=== 精神疾病診斷與統計手冊 ===
根據最新的精神疾病診斷與統計手冊第五版（DSM-V），以下表列之症狀必須持續至少六個月且其程度明顯高於多數同年齡層之同儕。除此之外，以下表列之症狀必須在至少兩種不同的情境下（例如：社交、課業/工作、或家庭）造成顯著的問題，且這些條件必須出現在大約十二歲以前。<ref name="autogenerated59">American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington: American Psychiatric Publishing. pp. 59–65. ISBN 0890425558.</ref>


ADHD隸屬於[[神經發展障礙|神經發育所致之精神疾患]]<ref name=Caroline2010/><ref name="Kooij-2010"/>。
一個以'''注意力不足'''（專注力失調）為主的注意力不足過動症擁有以下至少五項的症狀，且非由其他醫學疾病直接造成。<ref name="autogenerated59"/>
除此之外，ADHD也隸屬於{{tsl|en|disruptive behavior disorder||紊亂行為症候群}}，同樣隸屬於紊亂行為症候群的心理疾病有：[[對立反抗症]]、[[品行障碍]]、和[[反社会人格障碍]]<ref name="google-book-ref">{{Cite book | vauthors=Wiener JM, Dulcan MK | title=Textbook Of Child and Adolescent Psychiatry | publisher=American Psychiatric Publishing | edition=illustrated | year=2004 | isbn=978-1-58562-057-9 | url=https://books.google.com/books?id=EIgGKcp0SpkC | access-date=2014-11-02 | deadurl=no | archive-url=https://web.archive.org/web/20201222193748/https://books.google.com/books?id=EIgGKcp0SpkC | archive-date=2020-12-22 }}</ref>。ADHD的診斷並不暗指任何一個{{tsl|en|neurological disorder|神經系統疾病}}<ref name="NICE 2009"/>。


醫師在診斷過程中必須衡量個案的[[焦慮]]、{{tsl|en|depression|憂鬱}}程度、及[[對立反抗症]]、[[品行障碍]]、及[[學習]]和[[語言障礙]]。其他需要考量的問題包括：其他神經發育障礙、[[抽动综合症]]、和[[睡眠呼吸暂停]]<ref name="Wolraich-2011">{{cite journal | vauthors = Wolraich M, Brown L, Brown RT, DuPaul G, Earls M, Feldman HM, Ganiats TG, Kaplanek B, Meyer B, Perrin J, Pierce K, Reiff M, Stein MT, Visser S | title = ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents | journal = Pediatrics | volume = 128 | issue = 5 | pages = 1007–22 | date = 2011-11 | pmid = 22003063 | pmc = 4500647 | doi = 10.1542/peds.2011-2654 }}</ref>。
# 容易分心、粗心、忘記事情且經常從一件事情切換至另一件事情。
# 難以持續對於一件事情保持專注。
# 除非是從事自己有興趣的事情，否則很容易對從事一件事情感到無聊。
# 難以對組職（規劃）事情、完成一個任務或學習新事物保持專注。
# 難以完成或（如期）繳交家庭作業並且經常丟失一些用以完成任務或活動的必備東西（例如：鉛筆、玩具、作業）。
# 當他人跟患者說話時，患者似乎沒在聽其說話。
# 白日夢、容易困惑、且移動遲緩。
# 難以和其他<u>非</u>注意力不足過動症患者一樣精確且快速的在腦海中處理接收到的資訊。
# 難以遵從指示。
# 難以認知細微的細節。


自我評量表，例如：{{tsl|en|ADHD rating scale||ADHD 評量表}}和{{tsl|en|Vanderbilt ADHD diagnostic rating scale||Vanderbilt ADHD診斷評量表}}會在診斷和評估ADHD的過程中使用。<ref name="Smith(2007) in Mash & Barkley EBA">{{Cite book|title=Assessment of Childhood Disorders | vauthors = Smith BJ, Barkley RA, Shapiro CJ |publisher=Guilford Press|year=2007|isbn=978-1-59385-493-5 | veditors = Mash EJ, Barkley RA |edition=4th|location=New York, NY|pages=53–131|chapter=Attention-Deficit/Hyperactivity Disorder }}</ref>
一個以'''過動-衝動'''為主的注意力不足過動症擁有以下至少五項的症狀，且非由其他醫學疾病直接造成。<ref name="autogenerated59"/><ref name="books2000"/><ref name="找回專注力"/>


== 病因學==
# 坐在椅子上動來動去
# 一直講話
# 四處東奔西跑、碰觸或玩弄視野內的任一或每一個物體。
# 難以在吃飯時間、學校中、做功課的時間、及故事時間坐著。
# 一直在移動、動作。
# 難以從事安靜的任務或活動。
# 非常不耐煩。
# 脫口說出不恰當的話語、毫無掩飾地直接在表情中流露出心理的想法、不顧後果的豪放不羈。
# 難以接（忍）受延遲的滿足、難耐在遊戲中因輪流所產生的等待時間。
# 經常打斷他人的對話或活動。


[[File:Adhd_brain_timelapse.jpg|thumb|upright=1.5|ADHD患者的腦部與非ADHD患者（Typically developing controls）的腦部造影顯示的大腦發育成熟度的差異<ref>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</ref><ref name="National Institutes of Health (NIH) 2015">{{cite web | title=Brain Matures a Few Years Late in ADHD, But Follows Normal Pattern | website=National Institutes of Health (NIH) | date=2015-10-06 | url=https://www.nih.gov/news-events/news-releases/brain-matures-few-years-late-adhd-follows-normal-pattern | access-date=2018-12-29 | archive-date=2020-12-22 | archive-url=https://web.archive.org/web/20201222193752/https://www.nih.gov/news-events/news-releases/brain-matures-few-years-late-adhd-follows-normal-pattern | dead-url=no }}</ref>。]]
在青少年及成年的注意力不足過動症患者中，過動的症狀往往隨著[[社會化]]及年齡的增長而轉變為內在的不安寧。<ref>Kooij, SJ; Bejerot, S; Blackwell, A; Caci, H; et al. (2010). "European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD". BMC Psychiatry. 10: 67. doi:10.1186/1471-244X-10-67. PMC 2942810Freely accessible. PMID 20815868.</ref>


迄今為止，注意力不足過動症是兒童精神病學，獲得最多且最深入研究的領域，然而絕大多數ADHD的確切成因目前並沒有定論<ref name="ScienceDirect 2015 pp. 42–58 most studied disorder">{{cite web | title=Attention Deficit/Hyperactivity Disorder | website=ScienceDirect | date=2015-01-01 | doi=10.1016/B978-0-12-398270-4.00004-5 | url=https://www.sciencedirect.com/science/article/pii/B9780123982704000045 | access-date=2018-09-19 | pages=42–58 | quote=Despite being the most studied disorder in child psychiatry, the pathophysiology of ADHD remains elusive. | archive-date=2021-02-09 | archive-url=https://web.archive.org/web/20210209133442/https://www.sciencedirect.com/science/article/pii/B9780123982704000045 | dead-url=no }}</ref>，最有可能是基因、環境和社會等因素交互作用導致。<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長">{{cite book|author=高淑芬 |title=家有過動兒：幫助ADHD孩子快樂成長 |publisher=心靈工坊 |location=台北 |isbn=9789866112805 |date=2013-08-28 |accessdate=2016-12-09|url= }}</ref><ref name=Millichap_2010_chap2>{{cite book|last=Millichap|first=J. Gordon|title=Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD|year=2010|publisher=Springer Science|location=New York, NY|isbn=978-1-4419-1396-8|doi=10.1007/978-104419-1397-5|lccn=2009938108|page=26|chapter=Chapter 2: Causative Factors|chapter-url=https://books.google.com/books?id=KAlq0CDcbaoC&pg=PA26|edition=2nd|deadurl=no|archiveurl=https://web.archive.org/web/20201222193800/https://books.google.com/books?id=KAlq0CDcbaoC&pg=PA26|archivedate=2020-12-22|access-date=2021-02-06}}</ref><ref name="pmid22963644">{{cite journal |vauthors=Thapar A, Cooper M, Eyre O, Langley K | title = What have we learnt about the causes of ADHD? | journal = J Child Psychol Psychiatry | volume = 54 | issue = 1 | pages = 3–16 | date = 2013-01 | pmid = 22963644 | pmc = 3572580 | doi = 10.1111/j.1469-7610.2012.02611.x }}</ref>
一位求診患者即便在過去六個月中，症狀數量較診斷準則少，但若曾經完全符合診斷準則且症狀仍導致多重情境下（例如：工作、學業及社會等）功能減損之狀態，仍可能符合注意力不足過動症的診斷。此乃注意力不足過動症的部分緩解。<ref name="找回專注力"/>


有些個案的成因可能與腦部的疾病感染和腦部創傷有關。<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/><ref name=Millichap_2010_chap2/>根據研究統計，注意力不足過動症具有相當高的遺傳率。<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/>除了基因外，一些環境及社會因子也可能是注意力不足過動症的致病因素。<ref name=cdc2016_2>{{citation|author=CDC|title=Attention-Deficit / Hyperactivity Disorder (ADHD)|publisher=Centers for Disease Control and Prevention|url=http://www.cdc.gov/ncbddd/adhd/research.html|date=2016-03-16|accessdate=2016-04-17|deadurl=no|archiveurl=https://web.archive.org/web/20160414160548/http://www.cdc.gov/ncbddd/adhd/research.html|archivedate=2016-04-14}}</ref><ref>{{cite web | url=http://www.euro.who.int/document/MNH/ebrief14.pdf | format=PDF | title=Mental health of children and adolescents | date=2005-01-15 | accessdate=2011-10-13 | archiveurl=https://web.archive.org/web/20091024102724/http://www.euro.who.int/document/MNH/ebrief14.pdf | archivedate=2009-10-24 | dead-url=no }}</ref><ref name="NICE 2009"/>
兒童及成人之注意力不足過動症診斷必須由受過專業訓練的醫療團隊（例如：Pediatric psychiatrist 兒童精神科醫師團隊）才可，否則容易受到誤診與處方，這相當危險。<ref>{{cite web|url=http://www.chadd.org/Understanding-ADHD/For-Adults/Diagnosis-of-ADHD.aspx |title=For adults, an ADHD diagnostic evaluation should be conducted by a licensed mental health professional or a physician. These professionals include clinical psychologists, physicians (psychiatrist, neurologist, family doctor or other type of physician) or clinical social workers |publisher=Chadd.org |date=2016-02-05 |accessdate=2016-12-09}}</ref><ref>{{cite web|url=http://www.webmd.com/add-adhd/guide/diagnosing-adhd |title=Diagnosing ADHD in Children. Health care providers, such as pediatricians, psychiatrists, and child psychologists, can diagnose ADHD with the help of standard guidelines from the American Academy of Pediatrics or the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) |publisher=Webmd.com |date=2015-04-15 |accessdate=2016-12-09}}</ref><ref>{{cite web|url=http://www.additudemag.com/adhd/article/10597.html |title=Adults need an expert who has experience with adult ADHD, which can be harder to diagnose. “There’s a lack of trained people to talk to adults,” says William Dodson, M.D., a psychiatrist from Denver, Colorado |publisher=Additudemag.com |date= |accessdate=2016-12-09}}</ref><ref name="books2000"/><ref name="找回專注力"/>


=== 基因遺傳 ===
{{注解|兒童青少年精神疾病，例如：注意力不足過動症、
[[双生子研究]]指出此疾病常常是遺傳得來的，佔了所有案例的75%<ref name="NICE 2009">{{cite book |title=Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults |author=National Collaborating Centre for Mental Health |series=NICE Clinical Guidelines |volume=72 |publisher=British Psychological Society |location=Leicester |isbn=978-1-85433-471-8 |date=2009 |url=https://www.ncbi.nlm.nih.gov/books/NBK53652/ |via=NCBI Bookshelf |deadurl=no |archive-url=https://web.archive.org/web/20160113133612/http://www.ncbi.nlm.nih.gov/books/NBK53652/ |archive-date=2016-01-13 |access-date=2017-06-22 }}</ref><ref name="Neale-2010">{{cite journal | vauthors = ((Psychiatric GWAS Consortium: ADHD Subgroup)), Neale BM, Medland SE, Ripke S, Asherson P, Franke B, Lesch KP, Faraone SV, Nguyen TT, Schäfer H, Holmans P, Daly M, Steinhausen HC, Freitag C, Reif A, Renner TJ, Romanos M, Romanos J, Walitza S, Warnke A, Meyer J, Palmason H, Buitelaar J, Vasquez AA, Lambregts-Rommelse N, Gill M, Anney RJ, Langely K, O'Donovan M, Williams N, Owen M, Thapar A, Kent L, Sergeant J, Roeyers H, Mick E, Biederman J, Doyle A, Smalley S, Loo S, Hakonarson H, Elia J, Todorov A, Miranda A, Mulas F, Ebstein RP, Rothenberger A, Banaschewski T, Oades RD, Sonuga-Barke E, McGough J, Nisenbaum L, Middleton F, Hu X, Nelson S | display-authors = 6 | title = Meta-analysis of genome-wide association studies of attention-deficit/hyperactivity disorder | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 49 | issue = 9 | pages = 884–97 | date = 2010-09 | pmid = 20732625 | pmc = 2928252 | doi = 10.1016/j.jaac.2010.06.008 }}</ref><ref name="Burt-2009">{{cite journal | vauthors = Burt SA | title = Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences | url = https://archive.org/details/sim_psychological-bulletin_2009-07_135_4/page/608 | journal = Psychological Bulletin | volume = 135 | issue = 4 | pages = 608–37 | date = 2009-07 | pmid = 19586164 | doi = 10.1037/a0015702 }}</ref>。若一兒童的兄弟姊妹中有患有ADHD，其自己身罹患ADHD的機率，是兄弟姊妹都沒有ADHD的兒童的三至四倍<ref>{{cite book | vauthors = Nolen-Hoeksema S | title=Abnormal Psychology | year=2013 | isbn=978-0-07-803538-8 | pages=267 | edition=Sixth}}</ref>。一般也認為基因因素會決定ADHD的症狀是否會持續到成年<ref name="pmid22105624">{{cite journal | vauthors = Franke B, Faraone SV, Asherson P, Buitelaar J, Bau CH, Ramos-Quiroga JA, Mick E, Grevet EH, Johansson S, Haavik J, Lesch KP, Cormand B, Reif A | display-authors = 6 | title = The genetics of attention deficit/hyperactivity disorder in adults, a review | journal = Molecular Psychiatry | volume = 17 | issue = 10 | pages = 960–87 | date = 2012-10 | pmid = 22105624 | pmc = 3449233 | doi = 10.1038/mp.2011.138 }}</ref>。
自閉症等乃至<u>成人</u>注意力不足過動症、<u>成人</u>自閉症等，為台灣兒童青少年精神科醫師培訓過程中的重點科目。|註}}


一般來說，ADHD和許多基因有關，特別是和會影響[[多巴胺]]神經傳導的基因有關<ref name="Gizer-2009"/><ref name="Genes Rev" />。和多巴胺有關的有[[多巴胺轉運體]]（DAT）、[[多巴胺受体D4]]（DRD4）、{{link-en|多巴胺受体D5|DRD5}}、{{link-en|痕量胺相關受體1|TAAR1}}、{{link-en|單胺氧化酶A|MAOA}}、[[儿茶酚-O-甲基转移酶]]（COMT）及[[多巴胺β羟化酶]]（DBH）<ref name="Genes Rev">{{cite journal | vauthors = Kebir O, Tabbane K, Sengupta S, Joober R | title = Candidate genes and neuropsychological phenotypes in children with ADHD: review of association studies | journal = Journal of Psychiatry & Neuroscience | volume = 34 | issue = 2 | pages = 88–101 | date = 2009-03 | pmid = 19270759 | pmc = 2647566 | doi = }}</ref><ref name="Berry-2007">{{cite journal | vauthors = Berry MD | title = The potential of trace amines and their receptors for treating neurological and psychiatric diseases | journal = Reviews on Recent Clinical Trials | volume = 2 | issue = 1 | pages = 3–19 | date = 2007-01 | pmid = 18473983 | doi = 10.2174/157488707779318107 | url = http://www.eurekaselect.com/77537/article | quote = 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. | archive-url = https://web.archive.org/web/20170201213246/http://www.eurekaselect.com/77537/article | deadurl = no | archive-date = 2017-02-01 | citeseerx = 10.1.1.329.563 | access-date = 2021-02-06 }}</ref><ref name="TAAR1_2">{{cite journal | vauthors = Sotnikova TD, Caron MG, Gainetdinov RR | title = Trace amine-associated receptors as emerging therapeutic targets | journal = Molecular Pharmacology | volume = 76 | issue = 2 | pages = 229–35 | date = 2009-08 | pmid = 19389919 | pmc = 2713119 | doi = 10.1124/mol.109.055970 }}</ref>，其他和ADHD有關的有[[血清素轉運體]]（SERT）、{{link-en|HTR1B|HTR1B}}、{{link-en|SNAP25|SNAP25}}、{{link-en|GRIN2A|GRIN2A}}、{{link-en|ADRA2A|ADRA2A}}、{{link-en|TPH2|TPH2}}及[[脑源性神经营养因子]]（BDNF）<ref name="Gizer-2009">{{cite journal | vauthors = Gizer IR, Ficks C, Waldman ID | title = Candidate gene studies of ADHD: a meta-analytic review | journal = Human Genetics | volume = 126 | issue = 1 | pages = 51–90 | date = 2009-07 | pmid = 19506906 | doi = 10.1007/s00439-009-0694-x }}</ref><ref name="Genes Rev" />。有一種常見的{{link-en|Latrophilin 3|Latrophilin 3}}基因變異，估計造成9%的ADHD，若有這種變異時，會對興奮劑藥物格外有反應<ref name="pmid21432600">{{cite journal | vauthors = Arcos-Burgos M, Muenke M | title = Toward a better understanding of ADHD: LPHN3 gene variants and the susceptibility to develop ADHD | journal = Attention Deficit and Hyperactivity Disorders | volume = 2 | issue = 3 | pages = 139–47 | date = 2010-11 | pmid = 21432600 | pmc = 3280610 | doi = 10.1007/s12402-010-0030-2 }}</ref>。[[多巴胺受体D4|DRD4 7R]]變體基因會增強多巴胺造成的抑制作用，也和ADHD有關。DRD4受體是[[G蛋白偶联受体]]，會抑制[[腺苷酸环化酶]]。DRD4-7R變異會造成許多行為上的[[表型]]，包括反映了注意力分散的ADHD症狀<ref name="ADHD and the DRD4 allele">{{cite journal | vauthors = Nikolaidis A, Gray JR | title = ADHD and the DRD4 exon III 7-repeat polymorphism: an international meta-analysis | journal = Social Cognitive and Affective Neuroscience | volume = 5 | issue = 2–3 | pages = 188–93 | date = 2010-06 | pmid = 20019071 | pmc = 2894686 | doi = 10.1093/scan/nsp049 }}</ref>。
=== 世界通用疾病分類手冊 ===


演化也可能是造成ADHD高比率的原因，特別是男性過動以及衝動的傾向<ref name="pmid21250994"/>，有人曾提出假說，認為女性比較容易被會冒險的男性所吸引，因此增加了基因庫中愛好衝動及冒險的基因的比率<ref name="pmid=16849269"/>。其他人則認為這種傾向有助於男性面對有壓力或是危險的環境（例如更有衝勁，從事探索行為）<ref name="pmid21250994">{{cite journal | vauthors = Glover V | title = Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective | journal = Journal of Child Psychology and Psychiatry, and Allied Disciplines | volume = 52 | issue = 4 | pages = 356–67 | date = 2011-04 | pmid = 21250994 | doi = 10.1111/j.1469-7610.2011.02371.x }}</ref><ref name="pmid=16849269"/>。在特定情境下，ADHD傾向雖然對個體是有害的，但是對群體是有益的<ref name="pmid21250994"/><ref name="pmid=16849269">{{cite journal | vauthors = Williams J, Taylor E | title = The evolution of hyperactivity, impulsivity and cognitive diversity | journal = Journal of the Royal Society, Interface | volume = 3 | issue = 8 | pages = 399–413 | date = 2006-06 | pmid = 16849269 | pmc = 1578754 | doi = 10.1098/rsif.2005.0102 }}</ref><ref name="pmid20200842">{{cite journal | vauthors = Cardo E, Nevot A, Redondo M, Melero A, de Azua B, García-De la Banda G, Servera M | title = [Attention deficit disorder and hyperactivity: a pattern of evolution?] | language = es | journal = Revista de Neurologia | volume = 50 Suppl 3 | issue = | pages = S143–7 | date = 2010-03 | pmid = 20200842 | trans-title = Attention deficit disorder and hyperactivity: a pattern of evolution? }}</ref>。ADHD雖然對個體可能不利，但其高比例以及異質性也有利於群體的生殖健康，並且可以增加[[基因庫]]的多樣性，對群體有益<ref name="pmid20200842"/>。在特定環境下，ADHD也可能對個體有利，例如對捕食者的反應更快，以及{{link-en|農夫對比獵人的假說|Hunter vs. farmer hypothesis|較好的狩獵技巧}}等<ref>{{Cite book |title=Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment |volume=Volume 9 |series=Current Topics in Behavioral Neurosciences |last1=Adriani |first1=Walter |last2=Zoratto |first2=Francesca |last3=Laviola |first3=Giovanni |name-list-format=vanc |chapter=Brain Processes in Discounting: Consequences of Adolescent Methylphenidate Exposure |editor1-first=Clare |editor1-last=Stanford |editor2-first=Rosemary |editor2-last=Tannock |chapter-url=https://books.google.com/books?id=aH2qWZRpcf0C&pg=PA132 |date=2012-01-13 |publisher=Springer |location=New York |isbn=978-3-642-24611-1 |pages=132–134 |access-date=2019-12-03 |archive-date=2020-12-22 |archive-url=https://web.archive.org/web/20201222193827/https://books.google.com/books?id=aH2qWZRpcf0C&pg=PA132 |dead-url=no }}</ref>。
以下為2010年出版之《[[世界通用疾病分類手冊]] 第十版》（ICD-10, International Classification of Disease-10，又稱為國際通用的疾病分類表）第五章節：


患有[[唐氏综合征]]的人比較容易患有ADHD<ref>{{cite journal | vauthors = Ekstein S, Glick B, Weill M, Kay B, Berger I | title = Down syndrome and attention-deficit/hyperactivity disorder (ADHD) | journal = Journal of Child Neurology | volume = 26 | issue = 10 | pages = 1290–5 | date = 2011-10 | pmid = 21628698 | doi = 10.1177/0883073811405201 | url = http://jcn.sagepub.com/content/26/10/1290 | archive-url = https://web.archive.org/web/20151120083410/http://jcn.sagepub.com/content/26/10/1290 | deadurl = yes | archive-date = 2015-11-20 | access-date = 2021-02-06 }}</ref>。
心理與行為疾病（F00-F99）


=== 環境因素 ===
: 早發於青少年時期的情緒及行為疾病 （F90-F98）
<!--{{See also|Diet and attention deficit hyperactivity disorder}}-->
:: '''過度活躍症'''&nbsp;（Hyperkinetic Disorder, F90）
除了基因外，一些環境因子也可能是注意力不足過動症的致病因素<ref name=cdc2016>{{citation|author=CDC|title=Attention-Deficit / Hyperactivity Disorder (ADHD)|publisher=Centers for Disease Control and Prevention|url=https://www.cdc.gov/ncbddd/adhd/research.html|date=2016-03-16|access-date=2016-04-17|deadurl=no|archive-url=https://web.archive.org/web/20160414160548/http://www.cdc.gov/ncbddd/adhd/research.html|archive-date=2016-04-14}}</ref>。例如：在懷孕期間攝取酒精可能導致[[胎兒酒精譜系障礙]]，可能包括了注意力不足過動症，或是有類似症狀<ref name="Burger-2011">{{cite journal | vauthors = Burger PH, Goecke TW, Fasching PA, Moll G, Heinrich H, Beckmann MW, Kornhuber J | title = [How does maternal alcohol consumption during pregnancy affect the development of attention deficit/hyperactivity syndrome in the child] | language = de | journal = Fortschritte der Neurologie-Psychiatrie | volume = 79 | issue = 9 | pages = 500–6 | date = 2011-09 | pmid = 21739408 | doi = 10.1055/s-0031-1273360 | type = Review }}</ref>。暴露在特定有毒物質，例如：[[鉛]]或[[多氯聯苯]]等，可能會產生類似注意力不足過動症的中毒症狀<ref name=nimh /><ref name="Eubig-2010">{{cite journal | vauthors = Eubig PA, Aguiar A, Schantz SL | title = Lead and PCBs as risk factors for attention deficit/hyperactivity disorder | journal = Environmental Health Perspectives | volume = 118 | issue = 12 | pages = 1654–67 | date = 2010-12 | pmid = 20829149 | pmc = 3002184 | doi = 10.1289/ehp.0901852 | type = Review. Research Support, N.I.H., Extramural. Research Support, U.S. Gov't, Non-P.H.S. }}</ref>。暴露在[[磷酸酯]]的殺蟲劑[[毒死蜱]]及{{link-en|烷基磷酸酯|Alkyl phosphate}}中，也可能會增加患病的風險，不過此一論點尚未受到廣泛認可<ref name="de Cock-2012">{{cite journal | vauthors = de Cock M, Maas YG, van de Bor M | title = Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? Review | url = https://archive.org/details/sim_acta-paediatrica_2012-08_101_8/page/811 | journal = Acta Paediatrica | volume = 101 | issue = 8 | pages = 811–8 | date = 2012-08 | pmid = 22458970 | doi = 10.1111/j.1651-2227.2012.02693.x | type = Review. Research Support, Non-U.S. Gov't }}</ref>。在懷孕過程中吸菸，將不利於胚胎的腦部神經發育，並將增加罹患注意力不足過動症的機率<ref name="nimh"/><ref name="Abbott-2012">{{cite journal | vauthors = Abbott LC, Winzer-Serhan UH | title = Smoking during pregnancy: lessons learned from epidemiological studies and experimental studies using animal models | journal = Critical Reviews in Toxicology | volume = 42 | issue = 4 | pages = 279–303 | date = 2012-04 | pmid = 22394313 | doi = 10.3109/10408444.2012.658506 | type = Review }}</ref>。


新生兒極度[[早產]]、[[低出生体重儿|体重過輕]]、極端疏於照料、遭受凌虐、缺乏社會的互動也會增加ADHD的風險<ref name=nimh /><ref name="Thapar-2012">{{cite journal | vauthors = Thapar A, Cooper M, Jefferies R, Stergiakouli E | title = What causes attention deficit hyperactivity disorder? | journal = Archives of Disease in Childhood | volume = 97 | issue = 3 | pages = 260–5 | date = 2012-03 | pmid = 21903599 | pmc = 3927422 | doi = 10.1136/archdischild-2011-300482 | type = Review. Research Support, Non-U.S. Gov't }}</ref>。母親在懷孕期間、兒童在出生時或成長初期遭受一些疾病的感染都可能提高致病率（例如[[麻疹]]、, {{link-en|帶狀皰疹病毒|Varicella zoster virus|帶狀皰疹}}、[[脑炎]]、[[風疹]]、[[EV71]]等）<ref name="Millichap2008">{{cite journal | vauthors = Millichap JG | title = Etiologic classification of attention-deficit/hyperactivity disorder | journal = Pediatrics | volume = 121 | issue = 2 | pages = e358–65 | date = 2008-02 | pmid = 18245408 | doi = 10.1542/peds.2007-1332 | type = Review }}</ref>。長時間於妊娠期間使用對[[乙醯胺酚]]與孩子出生後帶有ADHD，有統計上的相關性<ref name=Ystrom2017>{{cite journal | vauthors = Ystrom E, Gustavson K, Brandlistuen RE, Knudsen GP, Magnus P, Susser E, Davey Smith G, Stoltenberg C, Surén P, Håberg SE, Hornig M, Lipkin WI, Nordeng H, Reichborn-Kjennerud T | title = Prenatal Exposure to Acetaminophen and Risk of ADHD | journal = Pediatrics | volume = 140 | issue = 5 | pages = e20163840 | date = 2017-11 | pmid = 29084830 | pmc = 5654387 | doi = 10.1542/peds.2016-3840 | hdl = 11250/2465905 }}</ref><ref>{{cite journal | vauthors = Wolraich ML | title = An Association Between Prenatal Acetaminophen Use and ADHD: The Benefits of Large Data Sets | journal = Pediatrics | volume = 140 | issue = 5 | pages = e20172703 | date = 2017-11 | pmid = 29084834 | doi = 10.1542/peds.2017-2703 }}</ref>。[[創傷性腦損傷]]的兒童中，後來至少有30%有ADHD的症狀<ref name="Eme-2012">{{cite journal | vauthors = Eme R | title = ADHD: an integration with pediatric traumatic brain injury | journal = Expert Review of Neurotherapeutics | volume = 12 | issue = 4 | pages = 475–83 | date = 2012-04 | pmid = 22449218 | doi = 10.1586/ern.12.15 | type = Review }}</ref>，其中約有5%是因為腦部損傷<ref name=Erk2009/>。
* 年紀輕輕（通常在零到五歲的時候）就出現難以持續進行一件需要動腦的活動、常常一件事情還沒做到一個段落就跳到另一個事情去，並伴隨組織與規劃能力的不足、聽從指示上的困難、過多的活動。
* ADHD可能與其他疾病共病。
* 患有過度活躍症 （Hyperkinetic Disorder）的孩子通常較衝動、沒有三思而後行。因此容易發生意外。聽從指示上的困難通常起因於沒有三思而後行，刻意造反相較之下的可能性較低。
* 患者對成人的溝通交流（相處）可能是毫無保留的，缺乏正常的戒心與保守。患者可能在群體之中不受歡迎且受到孤立。
* [[認知]]功能的不足是常見的，[[運動]]和[[語言]]發展上的延遲、遲緩更是頻繁。
* 次要的併發症包含「社會化」（社會無法接受）的行為以及低[[自尊]]心。


一些研究發現，人工[[食用色素]]或[[防腐劑]]可能與少部分兒童出現類似ADHD的症狀，或者是與ADHD的流行率增加有關<ref name=nimh/><ref name="pmid22232312">{{cite journal | vauthors = Millichap JG, Yee MM | title = The diet factor in attention-deficit/hyperactivity disorder | journal = Pediatrics | volume = 129 | issue = 2 | pages = 330–7 | date = 2012-02 | pmid = 22232312 | doi = 10.1542/peds.2011-2199 | url = http://pediatrics.aappublications.org/content/129/2/330.long | archive-url = https://web.archive.org/web/20150911071727/http://pediatrics.aappublications.org/content/129/2/330.long | deadurl = no | archive-date = 2015-09-11 | access-date = 2019-12-03 }}</ref>，但是這些研究的證據力薄弱，而且可能只適用於有[[食物敏感]]的孩子<ref name=pmid22232312/><ref name=Sonu2013/><ref name=EncycFoodSafety>{{cite encyclopedia |last1=Tomaska |first1=Luba D. |last2=Brooke-Taylor |first2=S. |name-list-format=vanc |title=Food Additives – General |pages= 449<!--–54--> |encyclopedia=Encyclopedia of Food Safety |volume=3 |editor1-last=Motarjemi |editor1-first=Yasmine |editor2-last=Moy |editor2-first=Gerald G. |editor3-last=Todd |editor3-first=Ewen C.D. |publisher=Elsevier/Academic Press |location=Amsterdam |edition=1st |date=2014 |isbn=978-0-12-378613-5 |oclc=865335120 }}</ref>。[[英国]]及[[欧洲联盟]]已針對這些疑慮發布相關食品管理措施<ref name=FDAdyecomm>{{citation|author=FDA|url=http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/FoodAdvisoryCommittee/UCM248549.pdf|title=Background Document for the Food Advisory Committee: Certified Color Additives in Food and Possible Association with Attention Deficit Hyperactivity Disorder in Children|date=2011-03|publisher=U.S. Food and Drug Administration|deadurl=no|archive-url=https://web.archive.org/web/20151106080629/http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/FoodAdvisoryCommittee/UCM248549.pdf|archive-date=2015-11-06|accessdate=2019-12-03}}</ref>。對於某些食物的[[食物過敏]]或[[食物不耐症]]，可能會惡化少數孩子既有的ADHD症狀<ref name=NiggHolton2014 />。
<ref>{{cite web|url=http://apps.who.int/classifications/icd10/browse/2010/en#/F90|title=ICD-10 | edition=10 |author=|date=2010|publisher=World Health Organization}}</ref>


{{Anchor|ADHD and Sugar}}<!-- Do not delete this code as it is used to link to this location regarding sugar and ADHD from other articles.-->
預定於2018年發行的ICD-11 （ICD 第十一版）的初始草稿中，注意力不足過動症被分類於6A42（ADHD）的類別裡，而該注意力不足過動症類別中的定義暨介紹已趨近現時之DSM-5。<ref>{{cite web|url=http://apps.who.int/classifications/icd11/browse/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f821852937|title=ICD-11 Beta Draft | edition = 11 Beta Draft|author=|date=|publisher=World Health Organization}}</ref>
截至2018年11月，研究並不支持注意力不足過動症是因為攝取過多的精緻糖、看太多電視、{{le|教養方式|parenting}}、貧窮或家庭吵吵鬧鬧所造成，不過這些可能會讓一些注意力不足過動症的症狀更加惡化<ref name=cdc2016facts>{{citation|author=CDC|title=Facts About ADHD|publisher=Centers for Disease Control and Prevention|url=https://www.cdc.gov/ncbddd/adhd/facts.html|date=2016-01-06|access-date=2016-03-20|deadurl=no|archive-url=https://web.archive.org/web/20160322103310/http://www.cdc.gov/ncbddd/adhd/facts.html|archive-date=2016-03-22}}</ref>。


=== 社會===
{{注解|兒童青少年精神疾病，例如：注意力不足過動症、自閉症等乃至<u>成人</u>注意力不足過動症、<u>成人</u>自閉症等，為台灣兒童青少年精神科醫師培訓過程中的重點科目。|註}}
有些情形下，ADHD的患者不是其自身的問題，而是反映了[[機能不全家族|家庭機能不全]]或是[[教育]]系統的不足<ref>{{cite web|url=http://www.euro.who.int/document/MNH/ebrief14.pdf|format=PDF|title=Mental health of children and adolescents|date=2005-01-15|access-date=2011-10-13|archive-url=https://web.archive.org/web/20091024102724/http://www.euro.who.int/document/MNH/ebrief14.pdf|archive-date=2009-10-24|dead-url=no}}</ref>。也有一種情形，診斷出ADHD表示其他人對其課業期待的增加，因為在一些國家，診斷是一種讓家長取得更多對小孩經濟及教育支持的方式<ref name=Erk2009>{{cite book |vauthors=Mayes R, Bagwell C, Erkulwater JL | title=Medicating Children: ADHD and Pediatric Mental Health |url=https://archive.org/details/medicatingchildr0000maye | publisher=Harvard University Press | date=2009 | pages=[https://archive.org/details/medicatingchildr0000maye/page/4 4]–24 | isbn=978-0-674-03163-0 | edition=illustrated }}</ref>。一般有經歷過暴力或是情感虐待的兒童比較容易出現ADHD的行為<ref name="NICE 2009"/>。


{{link-en|ADHD的社會建構理論|social construct theory of ADHD}}認為評斷正常及異常的標準是社會建構的（是由社會中的所有人建立並且使其有效的，特別是[[医生]]、病患、家長、教師等），然後再主觀的評估及判斷要使用哪一種準則，以及有多少人會因此受到影響<ref>{{cite journal | vauthors = Parens E, Johnston J | title = Facts, values, and attention-deficit hyperactivity disorder (ADHD): an update on the controversies | journal = Child and Adolescent Psychiatry and Mental Health | volume = 3 | issue = 1 | pages = 1 | date = 2009-01 | pmid = 19152690 | pmc = 2637252 | doi = 10.1186/1753-2000-3-1 }}</ref>。他們認為這是依DSM-IV標準診斷到的ADHD人數會是由ICD-10標準所診斷人數三至四倍的原因<ref name="Singh" />。[[湯瑪士·薩斯]]是ADHD社會建構理論的支持者，他認為ADHD是「發明出來的，之後取了這個名字」<ref>{{Cite book|last=Szasz |first=Thomas | name-list-format = vanc |chapter=Psychiatric Medicine: Disorder |chapter-url={{google books|29HP1q6JrgYC|pages=77|plainurl=yes}} |title=Pharmacracy: medicine and politics in America |url={{google books|29HP1q6JrgYC|plainurl=yes}} |via=Google Books |publisher=Praeger |location=Westport, CT |year=2001 |pages=101 |isbn=978-0-275-97196-0 |quote=Mental diseases are ''invented'' and then given a name, for example attention deficit hyperactivity disorder (ADHD). }}</ref>。
== 流行病學 <!--Epidemiology-->==


班上裡年齡最小的兒童比較容易診斷為ADHD，原因可能是他們的發展本來就比其他年齡略長幾個月到一年的同學要晚一些<ref>{{Cite journal|last=Holland|first=Josephine|last2=Sayal|first2=Kapil|date=2018-10-06|title=Relative age and ADHD symptoms, diagnosis and medication: a systematic review|url=https://www.ncbi.nlm.nih.gov/pubmed/30293121|journal=European Child & Adolescent Psychiatry|doi=10.1007/s00787-018-1229-6|issn=1435-165X|pmid=30293121|access-date=2019-12-03|archive-date=2020-05-13|archive-url=https://web.archive.org/web/20200513060022/https://www.ncbi.nlm.nih.gov/pubmed/30293121|dead-url=no}}</ref><ref>{{cite book|title=Disorders of Childhood: Development and Psychopathology|vauthors=Parritz R|publisher=Cengage Learning|year=2013|isbn=978-1-285-09606-3|pages=[https://books.google.com/books?id=VAj2rPTN1j0C&pg=PA151 151]}}<!--|access-date= 2014-01-17--></ref><ref name=TI2018>{{cite web|title=[110] Stimulants for ADHD in children: Revisited {{!}} Therapeutics Initiative|url=https://www.ti.ubc.ca/2018/05/28/110-stimulants-for-adhd-in-children-revisited/|access-date=2018-07-06|date=2018-05-28|archive-date=2021-01-30|archive-url=https://web.archive.org/web/20210130210327/https://www.ti.ubc.ca/2018/05/28/110-stimulants-for-adhd-in-children-revisited/|dead-url=no}}</ref>，在許多國家都有出現這種情形<ref name=TI2018/>，他們使用ADHD藥物的比例也是其他同學的兩倍左右<ref>{{cite book |last1=Stockman |first1=James A. |name-list-format=vanc |title=Year Book of Pediatrics 2014 E-Book |date=2016 |publisher=Elsevier Health Sciences |isbn=9780323265270 |pages=163 |url=https://books.google.ca/books?id=5b65DAAAQBAJ&pg=PT163 |language=en |access-date=2019-12-03 |archive-date=2020-12-22 |archive-url=https://web.archive.org/web/20201222193910/https://books.google.ca/books?id=5b65DAAAQBAJ&pg=PT163 |dead-url=no }}</ref>。
=== 美國的數據 ===
根據2000年版本的DSM-IV-TR，在美國大概有3%-7%的兒童有ADHD。而根據美國疾病控制中心於2004年出版的美國健康訪問調查年報，美國大約有400萬名18歲以下的兒童診斷出有注意力不足過動症。不過，有關評估的比率差異極大，有些校區甚至有60%的兒童診斷為注意力不足過動症患者。現時美國全國有超過100萬成年人及小童因為這個病症而需要服用處方的藥物。<ref>''服用ADHD藥　心臟病風險增''，《[[快線周報]]》2006年2月11日號，第10版，[[香港]]：星島報業集團。</ref> 診斷出有ADHD的男童在比例上比女童約高出兩倍。對於這個性別上差異的成因，目前仍然未知確切原因。不過，有專家指有可能由於女童的病症普遍與男童不同，因此在診斷時亦同時較男童難於察覺，所以較少讓家長及老師發現而作出轉介。<ref name="pmid19393378">{{cite journal |last1= Emond |first1= V |last2= Joyal |first2= C |last3= Poissant |first3= H | title= Neuroanatomie structurelle et fonctionnelle du trouble déficitaire d’attention avec ou sans hyperactivité (TDAH) |trans-title= Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD) | language=FR | journal=Encephale | volume=35 | issue=2 | pages=107–14 | date=April 2009 | pmid=19393378 | doi=10.1016/j.encep.2008.01.005}}</ref><ref name="Singh">{{cite journal |last= Singh |first= I | title = Beyond polemics: Science and ethics of ADHD | journal = Nature Reviews Neuroscience | volume = 9 | issue = 12 | pages = 957–64 | date = December 2008 | pmid = 19020513 | doi = 10.1038/nrn2514 }}</ref>


== 病理生理學==
=== 中華民國（台灣）的數據 ===
{{main article|注意力不足過動症的病理生理學}}


[[File:Attention deficit hyperactivity disorder - Attention deficit hyperactivity disorder - Reduced brain volume on the left side from ADHD.jpg|thumb|upright=1.5|ADHD的左前額葉通常與控制組（非ADHD患者）顯著不同<ref name="Malenka ADHD neurosci" /><ref name=Krain2006>{{cite journal |vauthors=Krain AL, Castellanos FX | title = Brain development and ADHD |url=https://archive.org/details/sim_clinical-psychology-review_2006-08_26_4/page/433 | journal = Clin Psychol Rev | volume = 26 | issue = 4 | pages = 433–444 | date =2006-08 | pmid = 16480802 | doi = 10.1016/j.cpr.2006.01.005 }}</ref>。]]
* ADHD在台灣兒童的[[盛行率]]（患病率）約為7%。依據[[衛生福利部]][[健保局|中央健保署]]之健保資料庫的資料顯示，兒童就醫者大約是2.5%左右。<br/>兒童及青少年ADHD的未就醫率 = ADHD兒童盛行率 - 就醫率 = 4.5 % ，也就是有超過一半（4.5>7/2=3.5%）患有注意力不足過動症的兒童及青少年沒有接受相關治療。<ref name="找回專注力"/>
* ADHD在台灣成人的盛行率推估為一百個成人中大約有四位（4%）左右的ADHD成人患者。根據健保資料庫的資料顯示：18~50歲成人，曾診斷為ADHD的比率為0.057%（十萬分之五十七、一百人中有0.057人曾經為此就診）。<ref name="找回專注力"/>


注意力不足過動症被認為是肇因於部分腦內的神經傳導物質系統的損傷（特別是與多巴胺和正腎上腺素有關的神經傳導系統），進而對患者的腦部執行功能產生不良的影響<ref name="VTA+LC projection systems">{{cite journal | vauthors = Chandler DJ, Waterhouse BD, Gao WJ | title = New perspectives on catecholaminergic regulation of executive circuits: evidence for independent modulation of prefrontal functions by midbrain dopaminergic and noradrenergic neurons | journal = Front. Neural Circuits | volume = 8 | issue = | pages = 53 | date = 2014-05 | pmid = 24904299 | pmc = 4033238 | doi = 10.3389/fncir.2014.00053 | quote = }}</ref><ref name="Malenka ADHD neurosci">{{cite book |vauthors=Malenka RC, Nestler EJ, Hyman SE | veditors = Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience |url=https://archive.org/details/molecularneuroph00nest | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 978-0-07-148127-4 | pages = [https://archive.org/details/molecularneuroph00nest/page/266 266], 315, 318–323 | edition = 2nd | chapter = Chapters 10 and 13 | quote = 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.}}</ref>。多巴胺與正腎上腺素的{{tsl|en|Neural_pathway|腦內神經傳導物質通道系統}}大多起源自腦內的[[腹側被蓋區]]和[[藍斑核]]，並由此投射至不同的腦區且管理許多認知的流程（與認知功能相關的處理流程）。<ref name="VTA+LC projection systems"/><ref name="Malenka pathways">{{cite book |vauthors=Malenka RC, Nestler EJ, Hyman SE |veditors=Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience |url=https://archive.org/details/molecularneuroph00nest | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 9780071481274 | pages = [https://archive.org/details/molecularneuroph00nest/page/148 148], 154–157 | edition = 2nd | chapter = Chapter 6: Widely Projecting Systems: Monoamines, Acetylcholine, and Orexin }} <br />''NOTE: DA: dopamine, LC: locus coeruleus, VTA: ventral tegmental area, 5HT: serotonin (5-hydroxytryptamine)''</ref>特別是那些投射至前額葉和[[紋狀體]]的{{tsl|en|dopaminergic pathway|腦內多巴胺神經傳導通道系統}}和[[norepinephrine pathway|腦內正腎上腺素通道系統/藍斑核系統]]。它們主要的工作就是負責調節執行功能（認知和行為的功能與管理）、[[動機]]、 [[獎賞系統|酬賞/報償]]的感受能力、和[[運動控制 (生物體)|運動神經的功能]]{{NoteTag|name=coordinatate|1=台灣兒童與青少年精神科醫師高淑芬在其著作《找回專注力：成人ADHD全方位自助手冊》提到，雖然「過動-衝動型」和「混合型」的ADHD從小就非常好動，坐不住，老是跑跑跳跳、追逐打鬧，精力無窮，但其實這類孩子的運動協調性可能不太好，運動協調性較弱的表象為：肢體動作較大、動作較粗魯。<ref name="找回專注力"/>}}。<ref name="VTA+LC projection systems"/><ref name="Malenka ADHD neurosci" /><ref name="Malenka pathways" />以上是目前已知在注意力不足過動症的[[病理生理學]]中扮演主要角色的幾條腦內神經傳導物質通道系統。也已經有人提議強化對於注意力不足過動症更全面的概觀以及更多可能與之相關的腦內神經傳導物質通道系統之探究。<ref name="Malenka ADHD neurosci" /><ref name="pmid22169776">{{cite journal |vauthors=Castellanos FX, Proal E | title=Large-scale brain systems in ADHD: beyond the prefrontal-striatal model | journal=Trends Cogn. Sci. (Regul. Ed.) | volume=16 | issue=1 | pages=17–26 | date=2012-01 | pmid=22169776| pmc=3272832 | doi=10.1016/j.tics.2011.11.007 | quote=Recent conceptualizations of ADHD have taken seriously the distributed nature of neuronal processing [10,11,35,36]. Most of the candidate networks have focused on prefrontal-striatal-cerebellar circuits, although other posterior regions are also being proposed [10].}}</ref><ref name="pmid22983386">{{cite journal |vauthors=Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, Castellanos FX | title = Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies |url=https://archive.org/details/sim_american-journal-of-psychiatry_2012-10_169_10/page/1038 | journal = Am J Psychiatry | volume = 169 | issue = 10 | pages = 1038–1055 | date = 2012-10 | pmid = 22983386 | pmc = 3879048 | doi = 10.1176/appi.ajp.2012.11101521 }}</ref>
=== 中國大陸的數據 ===


而研究也發現，注意力不足過動症是由一種發生於腦[[前額葉]]的[[遺傳]]性的[[多巴胺]]新陳代謝失常引致。更近期的研究認為[[正腎上腺素]]的[[新陳代謝]]亦會對病情有所影響<!-- <ref>Krause, Dresel, Krause in Psycho 26/2000 p.199ff</ref> --> <ref name="Dresel Krause Krause LaFougere 2000 pp. 1518–24">{{cite journal | last=Dresel | first=S | last2=Krause | first2=J | last3=Krause | first3=KH | last4=LaFougere | first4=C | last5=Brinkbäumer | first5=K | last6=Kung | first6=HF | last7=Hahn | first7=K | last8=Tatsch | first8=K | title=Attention deficit hyperactivity disorder: binding of &#91;99mTc&#93;TRODAT-1 to the dopamine transporter before and after methylphenidate treatment. | journal=European journal of nuclear medicine | volume=27 | issue=10 | year=2000 | issn=0340-6997 | pmid=11083541 | pages=1518–24}}</ref>
根据中國大陸的流行病学调研（調查研究），中國大陸学龄儿童ADHD患病率是4.31%—5.83%，这意味着中國大陸有近2000万儿童患有多动症。
<ref name="Krause Dresel Krause la Fougere 2003 pp. 605–13">{{cite journal | last=Krause | first=KH | last2=Dresel | first2=SH | last3=Krause | first3=J | last4=la Fougere | first4=C | last5=Ackenheil | first5=M | title=The dopamine transporter and neuroimaging in attention deficit hyperactivity disorder. | url=https://archive.org/details/sim_neuroscience-and-biobehavioral-reviews_2003_27_7/page/605 | journal=Neuroscience and biobehavioral reviews | volume=27 | issue=7 | year=2003 | issn=0149-7634 | pmid=14624805 | pages=605–13}}</ref>
<ref name="Bymaster 2002 pp. 699–711">{{cite journal | last=Bymaster | first=F | title=Atomoxetine Increases Extracellular Levels of Norepinephrine and Dopamine in Prefrontal Cortex of Rat A Potential Mechanism for Efficacy in Attention Deficit/Hyperactivity Disorder | journal=Neuropsychopharmacology | publisher=Springer Nature | volume=27 | issue=5 | year=2002 | pages=699–711 | url=https://doi.org/10.1016%2Fs0893-133x%2802%2900346-9 | doi=10.1016/s0893-133x(02)00346-9 | accessdate=2017-02-17|quote=The selective norepinephrine (NE) transporter inhibitor atomoxetine (formerly called tomoxetine or LY139603) has been shown to alleviate symptoms in Attention Deficit/Hyperactivity Disorder (ADHD).}}</ref>。


截至2019年8月底，已知ADHD也與 {{tsl|en|serotonin pathways|血清素傳導系統}}（5hydroxytryptamine [5-HT]）、 {{tsl|en|acetylcholine pathways|乙酰胆碱傳導系統}}（ACH）<!--目前還沒有對應的英文條目，但User:IGBA表示她個人即將創建。-->、{{tsl|en|opioid pathways|opioid system|鴉片類傳導系統}}<!--目前還沒有對應的英文條目，但User:IGBA表示她個人即將創建。-->、和{{tsl|en|glutamate pathways|glutamate system|谷氨酸傳導系統}}<!--目前還沒有對應的英文條目，但User:IGBA表示她個人即將創建。-->（GLU）的失調有關。<ref name="Faraone 2018 pp. 255–270">{{cite journal | last=Faraone | first=Stephen V. | title=The pharmacology of amphetamine and methylphenidate: Relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities | journal=Neuroscience and biobehavioral reviews | publisher=Elsevier BV | volume=87 | year=2018 | issn=0149-7634 | pmid=29428394 | doi=10.1016/j.neubiorev.2018.02.001 | pages=255–270 | quote=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).}}</ref><ref name="Cortese-2012">{{cite journal | vauthors = Cortese S | title = The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know | journal = European Journal of Paediatric Neurology | volume = 16 | issue = 5 | pages = 422–33 | date = 2012-09 | pmid = 22306277 | doi = 10.1016/j.ejpn.2012.01.009 }}</ref><ref name="pmid22939004">{{cite journal | vauthors = Lesch KP, Merker S, Reif A, Novak M | title = Dances with black widow spiders: dysregulation of glutamate signalling enters centre stage in ADHD | journal = European Neuropsychopharmacology | volume = 23 | issue = 6 | pages = 479–91 | date = 2013-06 | pmid = 22939004 | doi = 10.1016/j.euroneuro.2012.07.013 }}</ref>
=== 西班牙的數據 ===


== 治療==
ADHD在未成年族群中的盛行率約為6.8%。<ref>{{cite journal|last=Catalá-López|first=F|author2=Peiró, S |author3=Ridao, M |author4=Sanfélix-Gimeno, G |author5=Gènova-Maleras, R |author6= Catalá, MA |title=Prevalence of attention deficit hyperactivity disorder among children and adolescents in Spain: a systematic review and meta-analysis of epidemiological studies.|journal=BMC Psychiatry|date=2012-10-12|volume=12|pages=168|pmid=23057832|doi=10.1186/1471-244X-12-168}}</ref>
{{Main|注意力不足過動症的治療}}
注意力不足過動症的治療方式包括[[心理治療]]、[[行為治療]]及藥物，也有可能是用幾種方式一起進行。治療對病症會有長期的改善，但是無法完全根除病症的影響<ref name="pmid22947230">{{cite journal | vauthors = Shaw M, Hodgkins P, Caci H, Young S, Kahle J, Woods AG, Arnold LE | title = A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment | journal = BMC Medicine | volume = 10 | pages = 99 | date = 2012-09 | pmid = 22947230 | pmc = 3520745 | doi = 10.1186/1741-7015-10-99 }}</ref>。藥物包括有興奮劑、[[阿托莫西汀]]、{{link-en|腎上腺素受體α2|alpha-2 adrenergic receptor}}拮抗劑，有時也會包括抗抑鬱藥物<ref name="Wilens-2010"/><ref name="cognition enhancers">{{cite journal | vauthors = Bidwell LC, McClernon FJ, Kollins SH | title = Cognitive enhancers for the treatment of ADHD | journal = Pharmacology Biochemistry and Behavior | volume = 99 | issue = 2 | pages = 262–74 | date = 2011-08 | pmid = 21596055 | pmc = 3353150 | doi = 10.1016/j.pbb.2011.05.002 }}</ref>。若時無法專注在長期獎勵上的人，有許多的[[增强|正增强]]方式可以提昇其工作表現<ref name="Motivation">{{cite journal | vauthors = Modesto-Lowe V, Chaplin M, Soovajian V, Meyer A | title = Are motivation deficits underestimated in patients with ADHD? A review of the literature | journal = Postgraduate Medicine | volume = 125 | issue = 4 | pages = 47–52 | date = 2013-07 | pmid = 23933893 | doi = 10.3810/pgm.2013.07.2677 | quote = 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.&nbsp;... 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. }}</ref>。ADHD藥物中的興奮劑也可以提昇患者的毅力及工作表現<ref name="Malenka ADHD neurosci" /><ref name="Motivation" />。


=== 數據背後的意義 ===
===行為治療===
有關行為治療在ADHD上的應用，有許多良好的實證，若是針對學齡前，或是症狀輕微的病患，一般會建議用[[行為治療]]為第一線的療法<ref>{{cite journal | vauthors = Fabiano GA, Pelham WE, Coles EK, Gnagy EM, Chronis-Tuscano A, O'Connor BC | title = A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder | url = https://archive.org/details/sim_clinical-psychology-review_2009-03_29_2/page/129 | journal = Clinical Psychology Review | volume = 29 | issue = 2 | pages = 129–40 | date = 2009-03 | pmid = 19131150 | doi = 10.1016/j.cpr.2008.11.001 }}</ref><ref name=Clinics09>{{cite journal | vauthors = Kratochvil CJ, Vaughan BS, Barker A, Corr L, Wheeler A, Madaan V | title = Review of pediatric attention deficit/hyperactivity disorder for the general psychiatrist | url = https://archive.org/details/sim_psychiatric-clinics-of-north-america_2009-03_32_1/page/39 | journal = The Psychiatric Clinics of North America | volume = 32 | issue = 1 | pages = 39–56 | date = 2009-03 | pmid = 19248915 | doi = 10.1016/j.psc.2008.10.001 }}</ref>。心理療法包括有[[心理教育]]、[[行為治療]]、[[认知行为疗法]]（CBT）、[[人際取向心理治療]]、[[家庭治療]]、學校介入、社交技巧訓練、行為方面的同儕介入、機構培訓<ref name=Evans2014>{{cite journal | vauthors = Evans SW, Owens JS, Bunford N | title = Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder | journal = Journal of Clinical Child and Adolescent Psychology | volume = 43 | issue = 4 | pages = 527–51 | date = 2014 | pmid = 24245813 | pmc = 4025987 | doi = 10.1080/15374416.2013.850700 }}</ref>、[[父母管理訓練]]<ref name="NICE 2009"/>。父母管理訓練可以改善包括反對行為以及不合常規行為在內的一些行為問題<ref name=Dal2017>{{cite journal | vauthors = Daley D, Van Der Oord S, Ferrin M, Cortese S, Danckaerts M, Doepfner M, Van den Hoofdakker BJ, Coghill D, Thompson M, Asherson P, Banaschewski T, Brandeis D, Buitelaar J, Dittmann RW, Hollis C, Holtmann M, Konofal E, Lecendreux M, Rothenberger A, Santosh P, Simonoff E, Soutullo C, Steinhausen HC, Stringaris A, Taylor E, Wong IC, Zuddas A, Sonuga-Barke EJ | title = Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder | journal = Journal of Child Psychology and Psychiatry, and Allied Disciplines | volume = 59 | issue = 9 | pages = 932–947 | date = 2017-10 | pmid = 29083042 | doi = 10.1111/jcpp.12825 | url = http://eprints.nottingham.ac.uk/45391/1/Daley%20et%20al%202017%20JCPP.pdf | author = | access-date = 2019-11-21 | archive-url = https://web.archive.org/web/20190404183617/http://eprints.nottingham.ac.uk/45391/1/Daley%20et%20al%202017%20JCPP.pdf | archive-date = 2019-04-04 | dead-url = yes }}</ref>。心理療法也包括{{link-en|神經反饋|neurofeedback}}訓練<ref name="pmid19715181">{{cite journal | vauthors = Arns M, de Ridder S, Strehl U, Breteler M, Coenen A | title = Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis | journal = Clinical EEG and Neuroscience | volume = 40 | issue = 3 | pages = 180–9 | date = 2009-07 | pmid = 19715181 | doi = 10.1177/155005940904000311 }}</ref>，目前還不清楚是否有效<ref>{{cite journal | vauthors = Cortese S, Ferrin M, Brandeis D, Holtmann M, Aggensteiner P, Daley D, Santosh P, Simonoff E, Stevenson J, Stringaris A, Sonuga-Barke EJ | title = Neurofeedback for Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Clinical and Neuropsychological Outcomes From Randomized Controlled Trials | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 55 | issue = 6 | pages = 444–55 | date = 2016-06 | pmid = 27238063 | doi = 10.1016/j.jaac.2016.03.007 | hdl = 1854/LU-8123796 }}</ref>。


有關家庭治療的效果，目前還很少足夠品質的證據可以佐證。目前證據認為家庭治療的效果類似群體照顧（community care），效果比安慰劑要好<ref>{{cite journal | vauthors = Bjornstad G, Montgomery P | title = Family therapy for attention-deficit disorder or attention-deficit/hyperactivity disorder in children and adolescents | journal = The Cochrane Database of Systematic Reviews | volume = | issue = 2 | pages = CD005042 | date = 2005-04 | pmid = 15846741 | doi = 10.1002/14651858.CD005042.pub2 | editor = Bjornstad GJ }}</ref>。有許多注意力不足過動症支持組織可以提供相關資訊，並且協助家庭適應ADHD的情形<ref name="Brain encyclopedia">{{cite encyclopedia |last1=Turkington |first1=Carol |last2=Harris |first2=Joseph |title=attention deficit hyperactivity disorder (ADHD) |url={{google books|6hbKkynRxPYC|pages=42|plainurl=yes}} |encyclopedia=The Encyclopedia of the Brain and Brain Disorders |year=2009 |publisher=Infobase Publishing |isbn=978-1-4381-2703-3 |pages=[https://books.google.com/books?id=6hbKkynRxPYC&pg=PA47 47] |via=Google Books }}</ref>。
ADHD是一個全球性的問題。<ref name="tscap2"/>


有關社交技巧的訓練、行為調整以及藥物的對病患的好處可能有限。要減少後續心理及精神問題（例如[[重度抑郁症]]、[[犯罪]]、學校學習失敗、[[物質使用疾患]]）的主要因素是和沒有從事偏差行為的人建立友誼<ref name="pmid20490677">{{cite journal | vauthors = Mikami AY | title = The importance of friendship for youth with attention-deficit/hyperactivity disorder | journal = Clinical Child and Family Psychology Review | volume = 13 | issue = 2 | pages = 181–98 | date = 2010-06 | pmid = 20490677 | pmc = 2921569 | doi = 10.1007/s10567-010-0067-y }}</ref>。
== 病因學 <!--Etiology-->==


規律的[[體能鍛煉]]，特別是[[有氧运动]]，對於患有ADHD的兒童及成人而言也是有效的{{link-en|附加療法|adjunct therapy}}，特別是配合興奮劑藥物治療時更是如此，不過針對改善症狀，最理想的運動種類及強度還不清楚<ref name="ADHD exercise 2016 SystRev">{{cite journal | vauthors = Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O | title = Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review | journal = Journal of Neural Transmission | volume = 124 | issue = Suppl 1 | pages = 3–26 | date = 2017-02 | pmid = 27400928 | pmc = 5281644 | doi = 10.1007/s00702-016-1593-7 | quote = Beneficial chronic effects of cardio exercise were found on various functions as well, including executive functions, attention and behavior. }}</ref><ref name="ADHD Exercise 2014">{{cite journal | vauthors = Kamp CF, Sperlich B, Holmberg HC | title = Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters | journal = Acta Paediatrica | volume = 103 | issue = 7 | pages = 709–14 | date = 2014-07 | pmid = 24612421 | doi = 10.1111/apa.12628 | quote = We may conclude that all different types of exercise&nbsp;... 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}}</ref><ref name="ADHD Exercise 2013">{{cite journal | vauthors = Rommel AS, Halperin JM, Mill J, Asherson P, Kuntsi J | title = Protection from genetic diathesis in attention-deficit/hyperactivity disorder: possible complementary roles of exercise | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 52 | issue = 9 | pages = 900–10 | date = 2013-09 | pmid = 23972692 | pmc = 4257065 | doi = 10.1016/j.jaac.2013.05.018 | quote = The findings from these studies provide some support for the notion that exercise has the potential to act as a protective factor for ADHD. }}</ref>。長期規律有氧運動對ADHD患者的好處是提昇行為及運動能力、提昇[[管控功能]]（包括專注、[[抑制控制]]、計劃等）、較快的[[心理测时法|資訊處理速度]]，記憶力也會比較好<ref name="ADHD exercise 2016 SystRev" /><ref name="ADHD Exercise 2014" /><ref name="ADHD Exercise 2013" />。家長及教師針對ADHD兒童規律有氧运动對行為及以社交-情緒上的改善有：全身整體機能較佳、減少ADHD症狀、自尊感較好、減少焦慮及抑鬱的程度、較少身體症狀、課業成績及教室行為較佳，社交行為也有改善<ref name="ADHD exercise 2016 SystRev" />。若在有使用興奮劑治療時進行運動，會增加興奮劑藥物對執行功能的影響<ref name="ADHD exercise 2016 SystRev" />，一般認為運動的短期效果是因為運動時大腦[[突触]]多巴胺和去甲腎上腺素濃度的增加所造成<ref name="ADHD exercise 2016 SystRev" />。
&nbsp;絕大多數ADHD的確切成因<u>目前並沒有定論</u>，最有可能是[[注意力不足過動症#基因|基因]]和[[注意力不足過動症#環境因素|環境]]交互作用導致。<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/><ref name=Millichap_2010_chap2>{{cite book|last=Millichap|first=J. Gordon|title=Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD|year=2010|publisher=Springer Science|location=New York, NY|isbn=978-1-4419-1396-8|doi=10.1007/978-104419-1397-5|lccn=2009938108|page=26|chapter=Chapter 2: Causative Factors|chapter-url=https://books.google.com/books?id=KAlq0CDcbaoC&pg=PA26|edition=2nd}}</ref><ref name="pmid22963644">{{cite journal |vauthors=Thapar A, Cooper M, Eyre O, Langley K | title = What have we learnt about the causes of ADHD? | journal = J Child Psychol Psychiatry | volume = 54 | issue = 1 | pages = 3–16 | date = January 2013 | pmid = 22963644 | pmc = 3572580 | doi = 10.1111/j.1469-7610.2012.02611.x }}</ref> 有些個案的成因可能與腦部的疾病感染和腦部創傷有關。<ref name=Millichap_2010_chap2/><ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/><br/>根據研究統計，注意力不足過動症具有相當高的遺傳率。<ref name="找回專注力"/><ref name="幫助ADHD孩子快樂成長"/><br/>（詳見本條目的[[注意力不足過動症#遺傳|基因遺傳（Genetic Inheritance）]]章節）


=== 藥物===
[[File:Adhdbrain.png|thumbnail|upright=2|左側為<u>非</u>ADHD之功能性腦部[[磁共振成像|核磁共振照影]]（Functional Brain MRI）。顏色越接近白色表示葡萄糖利用率越高。]]
針對注意力不足過動症，可以用[[兴奋剂|中樞神經刺激劑]]（也稱為兴奋剂）藥物進行治療<ref name=CNS09>{{cite journal | vauthors = Wigal SB | title = Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults | journal = CNS Drugs | volume = 23 Suppl 1 | pages = 21–31 | year = 2009 | pmid = 19621975 | doi = 10.2165/00023210-200923000-00004 }}</ref><ref name="Cochrane Amphetamines ADHD">{{cite journal | vauthors = Castells X, Ramos-Quiroga JA, Bosch R, Nogueira M, Casas M | title = Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults | journal = The Cochrane Database of Systematic Reviews | volume = | issue = 6 | pages = CD007813 | date = 2011-06 | pmid = 21678370 | doi = 10.1002/14651858.CD007813.pub2 | editor = Castells X }}</ref>{{Update inline|reason=Updated version https://www.ncbi.nlm.nih.gov/pubmed/30091808|date = 2018-11}}，對於症狀至少會有一些效果，短期而言，約有80%會有效果<ref name=May2008 /><ref name="Long-term 36">{{cite journal | vauthors = Parker J, Wales G, Chalhoub N, Harpin V | title = The long-term outcomes of interventions for the management of attention-deficit hyperactivity disorder in children and adolescents: a systematic review of randomized controlled trials | journal = Psychology Research and Behavior Management | volume = 6 | issue = | pages = 87–99 | date = 2013-09 | pmid = 24082796 | pmc = 3785407 | doi = 10.2147/PRBM.S49114 | quote = Results suggest there is moderate-to-high-level evidence that combined pharmacological and behavioral interventions, and pharmacological interventions alone can be effective in managing the core ADHD symptoms and academic performance at 14 months. However, the effect size may decrease beyond this period.&nbsp;... There is high level evidence suggesting that pharmacological treatment can have a major beneficial effect on the core symptoms of ADHD (hyperactivity, inattention, and impulsivity) in approximately 80% of cases compared with placebo controls, in the short term.22 }}</ref><ref name="Cochrane Amphetamines ADHD" />。家長及教師反應[[哌甲酯]]比較可以改善其症狀<ref name=May2008 /><ref>{{cite journal | vauthors = Storebø OJ, Ramstad E, Krogh HB, Nilausen TD, Skoog M, Holmskov M, Rosendal S, Groth C, Magnusson FL, Moreira-Maia CR, Gillies D, Buch Rasmussen K, Gauci D, Zwi M, Kirubakaran R, Forsbøl B, Simonsen E, Gluud C | display-authors = 6 | title = Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD) | journal = The Cochrane Database of Systematic Reviews | volume = 11 | issue = 11 | pages = CD009885 | date = 2015-11 | pmid = 26599576 | doi = 10.1002/14651858.CD009885.pub2 }}</ref>，中樞神經刺激劑也可以減少ADHD兒童意外事故的風險<ref name=Ruiz2017>{{cite journal | vauthors = Ruiz-Goikoetxea M, Cortese S, Aznarez-Sanado M, Magallón S, Alvarez Zallo N, Luis EO, de Castro-Manglano P, Soutullo C, Arrondo G | title = Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis | journal = Neuroscience and Biobehavioral Reviews | volume = 84 | pages = 63–71 | date = 2018-01 | pmid = 29162520 | doi = 10.1016/j.neubiorev.2017.11.007 }}</ref>。針對ADHD的中樞神經刺激劑藥物除了哌甲酯外，還有[[苯丙胺]]、[[甲基苯丙胺]]等。


針對ADHD的非中樞神經刺激劑藥物有許多種，包括[[阿托莫西汀]]、[[安非他酮]]、[[胍法辛]]及[[可乐定]]，這些可以作為主要藥物治療，或是配合中樞神經刺激劑藥物一起使用<ref name=CNS09/><ref>{{cite journal | vauthors = Childress AC, Sallee FR | title = Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder | journal = Drugs of Today | volume = 48 | issue = 3 | pages = 207–17 | date = 2012-03 | pmid = 22462040 | doi = 10.1358/dot.2012.48.3.1750904 }}</ref>。目前有關各藥物之間的比較，還沒有說服力足夠的研究結果可以佐證，不過在副作用上似乎差不多<ref name=McD2011>{{cite journal | vauthors = McDonagh MS, Peterson K, Thakurta S, Low A | title = Drug Class Review: Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder | date = 2011-12 | pmid = 22420008 | url = https://www.ncbi.nlm.nih.gov/books/NBK84419 | publisher = United States Library of Medicine | archive-url = https://web.archive.org/web/20160831152630/http://www.ncbi.nlm.nih.gov/books/NBK84419/ | deadurl = no | archive-date = 2016-08-31 | series = Drug Class Reviews | journal = | access-date = 2019-11-21 }}</ref>。中樞神經刺激劑藥物比較可以提昇課業表現，阿托莫西汀則無此效果<ref name="pmid23179416">{{cite journal | vauthors = Prasad V, Brogan E, Mulvaney C, Grainge M, Stanton W, Sayal K | title = 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 | journal = European Child & Adolescent Psychiatry | volume = 22 | issue = 4 | pages = 203–16 | date = 2013-04 | pmid = 23179416 | doi = 10.1007/s00787-012-0346-x }}</ref>。阿托莫西汀比較不會有成癮問題，因此若有娛樂性藥物或是強迫性藥物使用風險的人，比較建議使用阿托莫西汀<ref name="Kooij-2010"/>。有關藥物對社交行為上的影響，目前的資料也還不充份<ref name=McD2011/>。{{As of|2015年6月}}，還沒有完全確定ADHD藥物的長期影響<ref name="ADHD 2015 review">{{cite journal | vauthors = Kiely B, Adesman A | title = What we do not know about ADHD… yet | journal = Current Opinion in Pediatrics | volume = 27 | issue = 3 | pages = 395–404 | date = 2015-06 | pmid = 25888152 | doi = 10.1097/MOP.0000000000000229 | quote = 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. }}</ref><ref name="pmid21519262">{{cite journal | vauthors = Hazell P | title = The challenges to demonstrating long-term effects of psychostimulant treatment for attention-deficit/hyperactivity disorder | journal = Current Opinion in Psychiatry | volume = 24 | issue = 4 | pages = 286–90 | date = 2011-07 | pmid = 21519262 | doi = 10.1097/YCO.0b013e32834742db }}</ref>。[[核磁共振成像]] 研究推測長期用[[苯丙胺]]或[[哌甲酯]]治療，會減少因為ADHD造成的大腦功能及結構異常<ref name="Neuroplasticity 1">{{cite journal | vauthors = Hart H, Radua J, Nakao T, Mataix-Cols D, Rubia K | title = Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: exploring task-specific, stimulant medication, and age effects | url = https://archive.org/details/sim_jama-psychiatry_2013-02_70_2/page/185 | journal = JAMA Psychiatry | volume = 70 | issue = 2 | pages = 185–98 | date = 2013-02 | pmid = 23247506 | doi = 10.1001/jamapsychiatry.2013.277 }}</ref><ref name="Neuroplasticity 2">{{cite journal | vauthors = Spencer TJ, Brown A, Seidman LJ, Valera EM, Makris N, Lomedico A, Faraone SV, Biederman J | title = Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies | url = https://archive.org/details/sim_journal-of-clinical-psychiatry_2013-09_74_9/page/902 | journal = The Journal of Clinical Psychiatry | volume = 74 | issue = 9 | pages = 902–17 | date = 2013-09 | pmid = 24107764 | pmc = 3801446 | doi = 10.4088/JCP.12r08287 }}</ref><ref name="Neuroplasticity 3">{{cite journal | vauthors = Frodl T, Skokauskas N | title = Meta-analysis of structural MRI studies in children and adults with attention deficit hyperactivity disorder indicates treatment effects | journal = Acta Psychiatrica Scandinavica | volume = 125 | issue = 2 | pages = 114–26 | date = 2012-02 | pmid = 22118249 | doi = 10.1111/j.1600-0447.2011.01786.x | quote = 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. }}</ref>。2018年的文獻回顧發現若考慮短期效果，哌甲酯對兒童最有效，苯丙胺對成人最有效<ref>{{cite journal |last1=Cortese |first1=Samuele |last2=Adamo |first2=Nicoletta |last3=Del Giovane |first3=Cinzia |last4=Mohr-Jensen |first4=Christina |last5=Hayes |first5=Adrian J |last6=Carucci |first6=Sara |last7=Atkinson |first7=Lauren Z |last8=Tessari |first8=Luca |last9=Banaschewski |first9=Tobias |last10=Coghill |first10=David |last11=Hollis |first11=Chris |last12=Simonoff |first12=Emily |last13=Zuddas |first13=Alessandro |last14=Barbui |first14=Corrado |last15=Purgato |first15=Marianna |last16=Steinhausen |first16=Hans-Christoph |last17=Shokraneh |first17=Farhad |last18=Xia |first18=Jun |last19=Cipriani |first19=Andrea |title=Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis |journal=The Lancet Psychiatry |date=2018-09 |volume=5 |issue=9 |pages=727–738 |doi=10.1016/S2215-0366(18)30269-4}}</ref>。
* 利用[[核磁共振成像]]技術（MRI, Magnetic Resonance Imaging）對[[腦部]]掃描的研究顯示患有ADHD和正常孩子的圖象有分別。不少科學家認為這足以證明ADHD是和腦部[[創傷]]有關。但另一方面，根據腦部的[[正电子发射断层扫描]]顯示，這種分別很可能只說明了ADHD患者的問題：因為他們並不能專注於一件事情，所以腦部影像只說明了作為腦內燃料的[[葡萄糖]]的分佈，在兩組兒童之間的分別。在成人ADHD患者的腦掃描中，控制專注力的部份由於葡萄糖水平較低，所以顯得不太活躍（''Zametkin et al.''）。不過，沒有證據顯示低葡萄糖水平與低注意力有關連，亦無法推論兩者之間的因果關係。
* 不少人有迟到的坏[[习惯]]。英国医生在给“迟到大王”吉姆·邓巴会诊后认为，他的这种“惯常迟到”或许源自脑部问题，导致迟到的脑部区域与和ADHD相关的区域相同。这使得他无法估计出自己完成一件事需要耗费的[[时间]]。<ref>{{cite web|url=http://edu.sina.com.cn/en/2015-07-29/102391468.shtml|title=迟到也是病：英国大叔迟到了一辈子(双语)|author=|date=|publisher=新浪教育edu.sina.com}}</ref><ref>{{cite web|url=http://www.wardheernews.com/finally-excuse-late-man-57-misses-every-appointment-makes-diagnosed-medical-condition-chronic-lateness/|title=Finally, an excuse for being late! Man, 57 who misses every appointment he makes is diagnosed with a medical condition - 'CHRONIC LATENESS' - WardheerNews|author=|date=2013-08-27|publisher=}}</ref><ref>{{cite web|url=http://www.dailymail.co.uk/health/article-2402902/Chronic-lateness-Man-57-whos-late-diagnosed-medical-condition.html|title=Finally, an excuse for being late! Man, 57 who misses every appointment he makes is diagnosed with a medical condition - 'CHRONIC LATENESS'|author=|date=|publisher=dailymail.co.uk}}</ref>


什麼情形要用[[胍法辛]]治療會依國家而不同，{{link-en|英國國家健康照護專業組織|National Institute for Health and Care Excellence}}（NICE）針對成人是第一線藥物，若針對兒童，只建議在病情嚴重時才使用，而大部份美國的醫學指南會建議可以針對各年齡層使用<ref name="CADDRA"/>。針對學齡前的兒童，一般不建議用藥物治療<ref name="NICE 2009"/><ref>{{cite journal | vauthors = Greenhill LL, Posner K, Vaughan BS, Kratochvil CJ | title = Attention deficit hyperactivity disorder in preschool children | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 17 | issue = 2 | pages = 347–66, ix | date = 2008-04 | pmid = 18295150 | doi = 10.1016/j.chc.2007.11.004 }}</ref>。若治療用的中樞神經刺激劑劑量不足，可能會有沒有藥效的情形<ref>{{cite journal | vauthors = Stevens JR, Wilens TE, Stern TA | title = Using stimulants for attention-deficit/hyperactivity disorder: clinical approaches and challenges | journal = The Primary Care Companion for CNS Disorders | volume = 15 | issue = 2 | date = 2013 | pmid = 23930227 | pmc = 3733520 | doi = 10.4088/PCC.12f01472 }}</ref>，這尤其常出現在青少年及成人身上，因為核可的劑量是針對學齡兒童的，因此有些醫療人員會依體重或是依其他因素給藥<ref>{{Cite web|url=http://www.medscape.org/viewarticle/734449|title=Individualizing Treatment for Adult ADHD: An Evidence-Based Guideline|last=Young|first=Joel L.|date=2010|website=Medscape|publisher=|access-date=2016-06-19|deadurl=no|archive-url=https://web.archive.org/web/20150508075829/http://www.medscape.org/viewarticle/734449|archive-date=2015-05-08}}</ref><ref>{{Cite web|url=http://www.medscape.com/viewarticle/464377_print|title=New-Generation Long-Acting Stimulants for the Treatment of Attention-Deficit/Hyperactivity Disorder|last=Biederman|first=Joseph|date=2003|website=Medscape|publisher=|access-date=2016-06-19|quote=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.... <br />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.|deadurl=no|archive-url=https://web.archive.org/web/20031207063556/http://www.medscape.com/viewarticle/464377_print|archive-date=2003-12-07}}</ref><ref>{{cite journal | vauthors = Kessler S | title = Drug therapy in attention-deficit hyperactivity disorder | url = https://archive.org/details/sim_southern-medical-journal_1996-01_89_1/page/33 | journal = Southern Medical Journal | volume = 89 | issue = 1 | pages = 33–8 | date = 1996-01 | pmid = 8545689 | doi = 10.1097/00007611-199601000-00005 }}</ref>。
=== 基因遺傳 <!--Genetic Inheritance--> ===


一般而言，在正常治療劑量的哌甲酯及中樞神經刺激劑是安全的，不過有其副作用以及禁忌症<ref name=CNS09/>。若哌甲酯給兒童及青少年使用，有研究發現這和一些嚴重或不嚴重的有害副作用有關，不過證據品質還不充份<ref name="StorebøPedersen2018">{{cite journal | vauthors = 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 | title = Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of adverse events in non-randomised studies | journal = The Cochrane Database of Systematic Reviews | volume = 5 | pages = CD012069 | date = 2018-05 | pmid = 29744873 | doi = 10.1002/14651858.CD012069.pub2 }}</ref>。若針對兒童開立這類藥物，需仔細的監測兒童的情形<ref name="StorebøPedersen2018" />。若ADHD的中樞神經刺激劑嚴重過量，可能會和{{link-en|興奮性精神病|stimulant psychosis}}或是[[狂躁]]的症狀<ref name="Cochrane recreational amph psychosis" />。若是治療用的劑量，出現類似情形的機率非常低，只有0.1%，會在開始用中樞神經刺激劑藥物治療後的前幾週出現<ref name="Cochrane recreational amph psychosis">{{cite journal | vauthors = Shoptaw SJ, Kao U, Ling W | title = Treatment for amphetamine psychosis | journal = The Cochrane Database of Systematic Reviews | volume = | issue = 1 | pages = CD003026 | date = 2009-01 | pmid = 19160215 | doi = 10.1002/14651858.CD003026.pub3 | quote = 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&nbsp;...<br />About 5–15% of the users who develop an amphetamine psychosis fail to recover completely (Hofmann 1983)&nbsp;...<br />Findings from one trial indicate use of antipsychotic medications effectively resolves symptoms of acute amphetamine psychosis. | editor = <!--Shoptaw SJ--> Shoptaw SJ, Ali R }}</ref><ref>{{cite web | title = Adderall XR Prescribing Information | url = http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf | publisher = Shire US Inc | work = United States Food and Drug Administration | date = 2013-12 | access-date = 2013-12-30 | quote = 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.&nbsp;... 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. | deadurl = no | archive-url = https://web.archive.org/web/20131230233702/http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf | archive-date = 2013-12-30 }}</ref><ref name="pmid19171629">{{cite journal | vauthors = Mosholder AD, Gelperin K, Hammad TA, Phelan K, Johann-Liang R | title = Hallucinations and other psychotic symptoms associated with the use of attention-deficit/hyperactivity disorder drugs in children | journal = Pediatrics | volume = 123 | issue = 2 | pages = 611–6 | date = 2009-02 | pmid = 19171629 | doi = 10.1542/peds.2008-0185 }}</ref>，若也使用[[抗精神病药]]，可以有效緩解急性苯丙胺精神病的症狀<ref name="Cochrane recreational amph psychosis" />，若長期治療，需要定期的監測<ref name="pmid20571380">{{cite journal | vauthors = Kraemer M, Uekermann J, Wiltfang J, Kis B | title = Methylphenidate-induced psychosis in adult attention-deficit/hyperactivity disorder: report of 3 new cases and review of the literature | journal = Clinical Neuropharmacology | volume = 33 | issue = 4 | pages = 204–6 | date = 2010-07 | pmid = 20571380 | doi = 10.1097/WNF.0b013e3181e29174 }}</ref>。興奮劑的藥物治療需要定期停藥，評估是否還需要用藥、減少發育遲緩的情形，並且減低抗藥性<ref name="pmid21530185">{{cite journal | vauthors = van de Loo-Neus GH, Rommelse N, Buitelaar JK | title = To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended? | journal = European Neuropsychopharmacology | volume = 21 | issue = 8 | pages = 584–99 | date = 2011-08 | pmid = 21530185 | doi = 10.1016/j.euroneuro.2011.03.008 }}</ref><ref>{{cite journal | vauthors = Ibrahim K, Donyai P | title = Drug Holidays From ADHD Medication: International Experience Over the Past Four Decades | journal = Journal of Attention Disorders | volume = 19 | issue = 7 | pages = 551–68 | date = 2015-07 | pmid = 25253684 | doi = 10.1177/1087054714548035 | url = https://www.researchgate.net/publication/266151922 | archive-url = https://web.archive.org/web/20160630122316/https://www.researchgate.net/profile/Kinda_Ibrahim2/publication/266151922_Drug_Holidays_From_ADHD_Medication_International_Experience_Over_the_Past_Four_Decades/links/56a5ec7408ae1b651134629a.pdf | deadurl = no | archive-date = 2016-06-30 | access-date = 2019-11-21 }}</ref>。若是長期使用超過ADHD治療劑量的興奮劑藥物濫用，一般會和[[成瘾]]及[[物質依賴]]有關<ref name="NHM therapeutic stim addiction liability" /><ref>{{Cite book|url=https://www.ncbi.nlm.nih.gov/books/NBK47127/|title=Black box warnings of ADHD drugs approved by the US Food and Drug Administration|year=2009|author=Oregon Health & Science University|location=Portland, Oregon|publisher=United States National Library of Medicine|access-date=2014-01-17|deadurl=no|archive-url=https://web.archive.org/web/20170908135126/https://www.ncbi.nlm.nih.gov/books/NBK47127/|archive-date=2017-09-08}}</ref>。不過未治療的ADHD，會提高物質濫用以及行為規範障礙的風險<ref name="NHM therapeutic stim addiction liability" />。興奮劑藥物的使用，可能可以降低風險，但也有可能沒有此效果<ref name="Kooij-2010"/><ref name="ADHD 2015 review" /><ref name="NHM therapeutic stim addiction liability">{{cite book | vauthors = Malenka RC, Nestler EJ, Hyman SE | veditors = Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience | url = https://archive.org/details/molecularneuroph00nest | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 978-0-07-148127-4 | pages = [https://archive.org/details/molecularneuroph00nest/page/323 323], 368 | edition = 2nd |quote = 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.&nbsp;... 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}}</ref>。還不清楚懷孕時服用這些藥物是否安全<ref>{{cite journal | vauthors = Ashton H, Gallagher P, Moore B | title = The adult psychiatrist's dilemma: psychostimulant use in attention deficit/hyperactivity disorder | journal = Journal of Psychopharmacology | volume = 20 | issue = 5 | pages = 602–10 | date = 2006-09 | pmid = 16478756 | doi = 10.1177/0269881106061710 | url = http://jop.sagepub.com/cgi/content/abstract/20/5/602 | archive-url = https://web.archive.org/web/20090815063002/http://jop.sagepub.com/cgi/content/abstract/20/5/602 | deadurl = no | archive-date = 2009-08-15 | access-date = 2019-11-21 }}</ref>。
[[File:Herència De La Malaltia De Tangier.jpg|thumb|upright=1.6|遺傳示意圖]]


=== 飲食===
* 根據{{tsl|en|National Institute of Mental Health|美國心理衛生中心}}的答問集，茲引文如下：
<!--{{Main|Diet and attention deficit hyperactivity disorder}}-->


飲食的調整可能對少部份的ADHD兒童有幫助<ref name="pmid22176942">{{cite journal | vauthors = Nigg JT, Lewis K, Edinger T, Falk M | title = Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 51 | issue = 1 | pages = 86–97.e8 | date = 2012-01 | pmid = 22176942 | pmc = 4321798 | doi = 10.1016/j.jaac.2011.10.015 }}</ref>。一份2013年的統合分析針對有ADHD症狀，而且有補充[[脂肪酸|游離脂肪酸]]或是減少食用有人工色素食品的兒童的相關研究發現，只有不到三分之一的兒童在症狀上有改善<ref name=Sonu2013>{{cite journal | vauthors = Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J | title = Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments | url = https://archive.org/details/sim_american-journal-of-psychiatry_2013-03_170_3/page/275 | journal = The American Journal of Psychiatry | volume = 170 | issue = 3 | pages = 275–89 | date = 2013-03 | pmid = 23360949 | doi = 10.1176/appi.ajp.2012.12070991 | quote = Free fatty acid supplementation and artificial food color exclusions appear to have beneficial effects on ADHD symptoms, although the effect of the former are small and those of the latter may be limited to ADHD patients with food sensitivities... }}</ref>。這方面的助益有可能只是對有食物敏感的兒童有幫助，也有可能是因為這些兒童同時也在接受ADHD的治療<ref name=Sonu2013/>。這些文獻也指出目前已有的證據無法支持減少食用特定食物來治療ADHD的療法<ref name=Sonu2013 />。2014年發表的文獻也發現[[排除飲食]]在治療ADHD上的成效有限<ref name=NiggHolton2014>{{cite journal | vauthors = Nigg JT, Holton K | title = Restriction and elimination diets in ADHD treatment | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 23 | issue = 4 | pages = 937–53 | date = 2014-10 | pmid = 25220094 | pmc = 4322780 | doi = 10.1016/j.chc.2014.05.010 | type = Review | quote = 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. }}</ref>。另一篇2016年文獻回顧指出，根據研究結果，「[[無麩質飲食]]在未來成為ADHD的標準療法」之機率是微乎其微<ref name="pmid26825336" />。
: “研究顯示ADHD會在[[家族]]中出現，所以有一定程度的遺傳影響。ADHD的病童通常都至少有一位[[近親]]（Kinship）亦有ADHD。患有ADHD的男童長大成為父親後，不少於三分之一人的子女亦是ADHD患者。一個更有說服力的遺傳聯繫，就是[[双胞胎|同卵雙生兒]]（雙胞胎），如果診斷出當中一位為ADHD患者，另一位同時亦是患者的機會非常高。”<ref>{{cite web|url=https://www.nimh.nih.gov/news/science-news/2013/new-data-reveal-extent-of-genetic-overlap-between-major-mental-disorders.shtml |title=New Data Reveal Extent of Genetic Overlap Between Major Mental Disorders, Schizophrenia, Bipolar Disorder Share the Most Common Genetic Variation. August 12, 2013 • Press Release |publisher=Nimh.nih.gov |date= |accessdate=2016-12-27}}</ref><ref>{{cite web|url=https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml |title=Attention Deficit Hyperactivity Disorder |publisher=Nimh.nih.gov |date= |accessdate=2016-12-27}}</ref>
:# 爸爸有『注意力不足過動症』，孩子有『注意力不足過動症』的比例略高於媽媽有注意力不足過動症，孩子有『注意力不足過動症』的比例。<br/>父遺傳率 ：母遺傳率 = 15%~45% ：14%~38%。
:# 成人注意力不足過動症患者的兄弟姊妹出現相似症狀的比例約為20%。<ref name="找回專注力"/>


2017的文獻回顧指出有一些排除飲食的方式對於非常小，無法用藥的幼童，以及對藥物沒有反應的患者可能有用，不過不鼓勵用補充游離脂肪酸或是減少食用有人工色素食品作為ADHD的正規治療方式<ref name="PelsserFrankena2017">{{cite journal|vauthors=Pelsser LM, Frankena K, Toorman J, Rodrigues Pereira R|title=Diet and ADHD, Reviewing the Evidence: A Systematic Review of Meta-Analyses of Double-Blind Placebo-Controlled Trials Evaluating the Efficacy of Diet Interventions on the Behavior of Children with ADHD|journal=PLoS One|volume=12|issue=1|pages=e0169277|date=2017-01|pmid=28121994|pmc=5266211|doi=10.1371/journal.pone.0169277|type=Systematic Review}}{{open access}}</ref> 。長期鐵、鎂及碘等礦物質的不足可能可以讓ADHD的症狀加劇<ref name="pmid22928358">{{cite journal | vauthors = Konikowska K, Regulska-Ilow B, Rózańska D | title = The influence of components of diet on the symptoms of ADHD in children | journal = Roczniki Panstwowego Zakladu Higieny | volume = 63 | issue = 2 | pages = 127–34 | year = 2012 | pmid = 22928358 }}</ref>，也有少數證據指出組織內[[锌]]含量過低和ADHD有關<ref name="pmid16190793">{{cite journal | vauthors = Arnold LE, DiSilvestro RA | title = Zinc in attention-deficit/hyperactivity disorder | journal = Journal of Child and Adolescent Psychopharmacology | volume = 15 | issue = 4 | pages = 619–27 | date = 2005-08 | pmid = 16190793 | doi = 10.1089/cap.2005.15.619 | hdl = 1811/51593 }}</ref>。不過除非證實有{{link-en|鋅不足|zinc deficiency}}的情形（目前多半是開發中國家才會有鋅不足的情形），一般不建議用{{link-en|鋅補充劑|zinc supplementation}}治療<ref name=pmid25220092>{{cite journal | vauthors = Bloch MH, Mulqueen J | title = Nutritional supplements for the treatment of ADHD | journal = Child and Adolescent Psychiatric Clinics of North America | volume = 23 | issue = 4 | pages = 883–97 | date = 2014-10 | pmid = 25220092 | pmc = 4170184 | doi = 10.1016/j.chc.2014.05.002 }}</ref>。不過若鋅礦物質和[[苯丙胺]]類藥物同時使用的話，可以減低苯丙胺藥物的最小[[有效劑量]]，也就是可以服用較少的藥物而達到相同的效果<ref name="Zinc binding sites + ADHD review">{{cite journal | vauthors = Krause J | title = SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder | journal = Expert Review of Neurotherapeutics | volume = 8 | issue = 4 | pages = 611–25 | date = 2008-04 | pmid = 18416663 | doi = 10.1586/14737175.8.4.611 | quote = Zinc binds at&nbsp;... 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. }}</ref>。另有證據指出[[Ω-3脂肪酸]]對於病情會有些許的改善，不過不建議取代醫學治療<ref name="pmid21961774">{{cite journal | vauthors = Bloch MH, Qawasmi A | title = Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis | journal = Journal of the American Academy of Child and Adolescent Psychiatry | volume = 50 | issue = 10 | pages = 991–1000 | date = 2011-10 | pmid = 21961774 | pmc = 3625948 | doi = 10.1016/j.jaac.2011.06.008 }}</ref><ref name="pmid27555775">{{cite journal | vauthors = Königs A, Kiliaan AJ | title = Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment | journal = Neuropsychiatric Disease and Treatment | volume = 12 | issue = | pages = 1869–82 | year = July 2016 | pmid = 27555775 | pmc = 4968854 | doi = 10.2147/NDT.S68652 }}</ref>。
更進一步來說，[[雙胞胎研究]]顯示ADHD通常遺傳自患者的父母。大約75%的患者的病因是基因因素。<ref name="NICE 2009">{{cite book | title=Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults | author=National Collaborating Centre for Mental Health | publisher=British Psychological Society | isbn=9781854334718 | date=2009 | pages = 19–27, 38, 130, 133, 317}}</ref><ref name="Neale-2010">{{cite journal |last1=Neale |first1=BM |last2=Medland |first2=SE |last3=Ripke |first3=S |last4=Asherson |first4=P |last5=Franke |first5=B |last6=Lesch |first6=KP |last7=Faraone |first7=SV |last8=Nguyen |first8=TT |last9=Schäfer |first9=H |last10=Holmans |first10=P |last11=Daly |first11=M |last12=Steinhausen |first12=HC |last13=Freitag |first13=C |last14=Reif |first14=A |last15=Renner |first15=TJ |last16=Romanos |first16=M |last17=Romanos |first17=J |last18=Walitza |first18=S |last19=Warnke |first19=A |last20=Meyer |first20=J |last21=Palmason |first21=H |last22=Buitelaar |first22=J |last23=Vasquez |first23=AA |last24=Lambregts-Rommelse |first24=N |last25=Gill |first25=M |last26=Anney |first26=RJ |last27=Langely |first27=K |last28=O'Donovan |first28=M |last29=Williams |first29=N |last30=Owen |first30=M |last31=Thapar |first31=A |last32=Kent |first32=L |last33=Sergeant |first33=J |last34=Roeyers |first34=H |last35=Mick |first35=E |last36=Biederman |first36=J |last37=Doyle |first37=A |last38=Smalley |first38=S |last39=Loo |first39=S |last40=Hakonarson |first40=H |last41=Elia |first41=J |last42=Todorov |first42=A |last43=Miranda |first43=A |last44=Mulas |first44=F |last45=Ebstein |first45=RP |last46=Rothenberger |first46=A |last47=Banaschewski |first47=T |last48=Oades |first48=RD |last49=Sonuga-Barke |first49=E |last50=McGough |first50=J |last51=Nisenbaum |first51=L |last52=Middleton |first52=F |last53=Hu |first53=X |last54=Nelson |first54=S |author55=Psychiatric GWAS Consortium: ADHD Subgroup |display-authors=3 | title = Meta-analysis of genome-wide association studies of attention-deficit/hyperactivity disorder | journal = J Am Acad Child Adolesc Psychiatry | volume = 49 | issue = 9 | pages = 884–897 | date = September 2010 | pmid = 20732625 | pmc = 2928252 | doi = 10.1016/j.jaac.2010.06.008 }}</ref><ref name="Burt-2009">{{Cite journal | author = Burt SA | title = Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences | journal = Psychol Bull | volume = 135 | issue = 4 |pages = 608–637 | date=July 2009 | doi = 10.1037/a0015702 | pmid = 19586164 }}</ref><br/>
兒童青少年的手足（兄弟姊妹）比起<u>非</u>ADHD患者的[[手足]]多上三到四倍的機率帶有ADHD的特徵或也有ADHD。<ref>{{cite book | author=Nolen-Hoeksema S | title=Abnormal Psychology | year=2013 | isbn=9780078035388 | page=267 | edition=Sixth}}</ref>基因可能也與注意力不足過動症是否從幼兒延續至成人有關聯。<ref name="pmid22105624">{{cite journal |vauthors=Franke B, Faraone SV, Asherson P, Buitelaar J, Bau CH, Ramos-Quiroga JA, Mick E, Grevet EH, Johansson S, Haavik J, Lesch KP, Cormand B, Reif A | title = The genetics of attention deficit/hyperactivity disorder in adults, a review | journal = Mol. Psychiatry | volume = 17 | issue = 10 | pages = 960–987 | date = October 2012 | pmid = 22105624 | pmc = 3449233 | doi = 10.1038/mp.2011.138 }}</ref>


== 流行病學==
在一般的情況下，ADHD大多與數個影響多巴胺（大腦內一種[[神經傳導物質]]）傳遞的基因有關<ref name="Gizer-2009"/><ref name="Genes Rev" />。這些[[基因]]分別是 [[Dopamine transporter|多巴胺輸送元（再攝取）DAT]]、[[DRD4]]、{{tsl|en|DRD5|DRD5}}、{{tsl|en|TAAR1|TAAR1}}、{{tsl|en|MAOA|MAOA}}、{{tsl|en|catechol O-methyltransferase|catechol O-methyltransferase}}（COMT）、和 {{tsl|en|Dopamine-beta-hydroxylase|Dopamine-beta-hydroxylase}}（DBH）。<ref name="Genes Rev">{{cite journal |vauthors=Kebir O, Tabbane K, Sengupta S, Joober R |title=Candidate genes and neuropsychological phenotypes in children with ADHD: review of association studies |journal=J Psychiatry Neurosci |volume=34 |issue=2 |pages=88–101 |date=March 2009 |pmid=19270759 |pmc=2647566 |doi= |url=}}</ref><ref name="Berry-2007">{{cite journal |last=Berry |first=MD |title=The potential of trace amines and their receptors for treating neurological and psychiatric diseases |journal=Reviews on Recent Clinical Trials |volume=2 |issue=1 |pages=3–19 |date=January 2007 |pmid=18473983 |doi=10.2174/157488707779318107 |url=http://www.eurekaselect.com/77537/article |quote=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. }}</ref><ref name="TAAR1_2">{{cite journal |vauthors=Sotnikova TD, Caron MG, Gainetdinov RR |title=Trace amine-associated receptors as emerging therapeutic targets |journal=Mol. Pharmacol. |volume=76 |issue=2 |pages=229–235 |date=August 2009 |pmid=19389919 |pmc=2713119 |doi=10.1124/mol.109.055970}}</ref>
{{main article|注意力不足過動症的流行病學}}


[[File:Approximate_Prevalence_Distribution_of_the_Subtypes_of_ADHD.PNG|thumb|upright=1.5|注意力不足過動症各子類型的比例分布（紫色為混合型；藍色為注意力缺陷為主型；粉紅色為過動—衝動為主型）<ref>Approximate Prevalence Distribution of the Subtypes of ADHD as cited by Cognitive-Behavioral Therapy for Adult ADHD. New York, NY: Routledge. 2008.</ref><ref name="Ramsay 2015 p. ">{{cite book | last=Ramsay | first=J | title=Cognitive-behavioral therapy for adult ADHD : an integrative psychosocial and medical approach | url=https://archive.org/details/cognitivebehavio0000rams_h5z5 | publisher=Routledge | publication-place=New York | year=2015 | isbn=0-415-81591-6 | oclc=876336915 | page=}}</ref>]]
其他基因分別是[[Serotonin transporter|血清素輸送元（SERT）]]、{{tsl|en|HTR1B|HTR1B}}、{{tsl|en|SNAP25|SNAP25}}、{{tsl|en|GRIN2A|GRIN2A}}、 {{tsl|en|ADRA2A|ADRA2A}}、{{tsl|en|TPH2|TPH2}}、和 [[Brain-derived neurotrophic factor|腦源性神經營養因子（BDNF）]]<ref name="Gizer-2009">{{cite journal |vauthors=Gizer IR, Ficks C, Waldman ID | title = Candidate gene studies of ADHD: a meta-analytic review | journal = Hum. Genet. | volume = 126 | issue = 1 | pages = 51–90 | date = July 2009 | pmid = 19506906 | doi = 10.1007/s00439-009-0694-x | url = }}</ref><ref name="Genes Rev" />。


注意力不足過動症是童年階段最常見的發育疾患<ref name="Lipkin Mostofsky 2007 pp. 631–639 most common">{{cite book | last=Lipkin | first=Paul H. | last2=Mostofsky | first2=Stewart | title=Neurobiology of Disease | chapter=Attention-Deficit Hyperactivity Disorder | publisher=Elsevier | year=2007 | isbn=978-0-12-088592-3 | doi=10.1016/b978-012088592-3/50059-1 | pages=631–639 | quote=Attention-deficit hyperactivity disorder (ADHD) is the most common developmental disorder of childhood, affecting approximately 3–9% of schoolchildren [1,2].}}</ref>。根據2015年發表的研究，依照DSM-III, DSM-III-R及DSM-IV的標準，國際ADHD流行率中位數，兒童為6-8%<ref name="Thomas Sanders Doust Beller 2015 pp. e994–e1001">{{cite journal | last=Thomas | first=R. | last2=Sanders | first2=S. | last3=Doust | first3=J. | last4=Beller | first4=E. | last5=Glasziou | first5=P. | title=Prevalence of Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis | type=secondary source or tertiary source| journal=PEDIATRICS | publisher=American Academy of Pediatrics (AAP) | volume=135 | issue=4 | year=2015 | pages=e994–e1001 | url=https://doi.org/10.1542%2Fpeds.2014-3482 | doi=10.1542/peds.2014-3482 | accessdate=2017-04-21|quote=7.2% (95% confidence interval: 6.7 to 7.8)}}</ref><ref name="pmid22976615">{{cite journal |author=Willcutt EG |title=The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review |journal=Neurotherapeutics|volume=9 |issue=3 |pages=490–9 |date=2012-07 |pmid=22976615 |doi=10.1007/s13311-012-0135-8 |pmc=3441936}}</ref>。若使用ICD-10的標準，同年齡兒童的流行率則為1–2%
一個名為{{tsl|en|LPN3|LPN3}}的基因，其變異體大約存在於9%的ADHD患者身上。而這9%的患者可能對於中樞神經興奮劑特別有反應。<ref name="pmid21432600">{{cite journal |vauthors=Arcos-Burgos M, Muenke M |title=Toward a better understanding of ADHD: LPHN3 gene variants and the susceptibility to develop ADHD |journal=Atten Defic Hyperact Disord |volume=2 |issue=3 |pages=139–147 |date=November 2010 |pmid=21432600 |pmc=3280610 |doi=10.1007/s12402-010-0030-2 |url=}}</ref>
<ref name="Cowen2012">{{cite book |last1= Cowen |first1= Philip |last2= Harrison |first2=Paul |last3= Burns |first3= Tom |chapter=Drugs and other physical treatments <!--|chapter-url={{google books|O3sSd-OAdP0C|page=507|plainurl=yes}}--> | title=Shorter Oxford Textbook of Psychiatry |year= 2012 | publisher= Oxford University Press | isbn=978-0-19-960561-3 |
page=546 | edition=6th |url={{google books|O3sSd-OAdP0C|plainurl=yes}}<!-- |via=Google Books--> }}</ref>。


美國的成人注意力不足過動症的流行率為4-5%<ref name="Kessler Adler Barkley Biederman 1963 p. ">{{cite journal | last=Kessler | first=Ronald C. | last2=Adler | first2=Lenard | last3=Barkley | first3=Russell | last4=Biederman | first4=Joseph | last5=Conners | first5=C. Keith | last6=Demler | first6=Olga | last7=Faraone | first7=Stephen V. | last8=Greenhill | first8=Laurence L. | last9=Howes | first9=Mary J. | last10=Secnik | first10=Kristina | last11=Spencer | first11=Thomas | last12=Ustun | first12=T. Bedirhan | last13=Walters | first13=Ellen E. | last14=Zaslavsky | first14=Alan M. | title=The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication | journal=The American journal of psychiatry | volume=163 | issue=4 | date=1963-06-08 | pmid=16585449 | doi=10.1176/appi.ajp.163.4.716 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859678/ | access-date=2018-09-26 | page= | archive-date=2021-05-25 | archive-url=https://web.archive.org/web/20210525173336/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859678/ | dead-url=no }}</ref><ref name="RC Al. 2018">{{cite web | last=RC | first=Kessler | last2=Al. | first2=Et | title=The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. - PubMed | website=NCBI | date=2018-09-26 | url=https://www.ncbi.nlm.nih.gov/pubmed/16585449 | access-date=2018-09-26 | archive-date=2020-05-19 | archive-url=https://web.archive.org/web/20200519011258/https://www.ncbi.nlm.nih.gov/pubmed/16585449 | dead-url=no }}</ref>。根據《找回專注力：成人ADHD全方位自助手冊》，成人ADHD在台灣的流行率推估為3-4%<ref name="找回專注力">{{cite book|author=[[高淑芬]] |title=找回專注力：成人ADHD全方位自助手冊 |publisher=心靈工坊|language =zh-tw|location=台北 |isbn=9789863570592 |date=2016-05-09 |accessdate=2016-12-12|url=http://books.google.com/books?id=0h8qnQAACAAJ }}</ref>{{rp|24-25}}。ADHD是全球性的<ref name="tscap2">{{cite web |author=TSCAP |url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=8&hidNewsID=117 |title=臺灣兒童青少年精神醫學會新聞稿20160603 |publisher=Tscap.org.tw |date= |accessdate=2016-12-27 |deadurl=no |archiveurl=https://web.archive.org/web/20161130124759/http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=8&hidNewsID=117 |archivedate=2016-11-30 }}</ref><ref name="Norén Selinus Molero Lichtenstein Anckarsäter pp. 533–545">{{cite journal | last=Norén Selinus | first=E. | last2=Molero | first2=Y. | last3=Lichtenstein | first3=P. | last4=Anckarsäter | first4=H. | last5=Lundström | first5=S. | last6=Bottai | first6=M. | last7=Hellner Gumpert | first7=C. | title=Subthreshold and threshold attention deficit hyperactivity disorder symptoms in childhood: psychosocial outcomes in adolescence in boys and girls | journal=Acta Psychiatrica Scandinavica | publisher=Wiley-Blackwell | volume=134 | issue=6 | date=2016-10-07 | issn=0001-690X | doi=10.1111/acps.12655 | pages=533–545}}</ref><ref name="Biederman Faraone 2004 pp. 453–454">{{cite journal | last=Biederman | first=Joseph | last2=Faraone | first2=Stephen V. | title=Attention Deficit Hyperactivity Disorder | url=https://archive.org/details/sim_journal-of-nervous-and-mental-disease_2004-07_192_7/page/453 | journal=The Journal of Nervous and Mental Disease | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=192 | issue=7 | year=2004 | issn=0022-3018 | doi=10.1097/01.nmd.0000131803.68229.96 | pages=453–454}}</ref><ref name="Polanczyk de Lima Horta Biederman 2007 pp. 942–948">{{cite journal | last=Polanczyk | first=Guilherme | last2=de Lima | first2=Maurício Silva | last3=Horta | first3=Bernardo Lessa | last4=Biederman | first4=Joseph | last5=Rohde | first5=Luis Augusto | title=The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis | url=https://archive.org/details/sim_american-journal-of-psychiatry_2007-06_164_6/page/942 | journal=American Journal of Psychiatry | publisher=American Psychiatric Publishing | volume=164 | issue=6 | year=2007 | issn=0002-953X | doi=10.1176/ajp.2007.164.6.942 | pages=942–948}}</ref>。世界各地ADHD流行率的差異主要是因為世界各地使用的ADHD診斷方法不同。<ref name="Polanczyk">{{Cite journal|vauthors=Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA |title=The worldwide prevalence of ADHD: a systematic review and metaregression analysis |url=https://archive.org/details/sim_american-journal-of-psychiatry_2007-06_164_6/page/942 |journal=The American Journal of Psychiatry |volume=164 |issue=6 |pages=942–8|date=2007-06 |pmid=17541055 |doi=10.1176/appi.ajp.164.6.942}}</ref> 若使用相同的診斷方法，則世界各地所得出的ADHD流行率將介於伯仲之間。<ref>{{cite book|last=Jones|first=edited by Ming Tsuang, Mauricio Tohen, Peter B.|title=Textbook of psychiatric epidemiology|publisher=Wiley-Blackwell|location=Chichester, West Sussex|isbn=9780470977408|page=450|url=https://books.google.com/books?id=fOc4pdXe43EC&pg=PA450|edition=3rd|access-date=2018-09-16|archive-date=2020-12-22|archive-url=https://web.archive.org/web/20201222193454/https://books.google.com/books?id=fOc4pdXe43EC&pg=PA450|dead-url=no}}</ref>
多巴胺輸送元[[多巴胺受体D4|DRD4]]的七個重複存在的變異體{{tsl|en|DRD4-7R|DRD4-7R}}與ADHD有關。因為它放大了由多巴胺觸發的[[抑制]]效果（inhibitory effects）。DRD4的接收元是一個[[G蛋白偶聯受體|G蛋白偶聯受體（G Protein-Coupled Receptors）]]，作用是抑制[[腺苷酸環化酶|腺苷酸環化酶（adenylyl cyclase）]]。DRD4的突變反映在許多行為表現上，包括ADHD的症狀群，例如：分心。<ref name="ADHD and the DRD4 allele">{{cite journal |vauthors=Nikolaidis A, Gray JR |title=ADHD and the DRD4 exon III 7-repeat polymorphism: an international meta-analysis | journal = Social Cognitive and Affective Neuroscience |volume=5 |issue=2-3 |pages=188–193 |date=Jun 2010 |pmc=2894686 |doi=10.1093/scan/nsp049 |url= |pmid=20019071}}</ref>


在亞洲，台灣<ref>{{cite web
[[演化]]可能在ADHD的[[盛行率]]中扮演一定的腳色{{efn|即為角色}}，特別是有<u>過動-衝動</u>症狀的男性患者。<ref name="pmid21250994">{{cite journal |author=Glover V |title=Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective |journal=J Child Psychol Psychiatry |volume=52 |issue=4 |pages=356–67 |date=April 2011 |pmid=21250994 |doi=10.1111/j.1469-7610.2011.02371.x |url=}}</ref>
|url = http://nhird.nhri.org.tw/

|title = 全民健康保險研究資料庫 National Health Insurance Research Database
[[唐氏綜合症|唐氏症]]患者可能有較高的機率出現ADHD。<ref>{{Cite journal|title = Down Syndrome and Attention-Deficit/Hyperactivity Disorder (ADHD)|url = http://jcn.sagepub.com/content/26/10/1290|journal = Journal of Child Neurology|date = 2011-10-01|issn = 0883-0738|pmid = 21628698|pages = 1290–1295|volume = 26|issue = 10|doi = 10.1177/0883073811405201|first = Sivan|last = Ekstein|first2 = Benjamin|last2 = Glick|first3 = Michal|last3 = Weill|first4 = Barrie|last4 = Kay|first5 = Itai|last5 = Berger}}</ref>
|access-date = 2017-03-17

|location = Taiwan, Republic of China.{{open access}}
=== 環境因素 <!--Environment reasons-->===
|language =

|deadurl = no
除了基因外，一些環境因子也可能是注意力不足過動症的致病因素。<ref name=cdc2016>{{citation|author=CDC|title=Attention-Deficit / Hyperactivity Disorder (ADHD)|publisher=Centers for Disease Control and Prevention|url=http://www.cdc.gov/ncbddd/adhd/research.html|date=2016-03-16|accessdate=2016-04-17}}</ref>例如：在[[懷孕]]期間攝取[[酒精]]可能導致包含類似注意力不足過動症症狀的[[胎兒酒精譜系障礙]]（fetal alcohol spectrum disorder）。暴露在特定有毒物質，例如：[[鉛]]或[[多氯聯苯]]、[[多氯聯二苯]]或[[二聯酚]]等，可能會產生類似注意力不足過動症的[[中毒]]症狀。<ref name="Burger-2011">{{cite journal |vauthors=Burger PH, Goecke TW, Fasching PA, Moll G, Heinrich H, Beckmann MW, Kornhuber J | title = [How does maternal alcohol consumption during pregnancy affect the development of attention deficit/hyperactivity syndrome in the child] | language = German | journal = Fortschr Neurol Psychiatr | volume = 79 | issue = 9 | pages = 500–506 | date = September 2011 | pmid = 21739408 | doi = 10.1055/s-0031-1273360 |type=Review}}</ref>暴露在[[磷酸酯]]（organophosphate）的[[殺蟲劑]]、[[毒死蜱|毒死蜱]]（chlorpyrifos、一種晶體[[有機磷]]殺蟲劑） 、{{le|烷基磷酸酯|Alkyl phosphate}} 或 {{tsl|en|dialkyl phosphate|二烷基磷酸酯}}中，將提高致病率，雖然此結論尚未在學界中被廣泛的認可。<ref name="de Cock-2012">{{cite journal |vauthors=de Cock M, Maas YG, van de Bor M | title = Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? Review | journal = Acta Paediatr. | volume = 101 | issue = 8 | pages = 811–818 | year = August 2012 | pmid = 22458970 | doi = 10.1111/j.1651-2227.2012.02693.x | type = Review. Research Support, Non-U.S. Gov't}}</ref>在懷孕過程中接觸到[[二手煙]]，將不利於[[胚胎]]的腦部神經[[發育]]，並將增加罹患注意力不足過動症的機率。<ref name="nimh">{{cite web |author=NIMH|title=Attention Deficit Hyperactivity Disorder (Easy-to-Read)|url=http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-easy-to-read/index.shtml|publisher=National Institute of Mental Health|year=2013|accessdate=2016-04-17}}{{dead link|date=February 2017}}</ref><ref name="Abbott-2012">{{cite journal |vauthors=Abbott LC, Winzer-Serhan UH | title = Smoking during pregnancy: lessons learned from epidemiological studies and experimental studies using animal models | journal = Crit. Rev. Toxicol. | volume = 42 | issue = 4 | pages = 279–303 | date = April 2012 | pmid = 22394313 | doi = 10.3109/10408444.2012.658506 |type = Review }}</ref>
|archiveurl = https://web.archive.org/web/20170215032736/http://nhird.nhri.org.tw/

|archivedate = 2017-02-15
新生兒嚴重[[早產]]、{{tsl|en|low birth weight|新生兒體重嚴重過輕}}、被極端疏於照料的兒童、遭受[[凌虐]]、嚴重地{{tsl|en|social deprivaton|社會剝奪|缺乏與社會的互動}}，也可能增加往後出現注意力不足過動症的機率。<ref name=nimh /><ref name="Thapar-2012">{{Cite journal | last1 = Thapar | first1 = A. | last2 = Cooper | first2 = M. |last3 = Jefferies | first3 = R. | last4 = Stergiakouli | first4 = E. | title = What causes attention deficit hyperactivity disorder? | journal = Arch Dis Child | volume = 97 | issue = 3 | pages = 260–5 |date=March 2012 | doi = 10.1136/archdischild-2011-300482 | pmid = 21903599 |type= Review. Research Support, Non-U.S. Gov't}}</ref>
}}</ref><ref name="WWW.COMMONHEALTH.COM.TW 2016 Prevalent ">{{cite web | title=注意力不足過動症ＡＤＨＤ的第三條路：心動家族 | website=[[康健雜誌]] | date=2016-10-04 | url=http://www.commonhealth.com.tw/article/article.action?nid=73700 | language=zh | access-date=2017-06-21 | quote=「台灣對這個疾病的知識不足，網路民間常流竄1-20年前過時的資料，而真正接受過此疾病診斷及整合式治療訓練的專科醫師如兒心科醫師又少之又少。」、「ADHD全世界平均盛行率為7.2%，台灣社區研究為7.5%，而台灣健保資料庫研究顯示只有2.3%接受診斷，1.6%用藥，1%的人接受足夠時間完整的治療，所以可了解有許多人求助無門因而情況日益惡化。 」 | archive-date=2020-11-25 | archive-url=https://web.archive.org/web/20201125094457/https://www.commonhealth.com.tw/article/article.action?nid=73700 | dead-url=no }}</ref>、日本<ref name="prevalence/epidemiologh rate of ADHD in Japan">{{cite web

| url=http://ezinearticles.co/?Is-Prevalence-of-ADD/ADHD-the-Same-in-the-U.S.,-Europe,-and-Japan?&id=7267426
母親在懷孕期間、兒童在出生時或成長初期遭受特定的[[感染]]都可能提高致病率。這些特定的感染包含但不限於：[[麻疹]]（measles）、 {{tsl|en|Varicella zoster virus|varicella zoster}}、 [[腦炎]]（encephalitis）、 [[風疹]]、德國麻疹或三日麻疹（rubella）、 [[EV71]]（enterovirus 71，[[腸病毒]]的一種）。<ref name="Millichap2008">{{Cite journal |author=Millichap JG |title=Etiologic classification of attention-deficit/hyperactivity disorder |journal=Pediatrics |volume=121 |issue=2 |pages=e358–65 |date=February 2008 |pmid=18245408 |doi=10.1542/peds.2007-1332|type=Review}}</ref>
| title=Is Prevalence of ADD/ADHD the Same in the U.S., Europe, and Japan?

| date=2012-09-10
曾遭受 {{tsl|en|traumatic brain injury|外傷性腦損傷}}（traumatic brain injury）{{en icon}}的兒童，其中至少30%將在往後的人生中發展出注意力不足過動症<ref name="Eme-2012">{{Cite journal | last1 = Eme | first1 = R | title = ADHD: an integration with pediatric traumatic brain injury | journal = Expert Rev Neurother | volume = 12 | issue = 4 | pages = 475–83 |date=April 2012 | doi = 10.1586/ern.12.15 | pmid = 22449218 | type= Review}}</ref>。因外力而導致腦部受損而致注意力不足過動症大約占所有注意力不足過動症所有個案的5%。<ref name=Erk2009>{{cite book |vauthors=Mayes R, Bagwell C, Erkulwater JL | title=Medicating Children: ADHD and Pediatric Mental Health | publisher=Harvard University Press | date=2009 | pages=4–24 | isbn=9780674031630 | edition=illustrated }}</ref>
| author=Domenic Greco, PhD

| access-date=2017-04-22
目前已有的證據無法支持減少食用特定食物來治療注意力不足過動症的療法<ref name=Sonu2013/>減少食用有[[人工]][[食用色素]]食品的兒童的相關研究，只有不到⅓的兒童在症狀上有改善<ref name=Sonu2013>{{cite journal |vauthors=Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J | title = Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments | journal = Am J Psychiatry | volume = 170 | issue = 3 | pages = 275–289 | date = March 2013 | pmid = 23360949 | doi = 10.1176/appi.ajp.2012.12070991 | quote= Free fatty acid supplementation and artificial food color exclusions appear to have beneficial effects on ADHD symptoms, although the effect of the former are small and those of the latter may be limited to ADHD patients with food sensitivities...}}</ref>，這方面的助益有可能只是對有[[食物過敏]]的兒童有幫助，也有可能是這些兒童同時也在接受注意力不足過動症的[[治療]]<ref name=Sonu2013/>
| archive-url=https://web.archive.org/web/20200703040407/http://ezinearticles.co/?Is-Prevalence-of-ADD%2FADHD-the-Same-in-the-U.S.%2C-Europe%2C-and-Japan%3F&id=7267426

| archive-date=2020-07-03
截至2016年，研究並不支持注意力不足過動症是因為攝取過多的精緻[[糖]]、看太多電視、[[貧窮]]或混亂、動盪不安、吵吵鬧鬧的[[家庭]]所致。然而前述的這些項目可能會惡化一些注意力不足過動症患者的注意力不足過動症[[症狀]]。<ref name=cdc2016facts>{{citation|author=CDC|title=Facts About ADHD|publisher=Centers for Disease Control and Prevention|url=http://www.cdc.gov/ncbddd/adhd/facts.html|date=2016-01-06|accessdate=2016-03-20}}</ref>
| quote=Japan reports a 7% of school-aged children have ADD/ADHD.
（詳見本條目之[[注意力不足過動症#飲食|飲食治療]]一節）
| dead-url=no

}}</ref>、韓國<ref name="Park Cho Chang Jeon 2011 pp. 378–383">
=== 可能造成類似注意力不足過動症之症狀、表現的相關疾患 ===

以下疾病可能造成類似注意力不足過動症的相關症狀表現，治療ADHD的時候，若患者亦有以下表列之疾病或問題，則可與ADHD同步治療、處置。<ref name="Art.218">{{cite journal |vauthors=Gentile JP, Atiq R, Gillig PM | title = Adult ADHD: Diagnosis, Differential Diagnosis, and Medication Management | journal = Psychiatry (Edgmont) | volume = 3 | issue = 8 | pages = 25–30 | date = August 2006 | pmid = 20963192 | pmc = 2957278 | doi = | url = }}</ref><ref name="pmid26825336">{{cite journal|last1=Ertürk|first1=E|last2=Wouters|first2=S|last3=Imeraj|first3=L|last4=Lampo|first4=A|title=Association of ADHD and Celiac Disease: What Is the Evidence? A Systematic Review of the Literature.|journal=Journal of Attention Disorders|date=2016-01-29|pmid=26825336|type=Review|quote=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.&nbsp;... 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)''|doi=10.1177/1087054715611493}}</ref><ref>{{cite web|url=http://www.tscap.org.tw/TW/ImgTscapOrg/20161013160730.pdf |title=Seasonal Digest published by Taiwanese Society of Child and Adolescent Psychiatry |format=PDF |date= |accessdate=2016-12-27}}</ref><ref name="pmid27664125"/><ref>{{cite web|url=http://care.american-rhinologic.org/septoplasty_turbinates |title=Septoplasty & Turbinate Surgery Parul Goyal, Md, Mba |publisher=Care.american-rhinologic.org |date=2015-02-17 |accessdate=2016-12-27}}</ref><ref name="books2000"/><ref>{{cite web|url=https://medlineplus.gov/hyperthyroidism.html |title=Home → Health Topics → Hyperthyroidism |publisher=Medlineplus.gov |date= |accessdate=2016-12-27}}</ref><ref name="Nielsen Benros 2016">{{cite journal | last=Nielsen | first=Philip Rising | last2=Benros | first2=Michael Eriksen | author3=S{\o | title=Associations Between Autoimmune Diseases and Attention-Deficit/Hyperactivity Disorder: A~Nationwide Study | journal=Journal of the American Academy of Child & Adolescent Psychiatry | publisher=Elsevier BV | year=2016 | url=https://doi.org/10.1016%2Fj.jaac.2016.12.010 | doi=10.1016/j.jaac.2016.12.010 | accessdate=2017-01-29|quote=Conclusion A personal history and a maternal history of autoimmune disease were associated with an increased risk of ADHD. The previously reported association between type 1 diabetes and ADHD was confirmed. In addition, specific parental autoimmune diseases were associated with ADHD in offspring.}}</ref>：
{{div col|cols=2}}
* [[甲狀腺機能亢進]]（hyperthyroidism）
* [[癲癇]]（seizure disorder）
* [[鉛中毒]]（lead toxicity）
* [[聽覺障礙]]（hearing deficits）
* [[自體免疫性疾病]]（Autoimmune disease）
:* [[1型糖尿病|第一型糖尿病]]（Type 1 Diabetes mellifluous）
:* [[乳糜瀉]]（celiac disease）
* {{le|肝病|Liver disease}}（hepatic disease）
* 不同藥品之間的{{le|藥品交互作用|Drug Interactions}}（Drug Interactions）
* [[睡眠呼吸中止症]]（sleep apnea）
* {{le|腦部缺氧|Brain Hypoxia}}（Brain Hypoxia/shortage of oxygen to the brain）
: 可能造成腦部缺氧的常見可能因素（[[過敏]]相關）：
:* [[鼻息肉]]肥厚（Enlarged nasal polyps）
:* {{le|鼻中隔彎曲|Nasal septum deviation}}（Inferior nasal turbinates/enlarged nasal turbinate/nasal turbinate hypertrophy）
:* [[氣管]]、[[支氣管]]收縮或肥厚、[[氣喘]]（asthma）
* [[頭部受傷]]（head injury）
{{div col end}}

== 病理生理學 <!--Pathophysiology--> ==

截至目前為止，注意力不足過動症被認為是肇因於部分腦內的[[神經傳導物質]]系統的損傷（特別是與[[多巴胺]]和[[正腎上腺素]]有關的神經傳導系統），進而對患者的腦部[[執行功能]]產生不良的影響。<ref name="VTA+LC projection systems">{{cite journal | vauthors = Chandler DJ, Waterhouse BD, Gao WJ | title = New perspectives on catecholaminergic regulation of executive circuits: evidence for independent modulation of prefrontal functions by midbrain dopaminergic and noradrenergic neurons | journal = Front. Neural Circuits | volume = 8 | issue = | pages = 53 | date = May 2014 | pmid = 24904299 | pmc = 4033238 | doi = 10.3389/fncir.2014.00053 | quote = }}</ref><ref name="Malenka ADHD neurosci" />多巴胺與正腎上腺素的{{tsl|en|Neural_pathway|腦內神經通道}}（neuro-pathway）大多起源自腦內的[[腹側被蓋區]]（ventral tegmental area） 和 [[藍斑核]]（locus coeruleus），並由此投射至不同的腦區且管理許多[[認知]]的流程（與認知功能相關的處理流程）。<ref name="VTA+LC projection systems"/><ref name="Malenka pathways" /> 特別是那些投射至[[前額葉]]（prefrontal cortex）和{{tsl|en|striatum|紋狀體}}（striatum）的{{tsl|en|dopaminergic pathway|腦內的多巴胺通道}}（dopaminergic pathway）和{{le|LC-NA system|norepinephrine pathway|腦內的正腎上腺素通道/藍斑核系統}}（norepinephrine pathway）。它們主要的工作就是負責調節執行功能（=認知和行為的功能與管理&nbsp;&nbsp;cognitive control of behavior）、[[動機]]、 酬賞、報償的感受能力（reward perception）、和{{tsl|en|Motor_control|運動神經的功能}}（motor function）。<ref name="VTA+LC projection systems"/><ref name="Malenka ADHD neurosci" /><ref name="Malenka pathways" />以上是目前已知在注意力不足過動症的[[病理生理學]]（Pathophysiology）中扮演主要腳色的幾條{{tsl|en|Neural_pathway|腦內神經通道}}（neuro-pathway）。對於注意力不足過動症更全面的概觀以及更多可能與之相關的腦內神經通道也已經被提議。<ref name="Malenka ADHD neurosci" /><ref name="pmid22169776">{{cite journal |vauthors=Castellanos FX, Proal E | title=Large-scale brain systems in ADHD: beyond the prefrontal-striatal model | journal=Trends Cogn. Sci. (Regul. Ed.) | volume=16 | issue=1 | pages=17–26 | date=January 2012 | pmid=22169776| pmc=3272832 | doi=10.1016/j.tics.2011.11.007 | quote=Recent conceptualizations of ADHD have taken seriously the distributed nature of neuronal processing [10,11,35,36]. Most of the candidate networks have focused on prefrontal-striatal-cerebellar circuits, although other posterior regions are also being proposed [10].}}</ref><ref name="pmid22983386">{{cite journal |vauthors=Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, Castellanos FX | title = Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies | journal = Am J Psychiatry | volume = 169 | issue = 10 | pages = 1038–1055 | date = October 2012 | pmid = 22983386 | pmc = 3879048 | doi = 10.1176/appi.ajp.2012.11101521 }}</ref>

延伸閱讀：{{tsl|en|Reward system}}、{{tsl|en|Incentive salience}}、{{tsl|en|Reward dependence}}、{{tsl|en|Brain stimulation reward}} 以了解關於大腦內回饋系統的運作機制。

{{注解|神經通道（neuro-pathway）等同 神經路徑（neuro-pathway）|註}}

{{div col end}}

=== 大腦結構 <!--Brain Structure-->===

在兒童注意力不足過動症患者中，普遍存有一些腦部結構（特別是左側的[[前額葉|前額葉 prefrontal cortex]]、{{tsl|en|後頂葉皮質|後頂葉皮質}}（posterior parietal cortex）在體積上小於平均值的現象。<ref name="Malenka ADHD neurosci" /><ref name=Krain2006>{{cite journal |vauthors=Krain AL, Castellanos FX | title = Brain development and ADHD | journal = Clin Psychol Rev | volume = 26 | issue = 4 | pages = 433–444 | date = August 2006 | pmid = 16480802 | doi = 10.1016/j.cpr.2006.01.005 }}</ref>其他諸如注意力不足過動症患者的：前額 - 紋狀體-小腦（prefrontal-striatal-cerebellar）和前額葉-紋狀體-丘腦 迴路（prefrontal-striatal-thalamic circuits）也被發現與<u>非</u>注意力不足過動症患者不同。<ref name="Malenka ADHD neurosci" /><ref name="pmid22169776" /><ref name="pmid22983386" />

=== 神經傳導物質的通道/路徑 <!--Neuro-transmitter pathway-->===

目前的研究模型包含了 {{tsl|en|mesocorticolimbic projection|中腦皮質素-多巴胺通道}}（mesocorticolimbic dopamine pathway） 及 {{tsl|en|locus coeruleus-noradrenergic system|蓝斑核-去甲腎上腺素系統}}（locus coeruleus-noradrenergic system）。<ref name="VTA+LC projection systems"/><ref name="Malenka ADHD neurosci" /><ref name="Malenka pathways" />用於治療注意力不足過動症的中樞神經興奮劑，其療效可能是起因於它增進了神經傳導物質在這些系統中的活動。<ref name="Malenka ADHD neurosci" /><ref name="Malenka pathways">{{cite book |vauthors=Malenka RC, Nestler EJ, Hyman SE |veditors=Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 9780071481274 | pages = 148, 154–157 | edition = 2nd | chapter = Chapter 6: Widely Projecting Systems: Monoamines, Acetylcholine, and Orexin | quote=DA has multiple actions in the prefrontal cortex. It promotes the "cognitive control" of behavior: the selection and successful monitoring of behavior to facilitate attainment of chosen goals. Aspects of cognitive control in which DA plays a role include working memory, the ability to hold information "on line" in order to guide actions, suppression of prepotent behaviors that compete with goal-directed actions, and control of attention and thus the ability to overcome distractions. Cognitive control is impaired in several disorders, including attention deficit hyperactivity disorder.&nbsp;... Noradrenergic projections from the LC thus interact with dopaminergic projections from the VTA to regulate cognitive control.&nbsp;... it has not been shown that 5HT makes a therapeutic contribution to treatment of ADHD.}} <br />''NOTE: DA: dopamine, LC: locus coeruleus, VTA: ventral tegmental area, 5HT: serotonin (5-hydroxytryptamine)''</ref><ref name="cognition enhancers">{{cite journal |vauthors=Bidwell LC, McClernon FJ, Kollins SH | title = Cognitive enhancers for the treatment of ADHD | journal = Pharmacol. Biochem. Behav. | volume = 99 | issue = 2 | pages = 262–274 |date=August 2011 | pmid = 21596055 | pmc = 3353150 | doi = 10.1016/j.pbb.2011.05.002 }}</ref> 注意力不足過動症患者腦部中的 {{tsl|en|serotoninergic|5-羥色胺能}}（serotoninergic，與血清素serotonin有關） 通道（=路徑=pathway）、 {{tsl|en|glutamate (neurotransmitter)|谷氨酸能}}（glutamatergic）（一種神經傳導物質）通道、 或 {{tsl|en|cholinergic|膽鹼能}}（cholinergic） 通道可能也存有一些導致注意力不足過動症症狀的原因。<ref name="cognition enhancers" /><ref name="Cortese-2012">{{cite journal | author = Cortese S | title = The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know | journal = Eur. J. Paediatr. Neurol. | volume = 16 | issue = 5 | pages = 422–433 | date = September 2012 | pmid = 22306277 | doi = 10.1016/j.ejpn.2012.01.009 }}</ref><ref name="pmid22939004">{{cite journal |vauthors=Lesch KP, Merker S, Reif A, Novak M | title = Dances with black widow spiders: dysregulation of glutamate signalling enters centre stage in ADHD | journal = Eur Neuropsychopharmacol | volume = 23 | issue = 6 | pages = 479–491 | date = June 2013 | pmid = 22939004 | doi = 10.1016/j.euroneuro.2012.07.013 }}</ref>

請參見：[[血清素]]（Serotonin）。

=== 執行功能和動機 <!--Executive function and motivation-->===

注意力不足過動症的[[症狀]]起因於某些[[執行功能]]上的缺陷，例如：[[專注力|注意力/專注力的控制]]（attentional control）、{{le|衝動-過動控制|inhibitory control}}（inhibitory control）、及 [[工作記憶]]（working memory）。<ref name="Brown-2008">{{cite journal | author = Brown TE | title = ADD/ADHD and Impaired Executive Function in Clinical Practice | journal = Curr Psychiatry Rep | volume = 10 | issue = 5 | pages = 407–411 | date = October 2008 | pmid = 18803914 | doi = 10.1007/s11920-008-0065-7}}</ref><ref name="Malenka ADHD neurosci" /><ref name="Malenka pathways" /><ref name="Executive functions">{{cite journal | author = Diamond A | title = Executive functions | journal = Annu. Rev. Psychol. | volume = 64 | issue = | pages = 135–168 | year = 2013 | pmid = 23020641 | pmc = 4084861 | doi = 10.1146/annurev-psych-113011-143750 | quote = EFs and prefrontal cortex are the first to suffer, and suffer disproportionately, if something is not right in your life. They suffer first, and most, if you are stressed (Arnsten 1998, Liston et al. 2009, Oaten & Cheng 2005), sad (Hirt et al. 2008, von Hecker & Meiser 2005), lonely (Baumeister et al. 2002, Cacioppo & Patrick 2008, Campbell et al. 2006, Tun et al. 2012), sleep deprived (Barnes et al. 2012, Huang et al. 2007), or not physically fit (Best 2010, Chaddock et al. 2011, Hillman et al. 2008). Any of these can cause you to appear to have a disorder of EFs, such as ADHD, when you do not.}}</ref>執行功能簡單來說就是一整群[[認知|認知處理過程]]的[[集合]]。而這集合必須能夠成功的幫助一個人選擇並督促自己做出得以實現他那經過深思熟慮過後的目標之行為。<ref name="Brown-2008"/><ref name="Malenka pathways" /><ref name="Executive functions" />注意力不足過動症患者先天的執行功能損傷造成以下這些症狀：難以維持有規劃的、有組織性的（problems with staying organized）、缺乏時間觀念（time keeping）、過度的[[拖延]]（excessive procrastination）、難以保持專注（maintaining concentration）、難以把注意力放對地方（paying attention）、難以忽略與任務不相干的外務/誘惑（ignoring distractions）、情緒管理的困難（regulating emotions）、難以把細節記起來（remembering details）。<ref name="Brown-2008"/><ref name="Malenka ADHD neurosci" /><ref name="Malenka pathways" />注意力不足過動症患者在[[長期記憶]]的表現可看出注意力不足過動症患者的長期記憶是沒有損傷的。注意力不足過動症患者在提取長期記憶時所產生的困難顯然是肇因於工作記憶（=短期記憶）的受損<ref name="Brown-2008"/><ref name="pmid24232170">{{cite journal | vauthors = Skodzik T, Holling H, Pedersen A | title = Long-Term Memory Performance in Adult ADHD: A Meta-Analysis | journal = J. Atten. Disord. | volume = | issue = | pages = | date = November 2013 | pmid = 24232170 | doi = 10.1177/1087054713510561 | url = }}</ref>。<!-- 大約有30%~50%的ADHD患者符合執行功能缺乏的門檻標準。<ref name="Brown-2008"/><ref name="pmid24232170"/> The criteria for an executive function deficit are met in&nbsp;30–50% of children and adolescents with ADHD.<ref name="pmid20406332">{{cite journal |vauthors=Lambek R, Tannock R, Dalsgaard S, Trillingsgaard A, Damm D, Thomsen PH | title = Validating neuropsychological subtypes of ADHD: how do children with and without an executive function deficit differ? | journal = J Child Psychol Psychiatry | volume = 51 | issue = 8 | pages = 895–904 | date = August 2010 | pmid = 20406332 | doi = 10.1111/j.1469-7610.2010.02248.x }}</ref> --> <!-- 一篇論文發現，80%的ADHD患者至少有一個執行功能的受損，高於非ADHD患者的50%。One study found that&nbsp;80% of individuals with ADHD were impaired in at least one executive function task, compared to&nbsp;50% for individuals without ADHD.<ref name="Nigg-2005">{{cite journal |vauthors=Nigg JT, Willcutt EG, Doyle AE, Sonuga-Barke EJ | title = Causal heterogeneity in attention-deficit/hyperactivity disorder: do we need neuropsychologically impaired subtypes? | journal = Biol. Psychiatry | volume = 57 | issue = 11 | pages = 1224–1230 | date = June 2005 | pmid = 15949992 | doi = 10.1016/j.biopsych.2004.08.025 }}</ref> -->

端視一個注意力不足過動症患者其腦部發展的程度與其所在環境對其執行功能要求的程度的比例，因此有些注意力不足過動症患者可能直到青少年時期甚至是成年初期才開始顯露出注意力不足過動症的症狀。<ref name="Brown-2008"/>

注意力不足過動症與在兒童青少年時期缺乏動機相關。兒童青少年注意力不足過動症患者會發現自己比起眼前立即的回饋/酬賞/滿足更難以專注在長遠的目標/回報/回饋/酬賞/滿足，並展現出對於眼前立即的回饋/酬賞/滿足的衝動言行。<ref name="Motivation">{{cite journal | vauthors = Modesto-Lowe V, Chaplin M, Soovajian V, Meyer A | title = Are motivation deficits underestimated in patients with ADHD? A review of the literature | journal = Postgrad Med | volume = 125 | issue = 4 | pages = 47–52 | year = 2013 | pmid = 23933893 | doi = 10.3810/pgm.2013.07.2677 | quote = 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.&nbsp;... 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.}}</ref>
{{noteTA
| 1 = 程序性記憶=>zh-cn:程序性記憶; 程序性記憶=>zh-hk:程序性記憶; 程序性記憶=>zh-tw:程序性記憶;
}}

延伸閱讀：[[記憶]]、[[感覺記憶]]、[[短期記憶]]、[[陳述性記憶]]、[[程序性記憶|程序性記憶（Procedural Memory）]]、[[外顯記憶]]、[[情節記憶]]

== 治疗 <!--Treatment/management--> ==

* 目前可用于治疗注意力不足過動症患者的数种方案包括各种医药治疗、[[行为治療]]、以及[[教育]]疗法。
* 台灣兒童青少年精神醫學會理事長、國立臺灣大學醫學院附設醫院-基因醫學部、精神醫學部主任高淑芬強調及早發現並接受治療，絕對是最佳策略。<ref name="找回專注力"/><ref name="Collaboration"/>
* 本身也是注意力不足過動症患者的哈洛威爾醫師則建議治療的策略應把握發揚優點、避免缺點的原則。<ref name="books2000"/>
* 藥物治療合併[[行為治療]]（{{le|應用行為分析|Applied behavior analysis}}）已證實為當前最有效的注意力不足過動症治療方式。<ref name="Tc_ADHD" /><ref name="ChanFogler2016_findings">{{cite journal|last1=Chan|first1=Eugenia|last2=Fogler|first2=Jason M.|last3=Hammerness|first3=Paul G.|title=Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents|journal=JAMA|volume=315|issue=18|year=2016|pages=1997|issn=0098-7484|doi=10.1001/jama.2016.5453 |quote=Findings Sixteen randomized clinical trials and 1 meta-analysis, involving 2668 participants, of pharmacological and psychosocial treatments for ADHD in adolescents aged 12 years to 18 years were included. Evidence of efficacy was stronger for the extended-release methylphenidate and amphetamine class stimulant medications (level 1B based on Oxford Centre for Evidence-Based Medicine criteria) and atomoxetine than for the extended-release α2-adrenergic agonists guanfacine or clonidine (no studies). For the primary efficacy measure of total symptom score on the ADHD Rating Scale (score range, 0 [least symptomatic] to 54 [most symptomatic]), both stimulant and nonstimulant medications led to clinically significant reductions of 14.93 to 24.60 absolute points. The psychosocial treatments combining behavioral, cognitive behavioral, and skills training techniques demonstrated small- to medium-sized improvements (range for mean SD difference in Cohen d, 0.30-0.69) for parent-rated ADHD symptoms, co-occurring emotional or behavioral symptoms, and interpersonal functioning. Psychosocial treatments were associated with more robust (Cohen d range, 0.51-5.15) improvements in academic and organizational skills, such as homework completion and planner use.}}</ref><ref name="ChanFogler2016">{{cite journal|last1=Chan|first1=Eugenia|last2=Fogler|first2=Jason M.|last3=Hammerness|first3=Paul G.|title=Treatment of Attention-Deficit/Hyperactivity Disorder in Adolescents|journal=JAMA|volume=315|issue=18|year=2016|pages=1997|issn=0098-7484|doi=10.1001/jama.2016.5453 |quote=Conclusions and Relevance Evidence supports the use of extended-release methylphenidate and amphetamine formulations, atomoxetine, and extended-release guanfacine to improve symptoms of ADHD in adolescents. Psychosocial treatments incorporating behavior contingency management, motivational enhancement, and academic, organizational, and social skills training techniques were associated with inconsistent effects on ADHD symptoms and greater benefit for academic and organizational skills. Additional treatment studies in adolescents, including combined pharmacological and psychosocial treatments, are needed..}}</ref><ref name="auto"/><ref name="tscap1">{{cite web|author=TSCAP |url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=8&hidNewsID=121 |title=20160728公聽會-台灣兒童青少年精神醫學會新聞稿 |publisher=Tscap.org.tw |date= |accessdate=2016-12-27}}</ref><ref name="Yen"/><ref name="tscap2">{{cite web|author=TSCAP |url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=8&hidNewsID=117 |title=臺灣兒童青少年精神醫學會新聞稿20160603 |publisher=Tscap.org.tw |date= |accessdate=2016-12-27}}</ref><ref>{{cite web|author=TSCAP |url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=8&hidNewsID=104 |title=新聞稿20160412-回應質疑注意力不足過動症之診斷、藥物治療等議題 |publisher=Tscap.org.tw |date= |accessdate=2016-12-27}}</ref><ref name="tscap2"/>
* 對於那些難以著眼於長遠報酬（報償、酬賞）的注意力不足過動症患者（傾向著眼於眼前立即回饋的注意力不足過動症患者），大量且持續的正向激勵可以增進患者的任務表現。注意力不足過動症的用藥亦有相同的功效。<ref name="Malenka ADHD neurosci">{{cite book |vauthors=Malenka RC, Nestler EJ, Hyman SE |veditors=Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 9780071481274 | pages = 266, 315, 318–323 | edition = 2nd | chapter = Chapters 10 and 13 | quote = 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.}}</ref><ref name="VTA+LC projection systems"/>

=== 医药治疗 ===

==== 中樞神經刺激劑 ====

治療注意力不足過動症的第一线药物（first-line medication）为[[中樞神經]]兴奋剂（又名為[[興奮劑|中樞神經刺激劑]]），其中包括：

{| class="wikitable sortable"
|-
! 藥廠 !! 藥物名 !! 藥物（主成分/有效成分）學名 !! 作用時間 !! 生效時間 !! 備註
|-
| [[诺华公司]]（Novartis） || [[利他能]]（Ritalin） || [[哌甲酯]]（methylphenidate） || 短：3.5小時左右 || 約服用後30分鐘 || N/A
|-
| {{tsl|en|Shire (pharmaceutical company)|沙尔公司}}（Shire） || {{tsl|en|Adderall|Adderall}} || 右旋苯丙胺（{{tsl|en|dextroamphetamine|dextroamphetamine}}）和（{{tsl|en|Levoamphetamine|Levoamphetamine}}） || N/A || N/A || 為[[安非他命]]产品（在台灣尚未批准為醫藥之用）
|-
| Ovation制药公司 || [[Desoxyn]] || [[甲基苯丙胺]]（methamphetamine） || N/A || N/A || 為安非他命产品（在台灣尚未批准為醫藥之用）
|-
| [[诺华公司]]（Novartis） || [[利他能LA]] || 哌甲酯（methylphenidate） || 中：8小時左右 || 約服用後30分鐘 || 藥物之半衰期（合格療效之作用期）介於Ritalin與Concerta之間
|-
| 楊森大藥廠（Janssen-Cilag） || 專思達/專注達 Concerta || 哌甲酯（methylphenidate） || 長：12小時左右 || 約服用後30分鐘 || 台灣譯作專思達，有18MG、27MG、36MG、54MG等數種劑量。中國大陸翻譯為專注達。
|}
<ref>{{cite web
| url =https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/ritalin_la.pdf
| title =Label of Ritalin LA
| date =Mid 2015
| website = Novartis.com
| publisher =Novartis
| access-date =January, 2017.}}</ref>
<ref>
{{cite web
| url =http://www.concerta.net/pdfs/Prescribing_Info-short.pdf
| title =Label of Concerta
| date =2013
| website = concerta.net
| publisher =Jassen Cilag
| access-date =January, 2017.}}</ref>
<ref name="找回專注力"/>

雖中樞神經興奮劑藥效約於服用後半小時左右開始，並不表示症狀會在服用後半小時就消失，如同其他疾病的治療一樣，病情的改善需要一定（段）時間的持續治療（時間長度因人而異）。藥物（包含：中樞神經興奮劑、非中樞神經興奮劑、......）會在這些患者的背後推他們一把，助他們一臂之力。然而，即便如此，患者本身仍需認真努力地改變自己。藥物是注意力不足過動症整體治療的其中一環。<ref name="找回專注力"/><ref name="books2000" /><ref>{{cite web|url=http://www.concerta.net/contact-us.html|title=CONCERTA® - Contact Us|author=|date=|publisher=Janssen Cilag|access-date=January, 2017.}}</ref><ref name="auto"/>

根據世界反運動禁藥組織（World Anti-Doping Agency），中樞[[神經]]興奮劑在未事先申請醫療許可及 非醫療所需服用都將視同違規行為。<ref>{{cite web|url=https://wada-main-prod.s3.amazonaws.com/resources/files/2016-09-29_-_wada_prohibited_list_2017_eng_final.pdf |title=THE PROHIBITED LIST Updated annually, the List identifies the substances and methods prohibited to athletes in- and out-of-competition |publisher=Wada-main-prod.s3.amazonaws.com |date= |accessdate=2016-12-27}}</ref>

部分用來治療注意力不足過動症的藥品（例如：[[興奮劑|中樞神經興奮劑]] Psycho-stimulant/stimulant）在美国食品藥物管理局划分为二级[[管制藥品]]（Schedule II，即指有滥用可能性的药品），在台灣則列為第三級管制藥品，以防濫用。<ref name="medlineplus1">{{cite web|url=https://medlineplus.gov/attentiondeficithyperactivitydisorder.html |title=Home of MedlinePlus→ Health Topics → Attention Deficit Hyperactivity Disorder Attention Deficit Hyperactivity Disorder Also called: ADHD |publisher=Medlineplus.gov |date= |accessdate=2016-12-27}}</ref><ref name="Taiwan_FDA_on_controlled_medications">{{cite web|url=http://www.fda.gov.tw/TC/site.aspx?sid=41 |title=衛生福利部-食品藥物管理署-管制藥品 |publisher=Fda.gov.tw |date=2013-12-30 |accessdate=2016-12-27}}</ref><ref name="Taiwan_FDA_on_controlled_medications_2">{{cite web|url=http://www.fda.gov.tw/TC/siteList.aspx?sid=50 |title=衛生福利部-食品藥物管理署-管制藥品的管理 |publisher=Fda.gov.tw |date= |accessdate=2016-12-27}}</ref><ref name="NIDAAAS" />

所有用來治療注意力不足過動症的藥物只要依照醫師指示用藥，都是相當安全的。<ref name="medlineplus1"/><ref name="NIDAAAS">{{cite web|url=https://www.drugabuse.gov/publications/drugfacts/stimulant-adhd-medications-methylphenidate-amphetamines|title=Stimulant ADHD Medications: Methylphenidate and Amphetamines|first=National Institute on Drug|last=Abuse|date=|publisher=}}</ref><ref name="NIDAAAS"/><ref name="NHS">{{cite web|url=http://www.nhs.uk/chq/Pages/1391.aspx?CategoryID=73|title=What is a controlled medicine (drug)? - Health questions - NHS Choices|first=N. H. S.|last=Choices|date=2016-12-12|publisher=}}</ref>
而藥物成分為哌甲酯（methylphenidate）的興奮劑，例如：利他能與專思達，可能導致：頭痛、胃痛、喪失食慾、失眠、因相對專注而變得冷淡（面無表情）等副作用，因此6歲以下的兒童不適宜服用。（副作用產生與否因人而異）
<ref>{{cite web
| title = Methylphenidate
| url = https://medlineplus.gov/druginfo/meds/a682188.html
| website = Home of MedlinePlus → Drugs, Herbs and Supplements → Methylphenidate Methylphenidate pronounced as (meth'' il fen' i date)
| date = 2016-02-15
| access-date = February twenty seventh, 2017}}</ref>
隨著時間推進與各方的努力，中樞神經興奮劑的相關副作用已可藉由包括但不限於劑量調整、服藥時間、飯前飯後服用、服藥頻率等服藥模式之改變以及改變藥物組合等方式獲得相當程度的減少。<ref name="Science_daily">{{cite web
| url =https://www.sciencedaily.com/releases/2016/08/160801093232.htm
| title =Combining medications could offer better results for ADHD patients
| archive-url =https://www.elsevier.com/about/press-releases/research-and-journals/Combining-Medications-Could-Offer-Better-Results-for-ADHD-Patients
| archive-date =August 2016
| date =2016-08-01
| website =Science News
| publisher =Elsevier
| access-date =January 2017
| quote = "Three studies to be published in the August 2016 issue of the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) report that combining two standard medications could lead to greater clinical improvements for children with attention-deficit/hyperactivity disorder (ADHD) than either ADHD therapy alone.", August, 2016}} </ref>
<ref>{{cite book
| title = Adults with ADHD
| publisher = NATIONAL LIBRARY OF MEDICINE at the NATIONAL INSTITUTES OF HEALTH
| series = MedlinePlus the Magazine
| volume =9
| ISSN= 1937-4712
| date = Spring 2014
| location =8600 Rockville Pike • Bethesda, MD 20894, United States of America
| pages =19
| language = en-us
| url =https://medlineplus.gov/magazine/issues/spring14/articles/spring14pg19.html}}</ref>
<ref>{{cite web
| url =https://medlineplus.gov/ency/article/001551.htm
| title =Attention deficit hyperactivity disorder
| date = 2016-05-25
| website = Home → Medical Encyclopedia → Attention deficit hyperactivity disorder
| publisher =NATIONAL LIBRARY OF MEDICINE at the NATIONAL INSTITUTES OF HEALTH
| access-date =February twenty seventh, 2017.}}</ref>
<ref name="NIDAAAS" />
<ref>
{{cite web
| url =http://www.ninds.nih.gov/disorders/adhd/adhd.htm
| title =All Disorders
| website = National Institute of Neurological Disorders and Stroke
| access-date = February twenty seventh, 2017
| quote = }}</ref>

{| style="margin: 0 auto;" | [[File:Ritalin LA exterior、outward appearance、藥罐外觀.jpg|left|thumb|upright=0.55|[[利他能]]LA（Ritalin LA）藥罐外觀]]
| [[File:Dextroamphetamine.jpg|center|thumb|upright=0.8|{{tsl|en|dextroamphetamine|Dextroamphetamine}}]]
| [[File:Lilly Strattera 60mg Capsule.jpg|center|thumb|upright=0.9|[[禮來公司]][[思銳]]60毫克膠囊（Lilly Strattera 60mg Capsule）]]
| [[File:Strattera atomoxetin.jpg|center|thumb|upright=1.3|[[思銳]]（Strattera）外盒]]
|}

{|
| [[File:Ritalin-SR-20mg-1000x1000.jpg|center|thumb|160px|[[利他能]]Ritalin（樣式A）]]
| [[File:Methylphenidate Concerta.jpg|center|thumb|[[Methylphenidate|專思達]]Concerta；數字"18" 表示18毫克]]
| [[File:Methylphenidat und andere Tabletten.jpg|center|thumb|upright=0.75|黃色為18mg專思達；白色為利他能（樣式B）]]
| [[File:Ritalin.jpg|center|thumb|upright=1.2|[[利他能]]10毫克藥丸(10 mg tablets)|alt=A picture of a Ritalin packet]]
|}
註釋：mg = milli-gram = 毫克。

==== 非中樞神經刺激劑 ====

數種非中樞神經刺激劑，例如：[[阿托莫西汀|阿托莫西汀（atomoxetine）]]、[[Clonidine|可樂定（clonidine）]]、[[bupropion|安非他酮（bupropion）]]和{{tsl|en|guanfacine}}，可與中樞神經刺激劑一起使用'''或'''作為中樞神經刺激劑的替代方案。<ref name=CNS09>{{cite journal
|author=Wigal SB
|title=Efficacy and safety limitations of attention-deficit hyperactivity disorder pharmacotherapy in children and adults |journal=CNS Drugs|volume=23 Suppl 1 |pages=21–31 |year=2009 |pmid=19621975 |doi=10.2165/00023210-200923000-00004 |url=}}</ref><ref name="Cochrane Amphetamines ADHD">{{cite journal |vauthors=Castells X, Ramos-Quiroga JA, Bosch R, Nogueira M, Casas M |title=Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults |journal=Cochrane Database Syst. Rev. |volume= |issue=6 |pages=CD007813 |year=2011 |pmid=21678370 |doi=10.1002/14651858.CD007813.pub2 |url= |editor=Castells X}}</ref><ref>{{Cite journal|last=Childress|first=A. C.|last2=Sallee|first2=F. R.|date=2012|title=Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder|journal=Drugs of Today (Barcelona, Spain: 1998)|volume=48|issue=3|pages=207–217|doi=10.1358/dot.2012.48.3.1750904|issn=1699-3993|pmid=22462040|quote=There are a number of non-stimulant medications, such as [[atomoxetine]], [[bupropion]], guanfacine, and [[clonidine]] that may be used as alternatives, or added to stimulant therapy.}}</ref>

[[禮來公司]]（Eli Lilly）的[[思銳]]（Strattera），有效成份為阿托莫西汀（atomoxetine）<ref name="Strattera label"/>，與中樞神經興奮劑同樣為治療ADHD的<u>第一線藥物</u>。思銳為非[[中樞神經]]刺激藥物（<u>非</u>興奮劑），且歸類於[[配體 (生物化學)#選擇性與非選擇性|選擇性]][[去甲腎上腺素再回收抑制劑|正腎上腺素再回收抑制劑]]{{efn|英文名：SNRI, Selective Norepinephrine Reuptake Inhibitor}}。思銳有六種劑量型，分別為：18MG、25MG、40MG、60MG、80MG和100MG<ref name="Strattera label"/>。思銳的副作用相較於中樞神經興奮劑來得輕微許多。思銳主要的副作用有：<!-- 胃腸不適、食慾不振、 -->疲倦<!-- 、情緒變化 -->、口乾（唾液分泌減少）等<ref name="Strattera label"/>。（副作用產生與否因人而異）<ref name="Strattera label">{{cite web|url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=309de576-c318-404a-bc15-660c2b1876fb|title=DailyMed - STRATTERA- atomoxetine hydrochloride capsule STRATTERA- atomoxetine hydrochloride|author=|date=June 2015|publisher=Eli Lilly | website=DailyMed.com}}</ref>患者如果對中樞神經興奮劑沒有反應、反應不佳或過敏，可考慮使用阿托莫西汀。患者可向醫生詢問，共同制定一個漸進的劑量法。

{| class="wikitable"
|+ 思銳（Strattera）仿單上的建議劑量<ref name="Strattera label"/>
|-
! 體重 !! 每天服用的起始劑量（Initial Daily Dose）!! 總計每天服用的目標劑量（Target Total Daily Dose） !! 總計每天服用劑量的上限（Maximum Total Daily Dose）
|-
| 年齡小於18歲且體重小於70公斤 || 0.5 毫克/每公斤（mg/Kg） || 1.2 毫克/每公斤（mg/Kg） || 1.4 毫克/每公斤（mg/Kg）
|-
| 年齡大於或等於18歲或年齡小於18歲且體重大於70公斤 || 40 毫克/天（mg/day） || 80 毫克/天（mg/day） || 100 毫克/天（mg/day）
|}

* 備註：1、藥品之仿單猶如藥品之說明書。2、建議劑量與種族無關。<ref name="Strattera label" />3、特定族群的服用劑量應低於建議劑量（詳見：[[阿托莫西汀#劑量]]）4、總計每天服用劑量的上限 = 無論分幾次服用，一天之內最多可攝取的劑量。5、每天的起始劑量應服用至少三天，使身體適應後，才可開始服用每天的目標劑量。<ref name="Strattera label"/> 6、若每天目標劑量效果不符預期，則可逐漸增加劑量至每天服用劑量的上限<ref name="Strattera label_2">

{{cite web
| url = https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=309de576-c318-404a-bc15-660c2b1876fb&type=pdf&name=309de576-c318-404a-bc15-660c2b1876fb
| title = Label of Strattera consisting of atomoxetine
| date = June 2015
| website = DailyMed.gov
| publisher =Eli Lilly Company
| access-date = February 2017
| quote =DOSAGE AND ADMINISTRATION 2.1 Acute Treatment Dosing of children and adolescents up to 70 kg body weight — STRATTERA should be initiated at a total daily dose of approximately 0.5 mg/kg and increased after a minimum of 3 days to a target total daily dose of approximately 1.2 mg/kg administered either as a single daily dose in the morning or as evenly divided doses in the morning and late afternoon/early evening. No additional benefit has been demonstrated for doses higher than 1.2 mg/kg/day [see Clinical Studies (14)]. 'The total daily dose in children and adolescents should not exceed 1.4 mg/kg or 100 mg, whichever is less'. Dosing of children and adolescents over 70 kg body weight and adults — STRATTERA should be initiated at a total daily dose of 40 mg and increased after a minimum of 3 days to a target total daily dose of approximately 80 mg administered either as a single daily dose in the morning or as evenly divided doses in the morning and late afternoon/early evening. 'After 2 to 4 additional weeks, the dose may be increased to a maximum of 100 mg in patients who have not achieved an optimal response'. There are no data that support increased effectiveness at higher doses [see Clinical Studies (14)]. The maximum recommended total daily dose in children and adolescents over 70 kg and adults is 100 mg. }}。</ref>

臨床測試顯示，思銳（Strattera）可提供24小時對於ADHD症狀的改善。思銳從第一天服用開始約需持續服用28~56天（4~8週）才會完全生效。然而患者或患者周遭的人在這期間便可能逐漸感受到藥效
<ref>[http://www.namihelps.org/assets/PDFs/fact-sheets/Medications/Strattera.pdf How long does Strattera take to work?_Minnesota_National_Alliance_of_Mental_Illness]</ref>
<ref name="How long for Strattera to start working"> {{cite web
| url =http://www.namihelps.org/assets/PDFs/fact-sheets/Medications/Strattera.pdf
| title= How long for Strattera to start working?
| website =Minnesota_National_Alliance_of_Mental_Illness
| access-date = February 2017
| archive-date=2017-02-27
| archive-url=http://www.namihelps.org/assets/PDFs/fact-sheets/Medications/Strattera.pdf}}</ref>
<ref name="How long does Strattera take to work?"> {{cite web
| url =http://www.strattera.com/parent/faqs.html
| title =Frequently Asked Questions
| date =September 2016
| website =Official website for Strattera
| publisher =Strattera-Eli Lilly
| access-date = February 2017
| quote =Strattera works gradually, so improvements are seen over time. When your child starts treatment with Strattera, it's important to set some small goals. Remember to be patient—some people notice small changes within 2 weeks, and by 4 to 6 weeks at target dose you should see significant improvement in your child's symptoms. }}</ref>。

縱然阿托莫西汀與中樞神經興奮劑同樣為治療ADHD的<u>第一線藥物</u>，然而其對特定症狀改善的程度可能與中樞神經興奮劑不同（兩類藥物各有其長處）。阿托莫西汀在改善過動-衝動的症狀上，略優於派甲酯；派甲酯則在改善分心的症狀上，略優於阿托莫西汀。<ref>{{Cite journal
| author = Chi-Yung Shang, Yi-Lei Pan, Hsiang-Yuan Lin, Lin-Wan Huang & Susan Shur-Fen Gau
| title = An Open-Label, Randomized Trial of Methylphenidate and Atomoxetine Treatment in Children with Attention-Deficit/Hyperactivity Disorder
| journal = Journal of child and adolescent psychopharmacology
| volume = 25
| issue = 7
| pages = 566–573
| date = September 2015
| doi = 10.1089/cap.2015.0035
| pmid = 26222447
| quote = At week 24, mean changes in ADHD-RS-IV Inattention scores were 13.58 points (Cohen's d, -3.08) for OROS-methylphenidate and 12.65 points (Cohen's d, -3.05) for atomoxetine; and mean changes in ADHD-RS-IV Hyperactivity-Impulsivity scores were 10.16 points (Cohen's d, -1.75) for OROS-methylphenidate and 10.68 points (Cohen's d, -1.87) for atomoxetine.
}}</ref><ref>{{cite web
| archive-url =https://www.mohw.gov.tw/MOHW_Upload/doc/心理衛生專輯/03注意力不足過動症.pdf
| archive-date=June 2015
| title =中華民國衛生福利部/心理衛生專輯/03注意力不足過動症.pdf
| date = June 2015
| website = http://www.mohw.gov.tw/
| publisher = 中華民國衛生福利部
| access-date = February 2017
| quote = 一般發現其對於專注度的改善沒有 MPH 明顯
| url=https://www.mohw.gov.tw/MOHW_Upload/doc/心理衛生專輯/03注意力不足過動症.pdf}} </ref><ref>{{Citation
| last =
| first =
| author-link =蔣丙煌
| last2 =
| first2 =
| author2-link =陳快樂
| author3-link=國立臺灣大學醫學院附設醫院精神醫學部
| author4=張雍敏、鄭淑心、賴淑玲、傅悅娟、張景瑞、侯育銘、郭約瑟、張君威、鄧惠文、陳嘉新、紀雪雲、黃雅文、連玉如、連盈如、吳其炘
| author5=高淑芬&陳劭芊
| title =注意力不足過動症
| place =中華民國衛生福利部/心理衛生專輯/03注意力不足過動症.pdf
| publisher =中華民國衛生福利部
| series =中華民國衛生福利部/心理衛生專輯
| volume =1
| orig-year =June 2015
| year =
| month=
| edition =1
| chapter =3
| chapter-url =
| page =22
| pages =
| language =Chinese Traditional, 繁體中文
| url =https://www.mohw.gov.tw/MOHW_Upload/doc/心理衛生專輯/03注意力不足過動症.pdf
| archive-url =https://www.mohw.gov.tw/MOHW_Upload/doc/心理衛生專輯/03注意力不足過動症.pdf
| archive-date =June 2015
| doi =
| id =
| isbn =9789860454154
| mr =
| zbl =
| jfm =
| quote=atomoxetine，用在病情 較為複雜、或是無法忍受MPH副作用的患者，然而一般發現其對於專注度的改善沒有MPH明顯}}</ref>

而阿托莫西汀（atomoxetine）與哌甲酯（methylphenidate）併服的處方尚未經[[美國食品藥物管理局]]核可，但醫師會視個案的情況（如：共病、預後、......）以開{{tsl|en|off-label use|仿單標示外使用}}（off-label use）的方式處方之。<ref>{{cite web
| archive-url =https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Child-Adolescent-Psychiatry/adhd-parents-medication-guide.pdf
| archive-date=July 2013
| url= https://www.psychiatry.org/patients-families/adhd/what-is-adhd
| title =Parent's Medication Guide: ADHD
| date = July 2013
| website = American Psychiatric Association
| publisher = American Psychiatric Association & American Academy of Child and Adolescent Psychiatry (AACAP)
| access-date = January 2017
| quote = Though not FDA-approved for combined treatment, atomoxetine (Strattera) is sometimes used in conjunction with stimulants as an off-label combination therapy.}} </ref><ref>{{cite web
| url= https://medlineplus.gov/ency/article/001551.htm
| title =Medical Encyclopedia → Attention deficit hyperactivity disorder
| date = 2017-01-05
| website = MedlinePlus.gov
| access-date = January 2017
| quote = Medicine combined with behavioral treatment often works best. Different ADHD medicines can be used alone or combined with each other. The doctor will decide which medicine is right, based on the person's symptoms and needs.}} </ref><ref name="pmid23560600">{{cite journal
| author=Treuer T, Gau SS, Méndez L, Montgomery W, Monk JA, Altin M et al.
| title=A systematic review of combination therapy with stimulants and atomoxetine for attention-deficit/hyperactivity disorder, including patient characteristics, treatment strategies, effectiveness, and tolerability.
| journal=J Child Adolesc Psychopharmacol
| year= 2013
| volume= 23
| issue= 3
| pages= 179-93
| pmid=23560600
| doi=10.1089/cap.2012.0093
| pmc=3696926
| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23560600
|quote=Existing evidence suggests, but does not confirm, that this drug combination may benefit some, but not all, patients who have tried several ADHD medications without success. }} </ref><ref name="pmid26364896">{{cite journal
| author=Perugi G, Vannucchi G| title=The use of stimulants and atomoxetine in adults with comorbid ADHD and bipolar disorder.
| journal=Expert Opin Pharmacother
| year= 2015
| volume= 16
| issue= 14
| pages= 2193-204
| pmid=26364896
| doi=10.1517/14656566.2015.1079620
| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26364896
|quote=Although systematic trials on the use of stimulants and ATX in ADHD-BD comorbidity in adulthood are necessary, both treatments should be considered possible options to be carefully evaluated once the patient has been stabilized.}} </ref>在臨床試驗中{{efn|clinical trial}}，並未發現兩者併服後產生加乘的心血管副作用。換言之，兩者併服之心血管副作用，與單獨服用哌甲酯所產生的心血管副作用相同。<ref name="Strattera label_3">{{cite web
| url = https://dailymed.nlm.nih.gov/dailymed/getFile.cfm?setid=309de576-c318-404a-bc15-660c2b1876fb&type=pdf&name=309de576-c318-404a-bc15-660c2b1876fb
| title = Label of Strattera consisting of atomoxetine
| date = June 2015
| website = DailyMed.gov
| publisher =Eli Lilly Company
| access-date = February 2017
| quote =7.7 Methylphenidate\ Coadministration of methylphenidate with STRATTERA did not increase cardiovascular effects beyond those seen with methylphenidate alone. }}</ref>

[[可樂定]]（clonidine）與{{tsl|en|guanfacine|胍法新}}（guanfacine）皆為非中樞神經興奮劑、{{tsl|en| alpha-2 adrenergic receptor|alpha-2 腎上腺素受體}}刺激劑/促進劑/活化劑 的一員；與哌甲酯（methylphenidate）併用或單獨服用都有顯著療效，其中兩藥物併服：可樂定（clonidine）或胍法新（guanfacine）與哌甲酯（methylphenidate）或安非他命合併使用的療效優於單獨服用任意一者。{{efn|延伸閱讀：[[腎上腺素受體]]}}
<ref name="Science_daily"/>
<ref>{{cite web
| archive-url =https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Professional-Topics/Child-Adolescent-Psychiatry/adhd-parents-medication-guide.pdf
| archive-date=July 2013
| url= https://www.psychiatry.org/patients-families/adhd/what-is-adhd
| title =Parent's Medication Guide: ADHD
| date = July 2013
| website = American Psychiatric Association
| publisher = American Psychiatric Association & American Academy of Child and Adolescent Psychiatry (AACAP)
| access-date = January 2017
| quote = Extended release guanfacine (Intuniv) and extended release clonidine (Kapvay) are approved to be added to stimulant treatment when the stimulant doesn’t fully reduce the ADHD symptoms.}} </ref>
<ref name="pmid27453081">{{cite journal
| author=Loo SK, Bilder RM, Cho AL, Sturm A, Cowen J, Walshaw P et al.
| title=Effects of d-Methylphenidate, Guanfacine, and Their Combination on Electroencephalogram Resting State Spectral Power in Attention-Deficit/Hyperactivity Disorder.
| journal=J Am Acad Child Adolesc Psychiatry
| year= 2016
| volume= 55
| issue= 8
| pages= 674-682.e1
| pmid=27453081
| doi=10.1016/j.jaac.2016.04.020
| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27453081 }} </ref>
<ref name="pmid27453079">{{cite journal
| author=McCracken JT, McGough JJ, Loo SK, Levitt J, Del'Homme M, Cowen J et al.
| title=Combined Stimulant and Guanfacine Administration in Attention-Deficit/Hyperactivity Disorder: A Controlled, Comparative Study.
| journal=J Am Acad Child Adolesc Psychiatry
| year= 2016
| volume= 55
| issue= 8
| pages= 657-666.e1
| pmid=27453079
| doi=10.1016/j.jaac.2016.05.015
| pmc=4976782
| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27453079 }} </ref>
<ref name="pmid27453080">{{cite journal
| author=Bilder RM, Loo SK, McGough JJ, Whelan F, Hellemann G, Sugar C et al.
| title=Cognitive Effects of Stimulant, Guanfacine, and Combined Treatment in Child and Adolescent Attention-Deficit/Hyperactivity Disorder.
| journal=J Am Acad Child Adolesc Psychiatry
| year= 2016
| volume= 55
| issue= 8
| pages= 667-73
| pmid=27453080
| doi=10.1016/j.jaac.2016.05.016
| pmc=4964604
| url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27453080 }} </ref>
<ref>{{cite web
| url =https://www.sciencedaily.com/releases/2016/08/160801093232.htm
| title =Combining medications could offer better results for ADHD patients
| archive-url =https://www.elsevier.com/about/press-releases/research-and-journals/Combining-Medications-Could-Offer-Better-Results-for-ADHD-Patients
| archive-date =August 2016
| date =2016-08-01
| website =Science News
| publisher =Elsevier
| access-date =January 2017
| quote = Summary:Three studies report that combining two standard medications could lead to greater clinical improvements for children with attention-deficit/hyperactivity disorder (ADHD) than either ADHD therapy alone. At present, studies show that the use of several ADHD medications result in significant reductions in ADHD symptoms. However, so far there is no conclusive evidence that these standard drug treatments also improve long-term academic, social, and clinical outcomes.}} </ref>

註釋：美國食品藥物管理局已證明數起曾因為併服：可樂定（clonidine）或 胍法新（guanfacine）和 哌甲酯（methylphenidate）或 安非他命（amphetamine）而致命的個案群與四种药物本身並無關聯。<ref>{{cite web
| url=http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/PediatricAdvisoryCommittee/UCM317388.pdf
| title =Death with the concomitant use of clonidine or guanfacine and amphetamine／dextroamphetamine or dexmethylphenidate or dextroamphetamine or lisdexamfetamine or methylphenidate.
| date = 2010-07-06
| website = American Psychiatric Association
| publisher = Department of Health and Human Services & Public Health Service & Food and Drug Administration & Center for Drug Evaluation and Research & Office of Surveillance and Epidemiology
| access-date = January 2017}} </ref>

{| class="wikitable"
|-
! 藥品學名 !! 藥物類別（屬性） !! 備註
|-
| atomoxetine || [[配體 (生物化學)#選擇性與非選擇性|選擇性]]正腎上腺素[[再回收抑制劑]]（Selective Norepinephrine Reuptake Inhibitor）、非中樞神經興奮劑（非興奮劑） || <div style="text-align: center;"> - </div>
|-
| clonidine || alpha <sub>2</sub> 腎上腺素受體[[激動劑|刺激劑/促進劑/激動劑/激活劑/活化劑]]（Alpha <sub>2</sub> adrenergic receptors agonist）、非中樞神經興奮劑（非興奮劑） || <div style="text-align: center;">-</div>
|-
| guanfacine || alpha <sub>2</sub> 腎上腺素受體刺激劑/促進劑/激動劑/激活劑/活化劑（Alpha <sub>2</sub> adrenergic receptors agonist）、非中樞神經興奮劑（非興奮劑） || 尚未引進台灣
|}

[[選擇性血清素再回收抑制劑]]（SSRI, Selective Serotonin Reuptake Inhibitor）、選擇性[[5-羥色胺和去甲腎上腺素再攝取抑制劑|血清素及正腎上腺素再回收抑制劑]]（SSNRI, Selective Serotonin and Norepinephrine Reuptake Inhibitor）、......等俗稱[[抗憂鬱劑]]的介入可能對於某些個案病情的改善亦有幫助。<ref>
{{cite journal
|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910994/
|title=Duloxetine May Improve Some Symptoms of Attention-Deficit/Hyperactivity Disorder
|first=Helmut
|last=Niederhofer
|date=2010-01-01
|publisher=
|journal=Prim Care Companion J Clin Psychiatry
|volume=12
|issue=2
|via=PubMed Central
|doi=10.4088/PCC.09l00807pin
|pmid=20694126
|pmc=2910994}}</ref>
<ref name="Wilens-2010">{{cite journal
|vauthors=Wilens TE, Spencer TJ
| title = Understanding attention-deficit/hyperactivity disorder from childhood to adulthood
| journal = Postgrad Med
| volume = 122
| issue = 5
| pages = 97–109
| date = September 2010
| pmid = 20861593
| pmc = 3724232
| doi = 10.3810/pgm.2010.09.2206 }}</ref>

[[安非他酮]]（[[國際非專利藥品名稱]]：{{lang|en|Bupropion}}{{efn|舊名：amfebutamone}}是{{tsl|en|Nicotinic antagonist|菸鹼拮抗劑}}（Nicotinic antagonist）和較微弱的[[去甲腎上腺素-多巴胺再吸收抑制劑]]（NDRI,&nbsp;norepinephrine–dopamine reuptake inhibitor）;一种主要作为抗抑郁药{{efn|即為抗憂鬱藥}}和戒烟药使用的[[药物]]、也可用作治療注意力不足過動症的第二線藥品（second-line medication）與[[中樞神經刺激劑]]合併使用，或作為中樞神經刺激劑的替代方案。<ref name="MortonMorton1999">{{cite book
| name-list-format = vanc
|author1=Dr. Ian Morton
|author2=I.K. Morton
|author3=Judith M. Hall
|title=Concise Dictionary of Pharmacological Agents: Properties and Synonyms
|url=http://books.google.com/books?id=mqaOMOtk61IC&pg=PA57
|date=1999-10-31|publisher=Springer Science & Business Media
|isbn=978-0-7514-0499-9|pages=57–}}</ref>
<ref>{{cite book | name-list-format = vanc
|title=Dictionary of Organic Compounds
|url=http://books.google.com/books?id=w5dpoQRjGNEC&pg=PA104
|publisher=CRC Press
|isbn=978-0-412-54090-5
|pages=104–}}</ref>
<ref>{{cite book
| name-list-format = vanc
|title=Index Nominum 2000: International Drug Directory
|url=http://books.google.com/books?id=5GpcTQD_L2oC&pg=PA38
|date=January 2000
|publisher=Taylor & Francis
|isbn=978-3-88763-075-1
|pages=38–}}</ref>
<ref name=CNS09/>
<ref>{{Cite journal
|last=Childress
|first=A. C.
|last2=Sallee
|first2=F. R.
|date=2012
|title=Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder
|journal=Drugs of Today (Barcelona, Spain: 1998)
|volume=48
|issue=3
|pages=207–217
|doi=10.1358/dot.2012.48.3.1750904
|issn=1699-3993
|pmid=22462040}}</ref>

一般來說，以藥物治療ADHD的效果相當顯著。
<ref name="Yen">{{cite web
|url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=1&hidNewsID=118
|title=孩子和家長接受專業醫療協助的權利，是需要被維護的
|author=顏正芳
|date= 2016/05
|access-date=February 27th, 2017.
|archive-date=February 27th, 2017.
|archive-url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=1&hidNewsID=118
|publisher=台灣兒童青少年精神醫學會 Taiwanese Society of Child and Adolescent Psychiatry}}</ref
><ref name="ChanFogler2016_findings"/>
<ref name="ChanFogler2016"/>
使用此類藥品的患者，長期治療的預後，超過八成以上可以改善其注意力不集中、衝動與人際衝突的症狀。而且患者的社會性互動及人際關係也都會有改善。<ref name="ChanFogler2016_findings"/><ref name="ChanFogler2016"/>

近年來，多項國際大型研究表明適當的注意力不足過動症藥物治療可以減少意外傷害的機會、降低頭部外傷的風險並且減少物質使用和濫用的機率{{efn|機率即為或然率 Probability}}。<ref name="tscap1" /><ref name="NIDAAAS" /><ref name="ChangLichtenstein2014">{{cite journal|last1=Chang
|first1=Zheng
|last2=Lichtenstein
|first2=Paul
|last3=Halldner
|first3=Linda
|last4=D'Onofrio
|first4=Brian
|last5=Serlachius
|first5=Eva
|last6=Fazel
|first6=Seena
|last7=Långström
|first7=Niklas
|last8=Larsson
|first8=Henrik
|title=Stimulant ADHD medication and risk for substance abuse|journal=Journal of Child Psychology and Psychiatry
|volume=55
|issue=8
|year=2014
|pages=878–885
|issn=00219630
|doi=10.1111/jcpp.12164
|quote=Results_ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57–0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse.}}</ref>
<ref name="ChangLichtenstein2014_2">{{cite journal
|last1=Chang
|first1=Zheng
|last2=Lichtenstein
|first2=Paul
|last3=Halldner
|first3=Linda
|last4=D'Onofrio
|first4=Brian
|last5=Serlachius
|first5=Eva
|last6=Fazel
|first6=Seena
|last7=Långström
|first7=Niklas
|last8=Larsson
|first8=Henrik
|title=Stimulant ADHD medication and risk for substance abuse|journal=Journal of Child Psychology and Psychiatry
|volume=55
|issue=8
|year=2014
|pages=878–885
|issn=00219630
|doi=10.1111/jcpp.12164
|quote=Conclusions：We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients.}}</ref>
<ref>{{Cite journal
| author = Soren Dalsgaard, James F. Leckman, Preben Bo Mortensen, Helena Skyt Nielsen & Marianne Simonsen
| title = Effect of drugs on the risk of injuries in children with attention deficit hyperactivity disorder: a prospective cohort study
| journal = The lancet. Psychiatry
| volume = 2
| issue = 8
| pages = 702–709
| date = August 2015
| doi = 10.1016/S2215-0366(15)00271-0
| pmid = 26249301
|quote=INTERPRETATION: Children with ADHD had an increased risk of injuries compared with other children. Treatment with ADHD drugs reduced the risk of injuries by up to 43% and emergency ward visits by up to 45% in children with ADHD. Taken together with previous findings of accidents being the most common cause of death in individuals with ADHD, these results are of major public health importance.
}}</ref><ref>{{Cite journal
| author = Rafael Mikolajczyk, Johannes Horn, Niklas Schmedt, Ingo Langner, Christina Lindemann & Edeltraut Garbe
| title = Injury prevention by medication among children with attention-deficit/hyperactivity disorder: a case-only study
| journal = JAMA pediatrics
| volume = 169
| issue = 4
| pages = 391–395
| date = April 2015
| doi = 10.1001/jamapediatrics.2014.3275
| pmid = 25686215
|quote = CONCLUSIONS AND RELEVANCE: No significant risk reduction for hospitalizations with injury diagnoses was observed during periods of ADHD medication, but there was a preventive effect on the risk of brain injuries (34% risk reduction). The effects were controlled for time-invariant characteristics of the patients by the study design.
}}</ref>

雖然治療注意力不足過動症的藥物如同多數藥物一樣，合理使用下，造成內臟器官受損的機率非常低，仍建議用藥者應定期追蹤自己的腦血管、心臟血管功能、肝腎功能、血液及[[生命徵象]]（Vital signs）等。

<span style="background:#ffc;">簡言之，治療ADHD核心症狀時，藥物是絕對不能忽略的治療選項。<ref name="tscap1" /></span>
<gallery mode="packed-hover" heights="180"> File:Concerta_54mg_OROS.png|''[[Methylphenidate|專思達]]''54毫克
File:Concerta OROS overcoat.gif|專思達長效推進機制
File:Concerta OROS diagram.png|專思達持續釋放(長效)推進機制(OROS)Concerta OROS Diagram
</gallery>
<gallery mode="packed-hover" heights="180">
File:Amph salts.jpg|''{{tsl|en|Adderall|Adderall}}''
File:Adderall 20mg capsules.JPG|Adderall長效膠囊(Capsule)
File:Front appearance of Concerta's container 專思（注）達的藥罐外觀.jpg|thumb|專思（注）達的藥罐外觀
File:Controlled med warning in Republic of China aka Taiwan 中華民國管制藥品標籤.jpg|中華民國管制藥品標籤（圖為專思達藥罐背面）
File:Ritalin LA exterior、outward appearance、藥罐外觀.jpg|[[利他能]]LA（Ritalin LA）藥罐外觀]]
</gallery>
註釋：XR為Extended Release的縮寫，持續釋放之意，表示長效型。<ref>{{cite web|url=https://en.wikipedia.org/zhwiki/w/index.php?title=Adderall&oldid=762441313|title=Adderall|author=|date=2017-01-28|publisher=|via=Wikipedia}}</ref>

=== 行為治療 ===

'''行為治療'''被認為是對注意力不足過動症孩子進行行為介入具有實證性效果的方法。透過系統化的行為分析，了解孩子犯錯的模式，並且配合後果增強與削弱的方法，以及教導他正確的行為模式，例如：懂得等待、輪流等觀念，減少他衝動、過動而引起的人際衝突。

對於那些學齡前且僅有些微注意力不足過動症症狀的孩童，已建議行為治療為治療該族群的第一線療法。<ref>
{{cite journal
| vauthors=Fabiano GA, Pelham WE, Coles EK, Gnagy EM, Chronis-Tuscano A, O'Connor BC
| date=March 2009.
| title= "A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder".
| journal=Clincal Psychology Rev.
| volume=29
|issue=2
|page= 129–140.
|doi=10.1016/j.cpr.2008.11.001
|PMID=19131150
|type=systematic review}}</ref>
<ref>
{{Cite journal
| vauthors=Fabiano GA, Pelham WE, Coles EK, Gnagy EM, Chronis-Tuscano A, O'Connor BC
| title=A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder
| journal=Clin Psychol Rev
| volume=29
| issue=2
| pages=129–140
| date=March 2009
| pmid=19131150
| doi=10.1016/j.cpr.2008.11.001|type=systematic review }}</ref>
<ref name=Clinics09>
{{cite journal
{{cite journal
| last=Park
|vauthors=Kratochvil CJ, Vaughan BS, Barker A, Corr L, Wheeler A, Madaan V
| first=Subin | last2=Cho | first2=Maeng Je | last3=Chang | first3=Sung Man | last4=Jeon | first4=Hong Jin | last5=Cho | first5=Seong-Jin | last6=Kim | first6=Byung-Soo | last7=Bae | first7=Jae Nam | last8=Wang | first8=Hee-Ryung | last9=Ahn | first9=Joon Ho | last10=Hong | first10=Jin Pyo | title=Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: Results of the Korean epidemiologic catchment area study | journal=Psychiatry Research | publisher=Elsevier BV | volume=186 | issue=2-3 | year=2011 | pages=378–383 | url=https://doi.org/10.1016%2Fj.psychres.2010.07.047 | doi=10.1016/j.psychres.2010.07.047 | accessdate=2017-04-21|quote=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).}}</ref>、越南<ref name="Pham Nguyen Tran 2015 pp. 856–859">{{cite journal | last=Pham | first=Hoai Danh | last2=Nguyen | first2=Huu Bao Han | last3=Tran | first3=Diep Tuan | title=Prevalence of ADHD in primary school children in Vinh Long, Vietnam | journal=Pediatrics international : official journal of the Japan Pediatric Society | publisher=Wiley | volume=57 | issue=5 | date=2015-08-19 | issn=1328-8067 | pmid=25864909 | doi=10.1111/ped.12656 | pages=856–859}}</ref>、中國大陸<ref name="Prevalence of ADHD among children and adolescents in China">
| title=Review of pediatric attention deficit/hyperactivity disorder for the general psychiatrist
{{citejournal
| journal=Psychiatr. Clin. North Am.
|last1=Wang
| volume=32
|first1=Tingting
| issue=1
|last2=Liu
| pages=39–56
|first2=Kaihua
| date=March 2009
|last3=Li
| pmid=19248915
|first3=Zhanzhan
| doi=10.1016/j.psc.2008.10.001 }}</ref>
|last4=Xu
<ref name="Guidelines_May_Have_Helped_Curb_ADHD_Diagnoses_in_Preschoolers_2">
|first4=Yang
{{cite web
|last5=Liu
| url =https://medlineplus.gov/news/fullstory_162041.html
|first5=Yuan
| title =Guidelines May Have Helped Curb ADHD Diagnoses in Preschoolers
|last6=Shi
| date =Tuesday, November 15, 2016
|first6=Wenpei
| website =MedlinePlus.gov
|last7=Chen
| publisher =HealthDay|type=tertiary source
|first7=Lizhang
| access-date =January 2017
|title=Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis |type=systematic review, meta-analysis (secondary source)
| archive-url=http://consumer.healthday.com/kids-health-information-23/attention-deficit-disorder-adhd-news-50/guidelines-may-have-helped-curb-adhd-diagnoses-in-preschoolers-716849.html
|journal=BMC Psychiatry
| archive-date=February twenty first, 2017.
|volume=17
| quote =The guidelines, issued by the American Academy of Pediatrics (AAP), called for a standardized approach to diagnosis, and recommended behavior therapy -- not drugs -- as the first-line therapy for preschoolers.}} </ref><!-- &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;行為方面的治療包含：{{le|心理教育|Psychoeducation}}（psycho-educational input）、 [[行為治療]]（behavioral therapy）、[[認知行為治療]]（cognitive behavioral therapy, CBT）、{{le|人際關係訓練|Interpersonal psychotherapy}}（interpersonal psychotherapy）、{{le|家庭治療|Family therapy}}（也稱家族治療，family therapy）、學校資源介入（School-based interventions）、{{le|社交技巧|Social skills}}訓練（social skills training）、運用同儕的行為干預（behavioral peer intervention）、生活管理能力與技巧的培養（organization training）<ref name=Evans2014>{{cite journal|last1=Evans|first1=SW|last2=Owens|first2=JS|last3=Bunford|first3=N|title=Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder.|journal=Journal of Clinical Child and Adolescent Psychology|date=2014|volume=43|issue=4|pages=527–51|pmid=24245813|doi=10.1080/15374416.2013.850700}}</ref>、針對注意力不足過動症患者之{{le|父母管理訓練|Parent management training|父母的教育訓練}}（parent management training）<ref name="pmid19715181">{{cite journal |vauthors=Arns M, de Ridder S, Strehl U, Breteler M, Coenen A | title = Efficacy of neurofeedback treatment in ADHD: the effects on inattention, impulsivity and hyperactivity: a meta-analysis | journal = Clin EEG Neurosci | volume = 40 | issue = 3 | pages = 180–189 | date = July 2009 | pmid = 19715181 | doi=10.1177/155005940904000311}}</ref>、{{le|生理（神經、腦波）回饋|Neurofeedback}}（neuro-feedback）和{{le|行為改正|Behavior modification}}（behavior modification）<ref>{{cite journal|last1=Hodgson|first1=K|last2=Hutchinson|first2=AD|last3=Denson|first3=L|title=Nonpharmacological treatments for ADHD: a meta-analytic review.|journal=Journal of Attention Disorders|date=May 2014|volume=18|issue=4|pages=275–82|pmid=22647288|doi=10.1177/1087054712444732}}</ref> --> <!-- Citations incorporated. Thus, do not delete it without notification in advance. =) -->
行為方面的治療包含：[[File:Walking Together.pdf|thumb|upright=1.1|alt=勇於對鏡自視♥|家族治療：環境的支持有利於注意力不足過動症的治療<ref>{{cite web|url=https://en.wikipedia.org/zhwiki/w/index.php?title=Family_therapy&oldid=757232236|title=Family therapy|author=|date=2016-12-29|publisher=|via=Wikipedia}}</ref>]]

{| class="wikitable sortable"
|-
!中文名 !! 英文名
|-
| {{le|心理教育|Psychoeducation}} || psycho-educational input
|-
| [[行為治療]] || behavioral therapy
|-
| [[認知行為治療]] || cognitive behavioral therapy, CBT
|-
| {{le|人際關係訓練|Interpersonal psychotherapy}} || interpersonal psychotherapy
|-
| {{le|家庭治療|Family therapy}}（也稱：家族治療） || Family therapy
|-
| 學校資源介入 || School-based interventions
|-
| {{le|社交技巧|Social skills}}訓練 || social skills training
|-
| 運用同儕的行為干預 || behavioral peer intervention
|-
| 生活管理能力與技巧的培養 || organization training
|-
| 針對注意力不足過動症患者之{{le|父母管理訓練|Parent management training|父母的教育訓練}} || parent management training
|-
| {{le|生理（神經、腦波）回饋|Neurofeedback}} || neuro-feedback
|-
| {{le|行為改正|Behavior modification}} || Behavior modification
|}

&nbsp;目前對於精神疾患的治療方式是基於生物-心理-社會模式，良好的精神治療模式必須結合生物醫學、心理治療，以及社會復健計畫。

例如：精神分裂症患者在疾病急性發作住院期間，給予藥物協助緩解正性症狀。病房中也會由專業人員，例如：精神科醫師、精神科護理師、臨床心理師、諮商心理師、[[職能治療師]]、精神科社工師等，帶領[[團體治療]]，或者給予個別治療。而在急性症狀緩解後，患者、家屬和醫療團隊一同討論[[復健]]計畫，例如到復健病房、日間留院或者工作坊，透過復健計畫，有效增加病識感（患者對於自身以及自身疾病的認識程度）、學習獨立生活能力、改善家庭與社會關係。

=== 運動 ===

規律的運動，特別是[[有氧運動]]，也證實為一個有效的{{tsl|en|add-on treatment|附加療法}}{{efn|即表示可附加在現有具備科學實證且能在[[統計學]]上達到顯著意義之有效改善症狀的醫學療法。}}（即表示可附加在現有具備科學實證且能在[[統計學]]上達到顯著意義之有效改善症狀的醫學療法）。<ref name="springer1">
{{cite journal
|url=http://link.springer.com/article/10.1007/s00702-016-1593-7
|title=Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review |type=systematic review-secondary source
|first1=Anne E. Den
|last1=Heijer
|first2=Yvonne
|last2=Groen
|first3=Lara
|last3=Tucha
|first4=Anselm B. M.
|last4=Fuermaier
|first5=Janneke
|last5=Koerts
|first6=Klaus W.
|last6=Lange
|first7=Johannes
|last7=Thome
|first8=Oliver
|last8=Tucha
|date=2016-07-11
|publisher=
|journal=Journal of Neural Transm
|volume=124
|issue=1
|issue=1
|year=2017
|pages=3–26
|issn=1471-244X
|via=link.springer.com
|doi=10.1186/s12888-016-1187-9}}</ref>、[[港澳]]<ref name="prevalence/epidemiology rate of ADHD in Hong Kong, China">{{cite web
|doi=10.1007/s00702-016-1593-7
|url = http://www.edb.gov.hk/attachment/tc/edu-system/special/support/wsa/secondary/24b.pdf
|pmid=27400928}}</ref><ref name="找回專注力"/><ref name="wiley1">
|title = Child with Attention Deficit/Hyperactivity Disorder (ADHD) 認識注意力不足 /過度活躍症
{{cite journal
|publisher = 中華人民共和國香港特別行政區政府教育局 The government of Hong Kong Special Administrative Region of People's Republic of China.
|url=http://onlinelibrary.wiley.com/doi/10.1111/apa.12628/abstract
|access-date = 2017-04-22
|title=Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters
|author = 陳國齡
|first1=Carolin Friederike
|deadurl = no
|last1=Kamp
|archiveurl = https://web.archive.org/web/20170329044502/http://www.edb.gov.hk/attachment/tc/edu-system/special/support/wsa/secondary/24b.pdf
|first2=Billy
|archivedate = 2017-03-29
|last2=Sperlich
}}</ref><ref name="Davis Lao 2013 pp. 269–277">{{cite journal | last=Davis | first=J. Mark | last2=Lao | first2=Ian Leong | title=Comparison of the Level and Prevalence of ADHD Symptoms in Macao (China) and U.S. University Students | journal=International Journal of School & Educational Psychology | publisher=Informa UK Limited | volume=1 | issue=4 | year=2013 | pages=269–277 | url=https://doi.org/10.1080%2F21683603.2013.804469 | doi=10.1080/21683603.2013.804469 | accessdate=2017-04-21}}</ref>等地的未成年之ADHD流行率均介於6-8%之間。
|first3=Hans-Christer
|last3=Holmberg
|date=2014-07-01
|publisher=
|journal=Acta Paediatr
|volume=103
|issue=7
|pages=709–714
|via=Wiley Online Library
|doi=10.1111/apa.12628}}</ref><ref name="autogenerated4">
{{cite journal|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257065/
|title=Protection from genetic diathesis in ADHD: Possible complementary roles of exercise
|first1=Anna-Sophie
|last1=Rommel
|first2=Jeffrey M.
|last2=Halperin
|first3=Jonathan
|last3=Mill
|first4=Philip
|last4=Asherson
|first5=Jonna
|last5=Kuntsi
|date=2017-02-16
|publisher=
|journal=Journal of American Academy of Child and Adolescent Psychiatry
|volume=52
|issue=9
|pages=900–910
|via=PubMed Central
|doi=10.1016/j.jaac.2013.05.018
|pmid=23972692
|pmc=4257065}}</ref><ref name="books2000"/><ref name="分心也有好成績"/><ref name="ADHD exercise 2016 SystRev">
{{cite journal
| vauthors = Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O
| title = Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review |type=systematic literature review: secondary source
| journal = J. Neural. Transm. (Vienna)
| volume =
| issue =
| pages =
| date = July 2016
| pmid = 27400928
| doi = 10.1007/s00702-016-1593-7
| url = http://link.springer.com/article/10.1007%2Fs00702-016-1593-7
| quote = Beneficial chronic effects of cardio exercise were found on various functions as well, including executive functions, attention and behavior.}}</ref><ref name="ADHD Exercise 2014">
{{cite journal
| vauthors = Kamp CF, Sperlich B, Holmberg HC
| title = Exercise reduces the symptoms of attention-deficit/hyperactivity disorder and improves social behaviour, motor skills, strength and neuropsychological parameters
| journal = Acta Paediatry.
|volume = 103
| issue = 7
| pages = 709–714
| date = July 2014
| pmid = 24612421
| doi = 10.1111/apa.12628
| quote = We may conclude that all different types of exercise&nbsp;... 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
|url = http://onlinelibrary.wiley.com/doi/10.1111/apa.12628/epdf
| accessdate = 2015-03-14 }}</ref><ref name="ADHD Exercise 2013">
{{cite journal
| vauthors = Rommel AS, Halperin JM, Mill J, Asherson P, Kuntsi J
| title = Protection from genetic diathesis in attention-deficit/hyperactivity disorder: possible complementary roles of exercise
| journal = Journal of American Academy of Child and Adolescent Psychiatry
| volume = 52
| issue = 9
| pages = 900–910
| date = September 2013
| pmid = 23972692
| pmc = 4257065
| doi = 10.1016/j.jaac.2013.05.018
| quote = The findings from these studies provide some support for the notion that exercise has the potential to act as a protective factor for ADHD.}}</ref>


英國和美國的ADHD診斷率和治療率自1970年代起逐年增加至今<ref name=CDCTime2013/>。學界的共識認為這個現象是因為診斷方法的變遷<ref name=CDCTime2013/>以及人們逐漸願意利用藥物來治療ADHD所致<ref name=Cowen2012/>，並非ADHD的流行率真的增加了。<ref name="Polanczyk"/><ref name=NICE2008>{{cite web|url=http://www.nice.org.uk/nicemedia/pdf/CG72FullGuideline.pdf|format=PDF|title=CG72 Attention deficit hyperactivity disorder (ADHD): full guideline|publisher=NHS|author=National Institute for Health and Clinical Excellence|authorlink=National Institute for Health and Clinical Excellence|date=2008-09-24|accessdate=2018-12-26|archive-date=2014-02-25|archive-url=https://web.archive.org/web/20140225061250/http://www.nice.org.uk/nicemedia/pdf/CG72FullGuideline.pdf|dead-url=no}}</ref>
長期規律的運動合併正規治療，將有更樂觀的預後（治療效果）-較好的行為以及運動協調性、大腦執行功能的提升（包含大腦認知領域中的：注意力、衝動克制力、和計畫組織的能力。）、更快速的資訊處理速度、和更棒的記憶力。<ref name="springer1"/><ref name="wiley1"/><ref name="autogenerated4"/><ref name="books2000"/><ref name="找回專注力"/><ref name="分心也有好成績">{{cite web|url=http://www.books.com.tw/products/0010348843 |title=Edward M. Hallowell, M.D. & John J. Ratey, M.D.著，丁凡譯，《分心也有好成績》， 台北：遠流出版社，2006 |publisher=Books.com.tw |isbn=9573259311 |date= |accessdate=2016-12-09}}</ref><br/>


學界共識認為，2013年起，DSM的版本從DSM&nbsp;4TR 推進到 DSM&nbsp;5 會使得ADHD的診斷數增加（特別是成人注意力不足過動症的診斷數）
請詳見[[運動與大腦神經元的關聯]]
<ref>{{cite journal|last=Dalsgaard|first=S|title=Attention-deficit/hyperactivity disorder (ADHD).|journal=European child & adolescent psychiatry|date=2013-02|volume=22 Suppl 1|pages=S43-8|pmid=23202886|doi=10.1007/s00787-012-0360-z}}</ref>。


=== 飲食 ===
== 歷史 ==
{{main article2|{{tsl|en|History of ADHD|「注意力不足/過動症」的歷史由來}}}}
[[File:CDCHisGraph.png|thumb|upright=1.8|關於ADHD治療、診斷標準及流行率的時間軸 {{英文}}]]


1798年時蘇格蘭醫師{{tsl|en|Alexander Crichton|亞歷山大·克里奇頓}}在其著作《對精神紊亂的性質和起源的探究》（An inquiry into the nature and origin of mental derangement）中提到了精神不安<ref>{{cite journal |date=2001-05 |title=An early description of ADHD (inattentive subtype): Dr Alexander Crichton and 'Mental restlessness' (1798) |volume=6 |issue=2 |pages=66–73 |journal=Child and Adolescent Mental Health |doi=10.1111/1475-3588.00324 |vauthors=Palmer ED, Finger S }}</ref><ref>{{cite book |author=Crichton A |title=An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects |url=https://books.google.com/books/about/An_inquiry_into_the_nature_and_origin_of.html?id=OMAtAAAAYAAJ |year=1798 |publisher=AMS Press |location=United Kingdom |isbn=9780404082123 |page=271 |accessdate=2014-01-17 |archive-date=2020-12-22 |archive-url=https://web.archive.org/web/20201222194217/https://books.google.com/books/about/An_inquiry_into_the_nature_and_origin_of.html?id=OMAtAAAAYAAJ |dead-url=no }}</ref>，1902年，英國兒科醫生{{tsl|en|George Frederic Still|George Still}}首次描述一項與注意力不足過動症近似的病徵<ref>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)</ref><ref name=CDCTime2013>{{cite web|title=ADHD Throughout the Years|url=http://www.cdc.gov/ncbddd/adhd/documents/timeline.pdf|publisher=Center For Disease Control and Prevention|accessdate=2013-08-02|deadurl=no|archiveurl=https://web.archive.org/web/20130807202545/http://www.cdc.gov/ncbddd/adhd/documents/timeline.pdf|archivedate=2013-08-07}}</ref>。
[[健康]]及均衡的[[飲食]]有助於病情的改善。[[維生素]]（例如：[[維他命B|維他命B群]]、[[維他命C]]等）對於改善病情的功效，有待更多的實驗證明。即便如此，適度補充[[水溶性]]的維生素是合理的。


不同的時期，描述注意力不足過動症的名詞也有所不同：在1952年的DSM-I稱為微細腦功能失常，在1968年的DSM-II則稱為兒童活动亢进，在1980年的DSM-III稱為注意力不足症（可能伴隨過動，也可能沒有）英文為 attention-deficit disorder (ADD) with or without hyperactivity<ref name=CDCTime2013/>，在1987年的DSM-III-R更名為注意力不足過動症，在1994年的DSM-IV將注意力不足過動症分為{{tsl|en|Attention deficit hyperactivity disorder predominantly inattentive|注意力散渙主導型的注意力不足過動症|注意力散渙主導型}}、活動量過多型以及混合型<ref name=Millichap_2010_chap1>{{cite book |last=Millichap |first=J. Gordon |title=Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD |chapter-url=https://books.google.com/books?id=KAlq0CDcbaoC&pg=PA2 |edition=2nd |date=2010 |publisher=Springer Science |isbn=978-1-4419-1396-8 |doi=10.1007/978-104419-1397-5 |lccn=2009938108 |pages=2–3 |chapter=Chapter 1: Definition and History of ADHD |deadurl=no |archiveurl=https://web.archive.org/web/20201222194145/https://books.google.com/books?id=KAlq0CDcbaoC&pg=PA2 |archivedate=2020-12-22 |access-date=2021-02-06 }}</ref>，在2013年的DSM-5仍延用此一分類<ref name=DSM5>{{cite book | author=American Psychiatric Association | title=Diagnostic and Statistical Manual of Mental Disorders | year=2013 | publisher=American Psychiatric Publishing | location=Arlington | isbn=0890425558 | pages=59–65 | edition=5th}}</ref>。其他的名詞有在1930年代使用的微細腦創傷<ref>{{cite book| author=Weiss M| title=ADHD in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment| year=2010| publisher=JHU Press| isbn=9781421401317| url=https://books.google.com/books?id=bcyI7dvawzMC&pg=PT72| accessdate=2014-01-17| deadurl=no| archiveurl=https://web.archive.org/web/20200906052127/https://books.google.com/books?id=bcyI7dvawzMC&pg=PT72| archivedate=2020-09-06}}</ref>，但因為不少病童都沒有發覺有受過任何創傷，因此後來改名為微細腦功能失常。
飲食的調整可能對少部份的ADHD兒童有幫助<ref name="pmid22176942">{{cite journal |vauthors=Nigg JT, Lewis K, Edinger T, Falk M | title = Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives | journal = J Am Acad Child Adolesc Psychiatry | volume = 51 | issue = 1 | pages = 86–97 | year = January 2012 | pmid = 22176942 | doi = 10.1016/j.jaac.2011.10.015 }}</ref>，一份2013年的[[統合分析]]針對有ADHD症狀，而且有補充{{le|游離脂肪酸|free fatty acid}}或是減少食用有人工色素食品的兒童的相關研究，只有不到1/3的兒童在症狀上有改善<ref name=Sonu2013/>，這方面的助益有可能只是對有食物敏感的兒童有幫助，也有可能是這些兒童同時也在接受ADHD的治療<ref name=Sonu2013/>，這些評論也發現目前已有的證據無法支持減少食用特定食物來治療ADHD的療法<ref name=Sonu2013/>。2014年的評論也發現{{le|排除饮食|elimination diet}}在ADHD上的成效有限<ref name=NiggHolton2014>{{cite journal|vauthors=Nigg JT, Holton K|title=Restriction and elimination diets in ADHD treatment|journal=Child Adolesc Psychiatr Clin N Am|volume=23|issue=4|pages=937–53|date=Oct 2014|pmid=25220094|pmc=4322780|doi=10.1016/j.chc.2014.05.010|type=Review|quote=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.}}</ref>，另一個2016年的評論不鼓勵用[[无麸质饮食]]作為主要治療ADHD的方式<ref name="pmid26825336" />。


1937年時，[[興奮劑|神經刺激劑]]開始用在注意力不足過動症的治療<ref>{{Cite journal|vauthors=Patrick KS, Straughn AB, Perkins JS, González MA |title=Evolution of stimulants to treat ADHD: transdermal methylphenidate |journal=Human Psychopharmacology |volume=24 |issue=1 |pages=1–17 |date=2009-02 |pmid=19051222 |pmc=2629554 |doi=10.1002/hup.992}}</ref>。1934年時美國許可將[[安非他命]]用在注意力不足過動症治療，是美國第一個許可的苯丙胺類藥物<ref name="Benzedrine">{{cite journal | author=Rasmussen N | title=Making the first anti-depressant: amphetamine in American medicine, 1929–1950 | journal=J . Hist. Med. Allied Sci. | volume=61 | issue=3 | pages=288–323 |date=2006-07 | pmid=16492800 | doi=10.1093/jhmas/jrj039}}</ref>，1950年代開始使用[[哌甲酯]]（商品名稱為利他能），1970年代則開始使用[[对映异构]]的[[右旋苯丙胺]]<ref name=CDCTime2013/>。
鐵、鎂及碘等礦物質的攝取也可以改善ADHD的症狀<ref name="pmid22928358">{{cite journal |vauthors=Konikowska K, Regulska-Ilow B, Rózańska D |title=The influence of components of diet on the symptoms of ADHD in children |journal=Rocz Panstw Zakl Hig|volume=63 |issue=2 |pages=127–134 |year=2012 |pmid=22928358 }}</ref>，有一些證據指出身體組織內的[[鋅]]成份過低和其ADHD症狀有關<ref name="pmid16190793">{{cite journal |vauthors=Arnold LE, DiSilvestro RA|title=Zinc in attention-deficit/hyperactivity disorder|journal=Journal of child and adolescent psychopharmacology|volume=15|issue=4|pages=619–27|year=2005|pmid=16190793|doi=10.1089/cap.2005.15.619}}</ref>，不過一般不建議用補充鋅礦物質的方式來治療ADHD，只有在有{{le|鋅缺乏|zinc deficiency}}的地區（幾乎只會在[[開發中國家]]）才建議補充鋅礦物質<ref name=pmid25220092>{{cite journal|last1=Bloch|first1=MH|last2=Mulqueen|first2=J|title=Nutritional supplements for the treatment of ADHD.|journal=Child and adolescent psychiatric clinics of North America|date=October 2014|volume=23|issue=4|pages=883–97|pmid=25220092|doi=10.1016/j.chc.2014.05.002}}</ref>。不過若鋅礦物質和[[苯丙胺]]類藥物同時使用的話，會減低苯丙胺藥物的最小[[有效劑量]]，也就是可以服用較少的藥物而達到相同的效果<ref name="Zinc binding sites + ADHD review">{{cite journal | vauthors = Krause J | title = SPECT and PET of the dopamine transporter in attention-deficit/hyperactivity disorder | journal = Expert Rev. Neurother. | volume = 8 | issue = 4 | pages = 611–625 | date = April 2008 | pmid = 18416663 | doi = 10.1586/14737175.8.4.611 | quote = Zinc binds at&nbsp;... 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.}}</ref>。另有證據指出[[ω-3脂肪酸|Omega3-脂肪酸]]能提供對於病情些許的改善，不過不建議用Omega3-脂肪酸來取代醫學治療<ref name="pmid21961774">{{cite journal |vauthors=Bloch MH, Qawasmi A |title=Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis |journal=J Am Acad Child Adolesc Psychiatry |volume=50 |issue=10|pages=991–1000 |date=October 2011 |pmid=21961774 |pmc=3625948|doi=10.1016/j.jaac.2011.06.008 |url=}}</ref><ref name="pmid27555775">{{cite journal | vauthors = Königs A, Kiliaan AJ | title = Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment | journal = Neuropsychiatr. Dis. Treat. | volume = 12 | issue = | pages = 1869–1882 | year = July 2016 | pmid = 27555775 | pmc = 4968854 | doi = 10.2147/NDT.S68652 | url = }}</ref>。


=== 音樂 ===
==預後==
孩童的ADHD有30–50%的機率持續到其成人時期，<ref name="Barkley Fischer Smallish Fletcher 2006 pp. 192–202">{{cite journal | last=Barkley | first=Russell A | last2=Fischer | first2=Mariellen | last3=Smallish | first3=Lori | last4=Fletcher | first4=Kenneth | title=Young Adult Outcome of Hyperactive Children: Adaptive Functioning in Major Life Activities | journal=Journal of the American Academy of Child and Adolescent Psychiatry | publisher=Elsevier BV | volume=45 | issue=2 | year=2006 | issn=0890-8567 | pmid=16429090 | doi=10.1097/01.chi.0000189134.97436.e2 | pages=192–202}}</ref><ref name="BIEDERMAN MONUTEAUX MICK SPENCER 2006 p=167">{{cite journal | last=BIEDERMAN | first=JOSEPH | last2=MONUTEAUX | first2=MICHAEL C. | last3=MICK | first3=ERIC | last4=SPENCER | first4=THOMAS | last5=WILENS | first5=TIMOTHY E. | last6=SILVA | first6=JULIE M. | last7=SNYDER | first7=LINDSEY E. | last8=FARAONE | first8=STEPHEN V. | title=Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study | journal=Psychological medicine | publisher=Cambridge University Press (CUP) | volume=36 | issue=02 | date=2006-01-18 | issn=0033-2917 | pmid=16420713 | doi=10.1017/s0033291705006410 | page=167}}</ref><ref name="Mannuzza Klein Bessler Malloy 1998 pp. 493–498">{{cite journal | last=Mannuzza | first=Salvatore | last2=Klein | first2=Rachel G. | last3=Bessler | first3=Abrah | last4=Malloy | first4=Patricia | last5=LaPadula | first5=Maria | title=Adult Psychiatric Status of Hyperactive Boys Grown Up | url=https://archive.org/details/sim_american-journal-of-psychiatry_1998-04_155_4/page/493 | journal=The American journal of psychiatry | publisher=American Psychiatric Publishing | volume=155 | issue=4 | year=1998 | issn=0002-953X | pmid=9545994 | doi=10.1176/ajp.155.4.493 | pages=493–498}}</ref> 那些持續被ADHD影響的成人可能會在成長過程中發展出一些技巧彌補部分ADHD的症狀。<ref name="Art.218">{{cite journal | vauthors = Gentile JP, Atiq R, Gillig PM | title = likelihood that the adult with ADHD has developed coping mechanisms to compensate for his or her impairment | journal = Psychiatry | volume = 3 | issue = 8 | pages = 25–30 | date = 2006-08 | pmid = 20963192 | pmc = 2957278 | doi = | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957278/ | access-date = 2019-01-02 | archive-date = 2020-12-22 | archive-url = https://web.archive.org/web/20201222194204/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2957278/ | dead-url = no }}</ref> 帶有ADHD的兒童與青少年相較於不帶有ADHD的兒童與青少年，有較高的風險發生意外受傷等事故。<ref name=Ruiz2017>{{cite journal | vauthors = Ruiz-Goikoetxea M, Cortese S, Aznarez-Sanado M, Magallón S, Alvarez Zallo N, Luis EO, de Castro-Manglano P, Soutullo C, Arrondo G | title = Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis | journal = Neuroscience and Biobehavioral Reviews | volume = 84 | pages = 63–71 | date = 2018-01 | pmid = 29162520 | doi = 10.1016/j.neubiorev.2017.11.007 }}</ref>


ADHD藥物能改善（非治癒）患者在生活中許多方面的功能性損傷（functional impairment ；可理解為應對能力的損傷）和{{tsl|en|Quality of life (healthcare)|生活品質 （身心健康）|生活品質}}（例如：發生意外事故的風險）。但是ADHD患者的學習障礙和執行功能缺損（例如時間管理、生活秩序以及組織能力<ref name="Biederman Mick Fried Wilner 2011 pp. 508–515">{{cite journal | last=Biederman | first=Joseph | last2=Mick | first2=Eric | last3=Fried | first3=Ronna | last4=Wilner | first4=Nicole | last5=Spencer | first5=Thomas J. | last6=Faraone | first6=Stephen V. | title=Are stimulants effective in the treatment of executive function deficits? Results from a randomized double blind study of OROS-methylphenidate in adults with ADHD | journal=European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology | publisher=Elsevier BV | volume=21 | issue=7 | year=2011 | issn=0924-977X | pmid=21303732 | doi=10.1016/j.euroneuro.2010.11.005 | pages=508–515}}</ref>）等症狀，即便在服用ADHD藥物後，這些症狀的改善程度極其有限或幾乎沒有效果。<ref>{{cite journal | vauthors = Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA, Rohde LA, Sonuga-Barke EJ, Tannock R, Franke B | title = Attention-deficit/hyperactivity disorder | journal = Nature Reviews. Disease Primers | volume = 1 | pages = 15020 | date = 2015-08 | pmid = 27189265 | doi = 10.1038/nrdp.2015.20 | url = http://sebastiaandovis.com/wp-content/uploads/2015/11/Faraone-et-al-2015-ADHD.pdf | type = Review | citeseerx = 10.1.1.497.1346 | access-date = 2018-12-31 | archive-date = 2020-07-28 | archive-url = https://web.archive.org/web/20200728154252/https://sebastiaandovis.com/wp-content/uploads/2015/11/Faraone-et-al-2015-ADHD.pdf | dead-url = no }}</ref>
音樂治療或可增加注意力不足過動症及[[自閉症]]或[[亞斯伯格症]]（ASD, Autism Spectrum Disorder）患者的腦部特定[[神經]]並使得預後更加樂觀。<ref name="找回專注力"/><ref name="music-lessons-may-help-kids-with-autism-adhd">{{cite web
| url =http://psychcentral.com/news/2016/11/23/music-lessons-may-help-kids-with-autism-adhd/112936.html
| title =Music Lessons May Help Kids with Autism & ADHD
| author=Rick Nauert PhD
| date =Novemeber 23rd, 2016
| website =psychcentral.com
| publisher =the Radiological Society of North America (RSNA)
| access-date =January 2017
| quote = A new imaging study suggests taking music lessons increases brain fiber connections in children. As such, the training may be useful in treating autism and attention-deficit hyperactivity disorder (ADHD), according to researchers from the Radiological Society of North America (RSNA).}} </ref>


考科藍協作組織於2015年發表的系統性文獻回顧指出，雖然中樞神經刺激劑不會令服用者產生嚴重的副作用，但他們較常出現失眠、食慾不振等較為輕微、影響較輕的副作用，並衍生出長期預後的不確定因素，因此未來的研究重點將會聚焦於探討解決前述的副作用的方法。與此同時，未來亦需要深入地研究「非藥物治療方式」以及可能的「非藥物治療方式」之[[隨機對照試驗]]<ref name="Storebø Ramstad Krogh Nilausen p. II ">{{cite | last=Storebø | first=Ole Jakob | last2=Ramstad | first2=Erica | last3=Krogh | first3=Helle B. | last4=Nilausen | first4=Trine Danvad | last5=Skoog | first5=Maria | last6=Holmskov | first6=Mathilde | last7=Rosendal | first7=Susanne | last8=Groth | first8=Camilla | last9=Magnusson | first9=Frederik L | last10=Moreira-Maia | first10=Carlos R | last11=Gillies | first11=Donna | last12=Buch Rasmussen | first12=Kirsten | last13=Gauci | first13=Dorothy | last14=Zwi | first14=Morris | last15=Kirubakaran | first15=Richard | last16=Forsbøl | first16=Bente | last17=Simonsen | first17=Erik | last18=Gluud | first18=Christian | editor-last=Storebø | editor-first=Ole Jakob | title=Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD) | journal=The Cochrane database of systematic reviews | publisher=John Wiley & Sons, Ltd | publication-place=Chichester, UK | issue=11 | date=2015-11-25 | pmid=26599576 | doi=10.1002/14651858.cd009885.pub2 | page=| type = systematic review}}</ref><ref name="Mannuzza Klein 2000 pp. 711–26">{{cite journal | last=Mannuzza | first=S | last2=Klein | first2=RG | title=Long-term prognosis in attention-deficit/hyperactivity disorder. | journal=Child and adolescent psychiatric clinics of North America | volume=9 | issue=3 | year=2000 | issn=1056-4993 | pmid=10944664 | pages=711–26}}</ref>。
{{注解|請參見：[[神經系統]]、[[神經節]]、[[神經元]]、[[軀體神經系統]]、和[[周圍神經系統]]以了結更多有關人類神經的知識。|註}}


迄今為止，對於ADHD的長期追蹤調查主要都是小規模的，代表性有限。唯一規模較大也較具有代表性的美國衛生及公共服務部MTA（多模式治療）研究發現，那些曾在1990年代參加MTA的兒童ADHD，六到八年後進入青春期，他們在許多方面的應對能力，取決於他們小時候治療前呈現的症狀、共病、疾病的嚴重度以及治療後對於MTA四種治療模式的任意一種模式的契合度高低等因素。<ref name="Molina Hinshaw Swanson Arnold 2009 pp. 484–500 V">{{cite journal | last=Molina | first=Brooke S.G. | last2=Hinshaw | first2=Stephen P. | last3=Swanson | first3=James M. | last4=Arnold | first4=L. Eugene | last5=Vitiello | first5=Benedetto | last6=Jensen | first6=Peter S. | last7=Epstein | first7=Jeffery N. | last8=Hoza | first8=Betsy | last9=Hechtman | first9=Lily | last10=Abikoff | first10=Howard B. | last11=Elliott | first11=Glen R. | last12=Greenhill | first12=Laurence L. | last13=Newcorn | first13=Jeffrey H. | last14=Wells | first14=Karen C. | last15=Wigal | first15=Timothy | last16=Gibbons | first16=Robert D. | last17=Hur | first17=Kwan | last18=Houck | first18=Patricia R. | title=The MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study | journal=Journal of the American Academy of Child and Adolescent Psychiatry | publisher=Elsevier BV | volume=48 | issue=5 | year=2009 | issn=0890-8567 | pmid=19318991 | pmc=3063150| doi=10.1097/chi.0b013e31819c23d0 | pages=484–500}}</ref>
=== 教育疗法（職能治療） ===


當MTA追蹤這些受試者長達十六年，直到受試者的平均年齡到達25歲的時候，發現這些患者生活中各領域的應對能力取決於ADHD的症狀是否持續到成年、ADHD的症狀嚴重度、和共病等因素。<ref name="Hechtman Swanson Sibley Stehli 2016 pp. 945–952.e2">{{cite journal | last=Hechtman | first=Lily | last2=Swanson | first2=James M. | last3=Sibley | first3=Margaret H. | last4=Stehli | first4=Annamarie | last5=Owens | first5=Elizabeth B. | last6=Mitchell | first6=John T. | last7=Arnold | first7=L. Eugene | last8=Molina | first8=Brooke S.G. | last9=Hinshaw | first9=Stephen P. | last10=Jensen | first10=Peter S. | last11=Abikoff | first11=Howard B. | last12=Perez Algorta | first12=Guillermo | last13=Howard | first13=Andrea L. | last14=Hoza | first14=Betsy | last15=Etcovitch | first15=Joy | last16=Houssais | first16=Sylviane | last17=Lakes | first17=Kimberley D. | last18=Nichols | first18=J. Quyen | last19=Vitiello | first19=Benedetto | last20=Severe | first20=Joanne B. | last21=Jensen | first21=Peter S. | last22=Arnold | first22=L. Eugene | last23=Hoagwood | first23=Kimberly | last24=Richters | first24=John | last25=Vereen | first25=Donald | last26=Hinshaw | first26=Stephen P. | last27=Elliott | first27=Glen R. | last28=Wells | first28=Karen C. | last29=Epstein | first29=Jeffery N. | last30=Murray | first30=Desiree W. | last31=Conners | first31=C. Keith | last32=March | first32=John | last33=Swanson | first33=James | last34=Wigal | first34=Timothy | last35=Cantwell | first35=Dennis P. | last36=Abikoff | first36=Howard B. | last37=Hechtman | first37=Lily | last38=Greenhill | first38=Laurence L. | last39=Newcorn | first39=Jeffrey H. | last40=Molina | first40=Brooke | last41=Hoza | first41=Betsy | last42=Pelham | first42=William E. | last43=Gibbons | first43=Robert D. | last44=Marcus | first44=Sue | last45=Hur | first45=Kwan | last46=Kraemer | first46=Helena C. | last47=Hanley | first47=Thomas | last48=Stern | first48=Karen | title=Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results | journal=Journal of the American Academy of Child and Adolescent Psychiatry | publisher=Elsevier BV | volume=55 | issue=11 | year=2016 | issn=0890-8567 | pmid=27806862 | pmc=5113724 | doi=10.1016/j.jaac.2016.07.774 | pages=945–952.e2}}</ref><ref name="Roy Hechtman Arnold Swanson 2017 pp. 687–695.e7">{{cite journal | last=Roy | first=Arunima | last2=Hechtman | first2=Lily | last3=Arnold | first3=L. Eugene | last4=Swanson | first4=James M. | last5=Molina | first5=Brooke S.G. | last6=Sibley | first6=Margaret H. | last7=Howard | first7=Andrea L. | last8=Vitiello | first8=Benedetto | last9=Severe | first9=Joanne B. | last10=Jensen | first10=Peter S. | last11=Arnold | first11=L. Eugene | last12=Hoagwood | first12=Kimberly | last13=Richters | first13=John | last14=Vereen | first14=Donald | last15=Hinshaw | first15=Stephen P. | last16=Elliott | first16=Glen R. | last17=Wells | first17=Karen C. | last18=Epstein | first18=Jeffery N. | last19=Murray | first19=Desiree W. | last20=Conners | first20=C. Keith | last21=March | first21=John | last22=Swanson | first22=James | last23=Wigal | first23=Timothy | last24=Cantwell | first24=Dennis P. | last25=Abikoff | first25=Howard B. | last26=Hechtman | first26=Lily | last27=Greenhill | first27=Laurence L. | last28=Newcorn | first28=Jeffrey H. | last29=Molina | first29=Brooke | last30=Hoza | first30=Betsy | last31=Pelham | first31=William E. | last32=Gibbons | first32=Robert D. | last33=Marcus | first33=Sue | last34=Hur | first34=Kwan | last35=Kraemer | first35=Helena C. | last36=Hanley | first36=Thomas | last37=Stern | first37=Karen | title=Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA) | journal=Journal of the American Academy of Child and Adolescent Psychiatry | publisher=Elsevier BV | volume=56 | issue=8 | year=2017 | issn=0890-8567 | pmid=28735698 | pmc=5555165 | doi=10.1016/j.jaac.2017.05.020 | pages=687–695.e7}}</ref><ref name="RICHTERS ARNOLD JENSEN ABIKOFF 1995 pp. 987–1000">{{cite journal | last=RICHTERS | first=JOHN E. | last2=ARNOLD | first2=L. EUGENE | last3=JENSEN | first3=PETER S. | last4=ABIKOFF | first4=HOWARD | last5=CONNERS | first5=C. KEITH | last6=GREENHILL | first6=LAURENCE L. | last7=HECHTMAN | first7=LILY | last8=HINSHAW | first8=STEPHEN P. | last9=PELHAM | first9=WILLIAM E. | last10=SWANSON | first10=JAMES M. | title=NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD: I. Background and Rationale | journal=Journal of the American Academy of Child and Adolescent Psychiatry | publisher=Elsevier BV | volume=34 | issue=8 | year=1995 | issn=0890-8567 | pmid=7665456 | doi=10.1097/00004583-199508000-00008 | pages=987–1000}}</ref>
Eric (2001)的一项对老师进行的调查，研究了哪些课堂方法正在实施，并能帮助提高注意力困难儿童上课时的注意力。教师们发现活动是最有效的方法。在坐的过程中提供活动可以提供持续的活动输入，而不用频繁的离开座位。 [[職能治療]]（Occupational therapy）方面的文献建议，在教室中采用动态座位系统是可以改善学生感觉调节和注意力的一种方法。（Kimball, 1999）


== 間接醫療協助 （社會資源協助） ==
==社會與文化==
[[FILE:Eliza Dushku 2009 Comic Con.jpg|thumb|upright=1|美國電影電視演員[[伊丽莎·杜什库]]鼓勵大眾認識ADHD<ref name="Eliza Dushku ADHD">{{cite web|title=CELEBRATION: Love & Bliss FLOW WITH ME..! 4/14/14|url=https://web.archive.org/web/20180703221440/http://www.elizapatriciadushku.com/news/celebration-love-bliss-flow-with-me-4-14-14 |website=Eliza Dushku's official website|date= |accessdate=2016-10-15}}</ref>]]


注意力不足過動症患者常被錯誤認為「只是懶惰或缺乏意志力」、「診斷只不過是用來為患者們的問題找藉口罷了」等。有ADHD患童因長期遭到霸凌，於獨處時結束生命。<ref name="TVBS 2018 林瑩真 ">{{cite web | author=林瑩真 | title=過動男童遭霸凌一年半　學校上吊輕生「妹目睹崩潰痛哭」 | archive-url=https://web.archive.org/web/20180929025853/https://news.tvbs.com.tw/world/999323 | archive-date=2018-09-29 | website=TVBS | date=2018-09-26 | url=https://news.tvbs.com.tw/world/999323 | language=zh | access-date=2018-09-28 | dead-url=no }}</ref><ref name="鍵盤大檸檬 2018">{{cite web | author=紅豆Q粉粿 | title=放學前先遮傷口！過動症男孩瞞著父母獨忍霸凌　自殺當天微笑上學 | website=鍵盤大檸檬 | date=2018-09-14 | url=https://www.ettoday.net/dalemon/post/38433 | language=zh | access-date=2018-09-28 | archive-url=https://archive.today/20180929030309/https://www.ettoday.net/dalemon/post/38433 | archive-date=2018-09-29 | dead-url=no }}</ref><ref name="The Sun 2018">{{cite web | title='Bullied' schoolboy, 14, was found hanged in school toilet by his sister as dad calls for headteacher's resignation | website=The Sun | date=2018-09-20 | url=https://www.thesun.co.uk/news/7308722/bullied-schoolboy-bradley-st-john-school-llanelli-headteacher/ | access-date=2018-09-29 | archive-url=https://web.archive.org/web/20180929030400/https://www.thesun.co.uk/news/7308722/bullied-schoolboy-bradley-st-john-school-llanelli-headteacher/ | archive-date=2018-09-29 | dead-url=no }}</ref>台灣醫師的研究發現，在台灣，注意力不足過動症患者具有顯著較高的「因傷致死」機率，起因來自：[[自殺]]、[[意外]]和[[謀殺]]。<ref name="Chen Chan Wu Lee p=e198714">{{cite journal | last=Chen | first=Vincent Chin-Hung | last2=Chan | first2=Hsiang-Lin | last3=Wu | first3=Shu-I | last4=Lee | first4=Meng | last5=Lu | first5=Mong-Liang | last6=Liang | first6=Hsin-Yi | last7=Dewey | first7=Michael E. | last8=Stewart | first8=Robert | last9=Lee | first9=Charles Tzu-Chi | title=Attention-Deficit/Hyperactivity Disorder and Mortality Risk in Taiwan | journal=JAMA network open | publisher=American Medical Association (AMA) | volume=2 | issue=8 | date=2019-08-07 | issn=2574-3805 | pmid=31390039 | doi=10.1001/jamanetworkopen.2019.8714 | page=e198714}}</ref>
=== 中華民國（台灣） ===


一些家庭對過度活躍症認識不深，不了解、誤解為弱智、低能，大部份會選擇以暴易暴的方法解決問題。有些會選擇送去智能庇護所，因為專業人員不懂得審查過度活躍症與智障無關，患者會被送去孤兒院、[[保良局]]及兒童之家。
除了在醫療、教育場所接受直接的醫療照護外，中華民國中央政府及地方政府亦下轄衛生福利部-社會及家庭署、衛生福利部-1957福利需求諮詢評估專線<ref>
{{cite web
|url=http://www.sfaa.gov.tw/SFAA/default.aspx
|title=::: 歡迎蒞臨社家署全球資訊網 :::
|location=11558臺北市南港區忠孝東路六段488號12樓
|access-date=2017-02-27
|publisher=中華民國衛生福利部}}</ref>
<ref>{{cite web
|url=http://1957.mohw.gov.tw/about1957.jsp
|website=1957福利諮詢專線
|title=關於1957
|quote=1957福利諮詢專線於95年11月17日正式啟動，而因應中央行政機關組織改造，自102年7月23日起主管機關由內政部改為衛生福利部。本專線之設置目的在協助生活上遭遇困難之家庭或個人，整合各公私立部門之各項服務與資源，提供單一窗口之社會福利諮詢與通報轉介服務，使有社會福利相關服務需求的民眾，只要一通電話，即可得到完善的服務，以落實社會安全照顧網絡。自97年下半年起，1957專線除通報急難救助個案、提供福利服務諮詢外，亦多次配合政府各項之業務推展，提供專案性的服務，如馬上關懷專案、工作所得補助方案、莫拉克風災、春節加強扶助弱勢家庭實施計畫、協助個案連結社會安全網就業輔導、自殺防治專線等服務資源，1957專線都扮演了不可或缺的角色。為強化1957專線之服務效能及社會安全網之功能，本專線自99年9月1日起委託財團法人台灣兒童暨家庭扶助基金會，聘有專業社工人員執行接線服務，可藉由專業的福利需求評估，提供民眾適切的福利服務諮詢及通報轉介服務。
|access-date=2017-02-27
|publisher=中華民國衛生福利部}}</ref>及社會局、衛生局等
<ref>{{cite web
|url=http://socbu.kcg.gov.tw/index.php
|title=中華民國高雄市政府社會局全球資訊網
|website=高雄市政府社會局
|language=zh-tw
|access-date=2017-02-27
|location=中華民國台灣高雄市}}</ref>
<ref>{{cite web
|url=http://khd.kcg.gov.tw/
|title=高雄市市政府衛生局
|language=zh-tw
|date=2011-07-11
|publisher=高雄市市政府
|location=中華民國台灣高雄市}}</ref>，彙整對於[[身心障礙|弱勢者]]社會支持的資源，以便讓這些患者能在接受直接醫療協助時無後顧之憂。


許多國家或地區都程度不等的在「精神醫療及心理衛生」方面遭遇資源不足以面對現實所需的情況。<ref name="environment">{{cite web
除此之外，特殊教育學校能協助具備特殊需求的孩子們在適當的環境中成長、茁壯。<ref>
| url=https://theinitium.com/article/20170425-taiwan-ADHD2/
{{cite web
| title=健保給付制度造成醫療資源分配傾斜
|url=http://sped.nttu.edu.tw/files/11-1004-1763.php
| publisher=端傳媒
|title=特殊學校
| author=呂苡榕
|author= 國立台東大學特殊教育學系
| location=Taiwan
|access-date=2017-02-27
| quote=健保給付制度困境令孩童就醫難\ 除了診斷的時間受到侷限，行為治療、親職教育等資源更是少得可憐。醫院的親子團體治療每一期排隊至少要排上四個月到半年才有可能有名額......
|publisher=}}</ref>&nbsp;&nbsp; 民間亦有許多特殊教育的支持團體及ADHD的社群。<ref>
| date=2017-04-25
{{cite web
| archive-url=https://web.archive.org/web/20170501160551/https://theinitium.com/article/20170425-taiwan-ADHD2/
|url=http://sped.nttu.edu.tw/files/11-1004-1764.php
| archive-date=2017-05-01
|title=特教團體網站
| access-date=2017-04-25
|website=nttu.edu.tw
| dead-url=no
|access-date=2017-02-27
}}</ref><ref name=adhd_hk/><ref name="Guidelines_May_Have_Helped_Curb_ADHD_Diagnoses_in_Preschoolers"/>以美國為例，美國精神醫療環境即便先進且持續進步中，然而注意力不足過動症患者接受行為治療的比例仍被當地學者專家認為仍然太低。
|publisher=國立台東大學特殊教育學系}}</ref>
<ref name="Guidelines_May_Have_Helped_Curb_ADHD_Diagnoses_in_Preschoolers">{{cite web
<ref>{{cite web
|url = https://medlineplus.gov/news/fullstory_162041.html
|url=http://www.tfrd.org.tw/tfrd/
|title = Guidelines May Have Helped Curb ADHD Diagnoses in Preschoolers
|title=財團法人罕見疾病基金會首頁
|date = 2016-11-15
|author=
|website = MedlinePlus.gov
|access-date=2017-02-27
|publisher = HealthDay
|publisher=財團法人罕見疾病基金會}}</ref>
|quote = Still, too few with disorder receive behavior therapy, child psychologist says.
<ref>{{cite web
|deadurl = yes
|url=http://disable.yam.org.tw/org/%E4%B8%AD%E8%8F%AF%E6%B0%91%E5%9C%8B%E6%AE%98%E9%9A%9C%E8%81%AF%E7%9B%9F
|accessdate = 2017-01-01
|title=中華民國殘障聯盟
|archiveurl = https://web.archive.org/web/20161225115223/https://medlineplus.gov/news/fullstory_162041.html
|website=身心障礙者服務資訊網
|archivedate = 2016-12-25
|author=
}}</ref> 2017年美國政府撥出一億美金用於支持兒童與青少年常見精神疾病的研究：如何提供自閉症者更好的治療、其他兒童心理精神疾病（包括ADHD在內）的[[病理學]]及[[生理學]]等。<ref name="National Institutes of Health (NIH) 2017">{{cite web | title=NIH awards nearly $100 million for Autism Centers of Excellence program | website=National Institutes of Health (NIH) | date=2017-09-06 | url=https://www.nih.gov/news-events/news-releases/nih-awards-nearly-100-million-autism-centers-excellence-program | accessdate=2017-11-08 | quote=Duke University, Durham, North Carolina – Understanding and potentially treating ASD-ADHD combination. <br/>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. | deadurl=no | archiveurl=https://web.archive.org/web/20171109023045/https://www.nih.gov/news-events/news-releases/nih-awards-nearly-100-million-autism-centers-excellence-program | archivedate=2017-11-09 }}</ref>
|access-date=2017-02-27
|publisher=}}</ref>
<ref>{{cite web
|url=http://searoc.aide.gov.tw/
|title=社團法人中華民國特殊教育學會
|author=
|access-date=2017-02-27
|publisher=}}</ref>於高等教育的部分，許多大學設有特殊教育學系及特殊教育中心
<ref>{{cite web
|url=http://sped.nttu.edu.tw/files/11-1004-1765.php
|title=國內特教系所網站列表
|author= 國立台東大學特殊教育學系
|access-date=2017-02-27
|publisher=國立台東大學}}</ref>
<ref>{{cite web|url=http://sped.nttu.edu.tw/files/11-1004-1821.php
|title=全國特教中心連結
|author=國立台東大學特殊教育學系
|access-date=2017-02-27
|publisher=國立台東大學}}</ref>
<ref>{{cite web
|url=http://sped.nttu.edu.tw/bin/home.php
|title=國立台東大學特殊教育學系
|author=
|access-date=2017-02-27
|publisher=國立台東大學}}</ref>
<ref>{{cite web
|url=http://dpd.nttu.edu.tw/secenter/contents/news/news_list.asp?menuID=1
|title=國立台東大學特殊教育中心
|website=國立台東大學
|access-date=2017-02-27}}</ref>
<ref>{{cite web
|url=http://web.spc.ntnu.edu.tw/
|title=特殊教育中心
|author=
|access-date=2017-02-27
|publisher=國立臺灣師範大學 }}</ref>
<ref>{{cite web
|url=http://www.spe.ntnu.edu.tw/
|title=特殊教育系
|website=國立臺灣師範大學　
|access-date=2017-02-27}}</ref>其他與心理衛生照護相關之政府部門為：衛生福利部-護理及健康照護司、衛生福利部-心理及口腔衛生司
<ref>{{cite web
|url=http://www.mohw.gov.tw/cht/DONAHC/
|title=護理及健康照護司
|access-date=2017-02-27
|publisher=中華民國衛生福利部}}</ref>
<ref>{{cite web
|url=http://www.mohw.gov.tw/CHT/DOMHAOH/
|title=心理及口腔健康司
|author=
|access-date=2017-02-27
|publisher=中華民國衛生福利部}}</ref>。

鑒於網路世代的來臨，中華民國的教育部成立了台灣特殊教育資訊網、特殊教育通報網、身心障礙職業教育資源網站協助具有相關需求之學生。<ref>
{{cite web
|url=https://www.set.edu.tw/
|title=台灣教育部特殊教育通報網
|access-date=2017-02-27}}</ref>
<ref>{{cite web
|url=http://www.cter.edu.tw/
|title=身心障礙學生職業教育資源網站首頁
|author=
|access-date=2017-02-27
|publisher=中華民國的教育部}}</ref>
<ref>{{cite web
|url=http://www.spc.ntnu.edu.tw/site
|title=台灣特殊教育資訊網
||access-date=2017-02-27}}</ref>中華民國中央政府下設之勞動部則涵蓋了各族群的勞動統計。
<ref>{{cite web
|url=http://www.mol.gov.tw/statistics/2462/19476/
|title=身心障礙者
|date=2015-06-08
|publisher=中華民國勞動部}}</ref><br/>
中華民國立法院則設立了身心障礙者權益保障法以維護相關弱勢族群的生活。
<ref>{{cite web
|url=http://law.moj.gov.tw/LawClass/LawAll.aspx?PCode=D0050046
|title=身心障礙者權益保障法-全國法規資料庫入口網站
|author=
|access-date=2017-02-27
|publisher=中華民國立法院}}</ref>

=== 中國大陸（大陸/內地） ===

一群对“注意缺陷多动障碍”诊断和治疗拥有丰富经验和学识的心理咨询师、医生、教师，自愿自发的组成一个针对“注意缺陷障碍”的非盈利性的组织－“中国注意缺陷障碍组织”，为儿童及其家长提供各种信息和帮助。
<ref name="Mainland China">
{{cite web
|url=http://www.adhd.org.cn/about.html
|title=关于我们
|date=January, 2017.
|publisher=中国注意缺陷多动障碍组织
|archive-date= February twenty seventh,2017.
|archive-url=http://www.adhd.org.cn/about.html
|language=zh-cn
}}</ref>
<ref name="Mainland China II">
{{cite web
|url=http://www.adhdchina.com/guanyuwomen/
|title=关于我们、关于成立
|access-date= January, 2017.
|publisher=多动症关爱协会
|archive-date= February twenty seventh,2017.
|archive-url=http://www.adhdchina.com/guanyuwomen/
|language=zh-cn
}}</ref>
<ref name="Mainland China III">
{{cite web
|url=http://a.jingsiedu.com/admin/answer_review.htm
|title=竞思注意力在线评估表 （注意力测评）
|access-date= January, 2017.
|archive-date= February twenty seventh,2017.
|archive-url=http://a.jingsiedu.com/admin/answer_review.htm
|publisher=竞思}}</ref>

=== 香港 ===

* 一群有《專注力不足/過度活躍症》兒童的家長，為了喚起社會大眾對這些學童的認識和關注，及推動有關專業人士對《專注力不足/過度活躍症》作進一步的研究與探討，於2006年成立協會，並於2013年把協會成功註冊為非牟利慈善團體。<ref>{{cite web
|url=http://www.adhd.org.hk/
|title=專注不足/過度活躍症(香港)協會 Hong Kong Association For AD/HD
|author=
|language=zh-hk
|access-date=2017-02-27
|publisher=}}</ref>
* 一群專業人員和熱心人士發起的非牟利組織專注力促進會，於2005年在香港成立，旨在提高公眾對專注力失調及/或者過度活躍症（Attention Deficit and / Hyperactivity Disorder - ADHD）的關注和認識，以促進患者得到平等的教育和發展機會。<ref>{{cite web
|url=http://www.adhd.hk
|title=專注力促進會 - 首頁
|author=
|language=zh-hk
|access-date=2017-02-27
|publisher=}}</ref>

=== 澳門 ===

專注不足過度活躍症（[[澳門]]）協會日前正式註冊成立，並於帝濠軒舉行第一次會員大會，推選產生首屆領導架構。黃潔貞當選會長，張捷當選理事長，戴華浩當選監事長。在該會成立儀式上，黃潔貞致辭，期望該會全體理監事共同努力，推動社會大衆對專注力失調或過度活躍症（AD/HD）學童的了解、關注、包容。該會也在臉書上成立粉絲專頁。<ref>{{cite web
|url=http://www.macaodaily.com/html/2014-02/03/content_875792.htm
|title=澳門日報電子版
|author=
|access-date=2017-02-27
|publisher=澳門日報}}</ref>

=== 新加坡 ===

* 新加坡政府新特殊教育學生的支援計畫始於2005年，計畫內容包括在派令教師接受特殊教育訓練並在校內配置特殊教育的專業人員。
* 持續發展、執行、觀察、評估特殊教育學生的需求是否有被滿足。<ref>{{cite web
|url=https://www.moe.gov.sg/education/programmes/support-for-children-special-needs
|title=Support for Children with Special Needs
|author=
|language=en-sg
|access-date=2017-02-27
|publisher=}}</ref>
* 新加坡的衛生當局曾在2014年開會討論ADHD的治療策略。<ref>{{cite web
|url=https://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical/2014/cpgmed_adhd.html
|title=ADHD - Ministry of Health
|author=
|language=en-sg
|access-date=2017-02-27
|publisher=}}</ref>

{{注解|請參見：世界各地的精神醫學會<ref>{{cite web
| url =http://www.aacap.org/AACAP/International/Int_Orgs.aspx
| title = Worldwide societies of Child and adolescent psychiatry
| website = American Academy of Child and adolescent psychiatry
| access-date = February twenty second, 2017.
| archive-url=http://www.aacap.org/AACAP/International/Int_Orgs.aspx
| archive-date= February twenty second, 2017.
| language = en-us }}</ref>。|註}}{{English}}

== 歷史 ==
1798年時蘇格蘭醫師{{le|亞歷山大·克里奇頓|Alexander Crichton}}在其著作《對精神紊亂的性質和起源的探究》（An inquiry into the nature and origin of mental derangement）中提到了精神不安（mental restlessness）<ref>{{cite journal |date=May 2001 |title=An early description of ADHD (inattentive subtype): Dr Alexander Crichton and 'Mental restlessness' (1798) |volume=6 |issue=2 |pages=66–73 |journal=Child and Adolescent Mental Health |doi=10.1111/1475-3588.00324 |vauthors=Palmer ED, Finger S }}</ref><ref>{{cite book |author=Crichton A |title=An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects |url=https://books.google.com/books/about/An_inquiry_into_the_nature_and_origin_of.html?id=OMAtAAAAYAAJ |year=1798 |publisher=AMS Press |location=United Kingdom |isbn=9780404082123 |page=271 |accessdate=2014-01017}}</ref>，1902年，英國兒科醫生{{tsl|en|George Frederic Still|George Still}}首次描述一項與注意力不足過動症近似的病徵<ref>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)</ref><ref name=CDCTime2013>{{cite web|title=ADHD Throughout the Years|url=http://www.cdc.gov/ncbddd/adhd/documents/timeline.pdf|publisher=Center For Disease Control and Prevention|accessdate=2013-08-02}}</ref>。

不同的時期，描述注意力不足過動症的名詞也有所不同：在1952年的DSM-I稱為微細腦功能失常（minimal brain dysfunction），在1968年的DSM-II則稱為兒童活动亢进（hyperkinetic reaction of childhood），在1980年的DSM-III稱為注意力不足症（可能伴隨過動，也可能沒有）英文為 attention-deficit disorder (ADD) with or without hyperactivity<ref name=CDCTime2013/>，在1987年的DSM-III-R更名為注意力不足過動症，在1994年的DSM-IV將注意力不足過動症分為{{le|注意力散渙主導型的注意力不足過動症|Attention deficit hyperactivity disorder predominantly inattentive|注意力散渙主導型}}、活動量過多型以及混合型<ref name=Millichap_2010_chap1>{{cite book |last=Millichap |first=J. Gordon |title=Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD |chapter-url=https://books.google.com/books?id=KAlq0CDcbaoC&pg=PA2 |edition=2nd |date=2010 |publisher=Springer Science |isbn=978-1-4419-1396-8 |doi=10.1007/978-104419-1397-5 |lccn=2009938108 |pages=2–3 |chapter=Chapter 1: Definition and History of ADHD }}</ref>，在2013年的DSM-5仍延用此一分類<ref name=DSM5>{{cite book | author=American Psychiatric Association | title=Diagnostic and Statistical Manual of Mental Disorders | year=2013 | publisher=American Psychiatric Publishing | location=Arlington | isbn=0890425558 | pages=59–65 | edition=5th}}</ref>。其他的名詞有在1930年代使用的微細腦創傷（minimal brain damage）<ref>{{cite book| author=Weiss M |title=ADHD in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment| year=2010| publisher=JHU Press| isbn=9781421401317| url=https://books.google.com/books?id=bcyI7dvawzMC&pg=PT72|accessdate=2014-01-17}}</ref>，但因為不少病童都沒有發覺有受過任何創傷，因此後來改名為微細腦功能失常。

1937年時，[[興奮劑|神經刺激劑]]開始用在注意力不足過動症的治療<ref>{{Cite journal|vauthors=Patrick KS, Straughn AB, Perkins JS, González MA |title=Evolution of stimulants to treat ADHD: transdermal methylphenidate |journal=Human Psychopharmacology |volume=24 |issue=1 |pages=1–17 |date=January 2009 |pmid=19051222 |pmc=2629554 |doi=10.1002/hup.992}}</ref>。1934年時美國許可將[[苯丙胺]]用在注意力不足過動症治療，是美國第一個許可的[[安非他命]]類藥物<ref name="Benzedrine">{{cite journal | author=Rasmussen N | title=Making the first anti-depressant: amphetamine in American medicine, 1929–1950 | journal=J . Hist. Med. Allied Sci. | volume=61 | issue=3 | pages=288–323 |date=July 2006 | pmid=16492800 | doi=10.1093/jhmas/jrj039}}</ref>，1950年代開始使用[[哌甲酯]]（Methylphenidate，商品名稱為利他能），1970年代則開始使用[[对映异构]]的{{le|右苯丙胺|dextroamphetamine}}<ref name=CDCTime2013/>。

==社會與文化==
{{Non-free|章節|time=2017-02-28T12:46:43+00:00}}
美國一年因ADHD造成的損失是1200億台幣以上<ref>{{cite web
| title =認識ADHD
| url =http://www.tc-adhd.com/?page_id=97
| website =社團法人台灣心動家族兒童青少年關懷協會
| access-date = 2017-02-16
| quote=美國一年因ADHD造成的損失是1200億台幣以上
| author=陳錦宏 醫師}}</ref>。

陳錦宏醫師{{efn|關於--教職：副教授。現職：醫教會 副主席、OSCE考官、心動家族協會 理事長、嘉義長庚精神科副教授級主治醫師、教育部部定副教授、嘉義長庚 醫師研究員。學歷：英國倫敦大學國王學院精神醫學研究所 博士高雄醫學大學醫學士}}指出：
{{Cquote|未治療的注意力不集中/過動症兒童會影響其學業表現，社會功能及生活品質，且將來容易因長期處在被指責，誤解的情況下（如長期作業品質不佳被罰寫甚至被記過），扭曲自尊及自信的人格發展，開始其他的問題，如反抗對立疾患 （易怒，指責他人，反抗規則），行為疾患（打架，說謊，偷竊，逃學等），藥酒癮及憂鬱症等；長期對學業成績，工作能力及工作維持均有負面影響。有注意力不集中/過動症兒童的家庭容易產生家人衝突及家庭壓力，父母會因處理這些兒童產生的問題減少自己工作、社交或休息的時間，甚至因此影響父母自己的身心健康及婚姻狀態。研究顯示美國一年因注意力不集中/過動症損失高達近40億美金，其中即包括父母的工作損失。<ref>{{cite web
| title =【誤解下的小孩】：談注意力不足/過動症 - 陳錦宏醫師
| url =http://www.tc-adhd.com/?p=147
| website =社團法人台灣心動家族兒童青少年關懷協會
| access-date = 2017-02-16
| date = 2012-07-09
| author=陳錦宏 醫師}}</ref>|陳錦宏 醫師|醫教會 副主席、OSCE考官、心動家族協會 理事長、嘉義長庚精神科副教授級主治醫師、教育部部定副教授}}
=== 治療方式的爭議 ===
=== 治療方式的爭議 ===
{{main|注意力不足過動症的爭議}}
自1970年代開始，注意力不足過動症疾病本身、其診斷及醫療在歐美就已經是有爭議性的議題。爭議和臨床醫師、教師、政策訂定者、家長及媒體有關。世界衛生組織也認可治療ADHD兒童時，先進行非藥物治療再進行藥物治療的作法<ref>{{cite web
|url = http://www.who.int/mental_health/mhgap/evidence/child/q7/en/
|title = Pharmacological and nonpharmacological interventions for children with attention-deficit hyperactivity disorder (ADHD)
|language = en-us
|author = WHO
|access-date = 2017-02-22
|publisher = 世界衛生組織 Wolrd Health Organization
|deadurl = no
|archiveurl = https://web.archive.org/web/20170108183309/http://www.who.int/mental_health/mhgap/evidence/child/q7/en/
|archivedate = 2017-01-08
}}</ref><ref>{{cite web|url=http://www.who.int/mental_health/mhgap/evidence/child/q7/zh/|title=注意缺陷多动障碍儿童的药物和非药物介入/干预|author=世界卫生组织|access-date=2017-02-22|publisher=世界卫生组织|language=zh-hans|deadurl=no|archiveurl=https://web.archive.org/web/20161129222854/http://www.who.int/mental_health/mhgap/evidence/child/q7/zh/|archivedate=2016-11-29}}</ref>，但各觀點對注意力不足過動症的認知差異很大。


有的觀點認為注意力不足過動症是正常行為的範圍內，也有的假定注意力不足過動症是一種遺傳疾病。其他有關注意力不足過動症的爭議包括對兒童用（合理劑量的）中樞神經刺激劑（俗稱興奮劑）藥物進行治療、診斷的方式，以及是否有{{tsl|en|Overdiagnosis|過度診斷}}的情形。有些宗教對治療方式也會有不同的認知，例如[[公民人權委員會]]（[[山達基]]在1969年成立的反精神醫學團體）曾在1980年代提出反對使用[[利他能]]的運動，目前該組織的立場仍是不主張用中樞神經刺激劑處方治療ADHD<ref>{{Cite web |url=http://www.cchr.org.tw/?p=740 |title=亞洲不應使用西方精神科對於注意力不足過動症（ADHD）的診斷，及興奮劑處方的治療 |accessdate=2017-09-02 |archive-date=2017-09-02 |archive-url=https://web.archive.org/web/20170902100630/http://www.cchr.org.tw/?p=740 |dead-url=no }}</ref>。
==== 中華民國（台灣） ====


=== 中國大陸、香港 ===
即便目前注意力不足過動症的治療策略（涵蓋藥物既非藥物治療）獲得中國大陸
目前注意力不足過動症的治療策略（涵蓋藥物及非藥物治療）已成為中國大陸的相關[[醫學指南]]
<ref>
<ref>{{cite journal|author1=鄭毅|author2=刘靖|year=2016|title=《中国注意缺陷多动障碍防治指南》第二版解读|journal=中华精神科杂志|volume=0|issue=3|pages=p.132-135|url=http://lib.cqvip.com/qk/90113A/201603/669219092.html|accessdate=2017-03-04|deadurl=no|archiveurl=https://web.archive.org/web/20170304194214/http://lib.cqvip.com/qk/90113A/201603/669219092.html|archivedate=2017-03-04}}</ref>，中國大陸的多动症关爱协会指出：「中國大陸对『注意力缺陷多动障碍』的诊断、治疗尚不规范，家长的认知亦不够全面，导致社会上仍有很多[[偽科學|不科学]]的治疗方式和训练方法在被家长们使用。」
{{cite journal
|author=鄭毅、刘靖
|year= 2016
|title=《中国注意缺陷多动障碍防治指南》第二版解读
|journal=中华精神科杂志
|volume=0
|issue=3
|pages=p.132-135
|url=http://lib.cqvip.com/qk/90113A/201603/669219092.html
|accessdate=2017-03-04}}
</ref>、歐美衛生機構及[[世界衛生組織]]的安全及[[臨床試驗]]認可
<ref>{{cite web
|url=http://www.who.int/mental_health/mhgap/evidence/child/q7/en/
|title=Pharmacological and nonpharmacological interventions for children with attention-deficit hyperactivity disorder (ADHD)
|language=en-us
|author=WHO
|access-date=February twenty second, 2017.
|archive-date=February twenty second, 2017.
|archive-url=http://www.who.int/mental_health/mhgap/evidence/child/q7/en/
|publisher=世界衛生組織 Wolrd Health Organization}}</ref><ref>{{cite web
|url=http://www.who.int/mental_health/mhgap/evidence/child/q7/zh/
|title=注意缺陷多动障碍儿童的药物和非药物干预
|author=世界卫生组织
|access-date=February twenty second, 2017.
|archive-url=http://www.who.int/mental_health/mhgap/evidence/child/q7/zh/
|archive-date=February twenty second, 2017.
|publisher=世界卫生组织
|language=zh-cn}}</ref><ref name="NIDAAAS" /><ref name="Tc_ADHD"/>，少部分台灣的中國醫學科醫師（中醫師）仍對此不以為然，認為[[西藥]]有毒又有[[副作用]]。坊間亦有人宣傳[[保健食品]]、花精皂（宣稱多搭配此香皂洗手可治療ADHD）、人造磁鐵、自然/天然療法、營養食譜/處方等試驗者、提倡者、成分、短中長期之安全性、有效性、科學根據、官方認證等皆不明的療法。


香港特別行政區則遇到特教需求的識別及輪流服務的等候時間過長、資源及服務不足、教師人手不足及培訓有待改善、醫校社合作不順暢以及政府未有整體支援特教學生的政策藍圖及願景的問題。目前正在推動特殊教育進行立法，以全面保障特殊教育需要學生的權利。<ref name=adhd_hk>{{cite web
對此，臺灣兒童青少年精神醫學會理事長、國立臺灣大學醫學院附設醫院-精神科主治醫師高淑芬回應指出，對注意力不足過動症治療想法可以很多元，但介入方式必需要有科學證據及嚴謹的研究設計，包括對象治療多久，都應受到密切監督<ref>{{cite web
|title = 《立法是否保障特殊教育需要學生的出路？》論壇
|url=http://www.udn.com/news/story/1/1859185-ADHD
|date = 2015-03-29
|title=用藥爭議-立法院上演大對決 ADHD用藥爭議 立法院上演大對決
|url = http://www.adhd.org.hk/education-event-detail.aspx?id=26
|date=2016年8月
|location = Hong Kong, China.
|website=聯合報官方網站
|author = 專注不足/過度活耀協會
|archive-date=2017-02-27
|access-date = 2017-03-15
|archive-url=http://www.udn.com/news/story/1/1859185-ADHD
|deadurl = no
|language=zh-tw
|archiveurl = https://web.archive.org/web/20170305114342/http://www.adhd.org.hk/education-event-detail.aspx?id=26
|location=Taipei}}</ref>
|archivedate = 2017-03-05
<ref>{{cite web
}}</ref>另外，香港的一項問卷調查發現，有特殊教育需要的學生受欺凌的比率極高，在小學環境下有33%遭受[[欺凌]]，在中學環境下有47%。而於[[國際學生能力評估計劃]]的調查亦顯示，香港中學生遭到欺凌的比率為32.3%。即使家長們想尋求協助亦因資源問題，大部分服務需要自費，而基層家長較為難以負擔。另外，亦有[[社會工作|社工]]指出服務缺乏系統整理，而大部分學校都缺乏動機正面處理事件<ref name="明周文化 2018">{{cite web| title=【校園欺凌】產後抑鬱媽媽：過度活躍的七歲兒子，最怕他自殺| website=明周文化| date=2018-03-19| url=https://bkb.mpweekly.com/cu0001/20180319-69320| language=zh| access-date=2018-03-31| deadurl=yes| archiveurl=https://web.archive.org/web/20180329121916/https://bkb.mpweekly.com/cu0001/20180319-69320| archivedate=2018-03-29}}</ref>。
|url=http://a.udn.com/focus/2016/07/04/22965/index.html
|title=寧花100萬讓過動兒上課 就是不看病… - 聯合報 Focus
|website=聯合報官方網站
|date=2016-07-04
|archive-date=2017-02-27
|archive-url=http://a.udn.com/focus/2016/07/04/22965/index.html
|publisher=聯合報}}</ref>
<ref name="NIDAAAS" />。


==備註==
臺灣兒童青少年精神醫學會並在其官方公告發布數篇新聞稿<ref name="tscap1" />
{{noteFoot}}
<ref>{{cite web
|url=https://zh.wikisource.org/wiki/%E5%8F%B0%E7%81%A3%E5%85%92%E7%AB%A5%E9%9D%92%E5%B0%91%E5%B9%B4%E7%B2%BE%E7%A5%9E%E9%86%AB%E5%AD%B8%E6%9C%83%E6%96%B0%E8%81%9E%E7%A8%BF%EF%BC%882010.1.13%EF%BC%89
|title=台灣兒童青少年精神醫學會新聞稿（2010.1.13）
|website= 维基文库，自由的图书馆
|author=
|date=2010-01-13
|archive-date=2017-02-27
|archive-url=https://zh.wikisource.org/wiki/%E5%8F%B0%E7%81%A3%E5%85%92%E7%AB%A5%E9%9D%92%E5%B0%91%E5%B9%B4%E7%B2%BE%E7%A5%9E%E9%86%AB%E5%AD%B8%E6%9C%83%E6%96%B0%E8%81%9E%E7%A8%BF%EF%BC%882010.1.13%EF%BC%89
|publisher=}}</ref>，其內容除涵蓋對於當前治療策略的明確釋疑外，亦重申有科學根據、通過臨床試驗、獲得政府安全許可的把關才是一個療法對患者人生負責任的體現。<ref name="幫助ADHD孩子快樂成長"/>

以下為一位成人ADHD患者的心聲以及對治療方式的爭議之看法。<br/>（取自《家有過動兒：幫助ADHD孩子快樂成長》一書之書評。）<ref name="Having child with ADHD">{{cite book|author=高淑芬 |title=家有過動兒：幫助ADHD孩子快樂成長|year=2013 |publisher=心靈工坊 |location=台北 |isbn=9789866112805 |date=2013-08-28 |accessdate=2016-12-12|url=http://www.books.com.tw/products/0010597713 }}</ref>

{{Quote|text=...至此，我想說聲謝謝。我還記得大約四年前的我，光是要寫一篇一百多字的短文就要花上我超過兩個小時的時間。在那時，我經常遇到詞窮或是文句不通順的問題。文章常常寫到後來，我自己都看不懂自己到底在寫些什麼。歷經四年多不間斷的治療與自己的努力，這篇早已超過一百字的書評大約只花上半個小時的時間。這裡並沒有炫耀的意思，只是我從這樣的變化中看見了自己進步的軌跡。很高興當初的我沒有誤信[[偏方]]。

謝謝所有投入治療ADHD的相關人員，謝謝你們幫助我們的父母，學會用科學的角度看事情，讓這些天真的孩子們不再遭受主觀的道德審判。|author=SpringTed|title=''Book Review to Having a child with ADHD by Susan Shur-Feng Gau''|}}

==== 中國大陸 ====
中國大陸的多动症关爱协会指出：「中國大陸对『注意力缺陷多动障碍』的诊断、治疗尚不规范，家长的认知亦不够全面，导致社会上仍有很多不科学的治疗方式和训练方法在被家长们使用。」
<ref name="Mainland China II" />

== 常見的迷思与答复 ==
{{Inappropriate tone|章節|time=2017-02-25T07:02:10+00:00}}

=== 中華民國（台灣） ===

* 問題&nbsp;Question:
: 「ADHD及其藥物在台灣有被過度診斷、過度治療與濫用之虞。」
:: 答覆&nbsp;Answer： <br />
:: {{border |台灣兒童青少年ADHD-盛行率約7%~7.5%。全世界平均值約7.2%。<br/>根據健保資料庫，小於18歲之ADHD患者求診率約2.3％~2.5%，用藥率約1.6％，約1%的患者接受足夠時間完整的治療。<br/>因此「ADHD在台灣被過度診斷、過度治療根本是藥物濫用！」是不成立的。<ref>{{cite web|url=http://www.healthnews.com.tw/news/article/30113|title=三人成虎！　ADHD過動症須正視、勿輕信謠傳|first=|last=健康醫療網／編輯部報導|date=|publisher=}}</ref><ref name="Pingtung Hospital">{{cite news|url=http://news.ltn.com.tw/news/life/breakingnews/1937245|title=家有頑童？ 屏東醫院籲把握ADHD黃金治療期 | pages=生活 |newspaper=自由時報電子報|author=|date=2016|location=中華民國台灣 屏東縣屏東市|language=zh-tw|archive-date=2017-02-27|archive-url=http://news.ltn.com.tw/news/life/breakingnews/1937245}}</ref><ref name="Tc_ADHD"/>|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

* 問題&nbsp;Question:
: 「精神科醫師都只會開藥？」
:: 答覆&nbsp;Answer：
:: {{border |「至少一半以上的兒童青少年精神科醫師，門診的時間都是超時的，舉例來說：下午一兩點開始的門診幾乎都是看到晚上八點左右才下班的。倘若兒童青少年精神科醫師們都只是開藥、只想開藥，何須花這麼多時間呢？」<ref>{{cite news
|url=http://www.appledaily.com.tw/realtimenews/article/new/20160531/873827/|author=王浩威 |title=當正義成為法西斯 |pages= 即時新聞 |date= 2016-05-31 |newspaper= 蘋果日報 website=appledaily.com.tw|language=zh-tw|location=Taipei, Taiwan, Republic of China.|publisher=Apple Daily Incorporation|archive-date=2017-02-27|archive-url=http://www.appledaily.com.tw/realtimenews/article/new/20160531/873827/}}</ref>|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

* 問題&nbsp;Question:
: 「醫界不乏欠缺專業素養的醫師，難道醫界本身就不需要自我反省並改進？」
:: 答覆&nbsp;Answer：
:: {{border |您說的對，醫界本身也是需要持續的反省並求進。<ref>{{cite web|url=https://www.racp.edu.au/fellows/supporting-physicians-professionalism-and-performance-(sppp)/self-reflecting-on-your-practice|title=The Royal Australasian College of Physicians|first=The Royal Australasian College of|last=Physicians|date=|publisher=}}</ref>|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

* 問題&nbsp;Question:
: 「興奮劑藥物是否會造成幻覺及心臟問題？」
:: 答覆&nbsp;Answer：
:: {{border |網路常傳的嚴重問題機率都非常低（如幻覺，心臟問題），常只有千分之一到萬分之一，而且發生的機率和沒吃藥的人沒有差異。因此最新的頂尖期刊整理過去 185個研究(達一萬兩千多人），其研究結論是ADHD藥物未增加嚴重副作用風險的機會。相對上述風險，常被忽略的是注意力不足過動症。不治療，未來嚴重風險高達50%。<ref>{{cite web

| url =http://www.tc-adhd.com/?p=1565
| title =心動家族協會理事長專文：問ADHD藥物有無風險，不如問「不治療和治療的風險哪一個高」
| date =2016-04-18
| website =心動家族協會
| author=嘉義長庚醫院精神科副教授級主治醫師 陳錦宏
| access-date = January 2017
| quote = 最近網路冒出一些認為藥物沒有必要用、反而有害如毒品而倡導都不要用藥的訊息，因此許多人有所擔心，甚至造成許多認同治療的家長或老師被質疑與指責。因很遺憾依循知識並尋求專業協助的家長受到莫名的壓力，在此就用現代的研究知識來做說明。因為許多質疑在於藥物，此處就專門討論藥物，並不代表藥物為單一的治療選項。 先說兩個前提1.ADHD的理想治療一直都是多模式治療，即包含生物-心理-社會(教育與家庭)的協助，而非單靠單一模式可以完全處理，而這些模式彼此有加成效果而非互斥。2.對網路訊息來源的判斷依據的證據完整性了解，對於用”聽說”或”個案經驗”的傳遞訊息保留，是在現代網路資訊亂竄的情況下尤其重要。... 因此對那些根據現代知識，尋求專業協助，包括讓孩子使用藥物的家長們而言，提供了孩子ADHD這個問題帶來的許多嚴重後果的最大保護，他們沒有道理接受責難。反而是放棄這些可能的保護作用，選擇其他處理方式的人應該要注意到這些風險，因為任何淡化與忽視ADHD造成的未來風險，正是讓ADHD孩子將來進入險境的推手。我的門診持續遇到太晚來就診而已有輟學、吸毒、犯罪行為的ADHD國高中生被父母帶來想要改善這些問題，令人扼腕的是幾年前他們都曾在別的醫師處診斷出，然而因為聽信混淆言論未認真追蹤處理而陷於目前的險境。那很多人質疑：藥物沒有風險(副作用)嗎？答案當然是有，所以才需要專業醫師的協助評估使用需要性、種類、劑量、期限、副作用的監測及處理，否則藥就放在便利商店賣就好了。麻醉藥有風險、開刀的手術刀有風險、出門上學有風險、包括吃東西有噎到的風險，然而不會因此因噎廢食，因為不吃、不出門、不開刀，風險更高，能做的是在專業協助下將風險降到最低。所以當家長問治療有無風險時，我常說要問的正確問題其實該是「不治療和治療的風險哪一個高」。}}</ref>|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

* 問題&nbsp;Question:
: 「藥物只是用來控制服藥者?」
:: 答覆&nbsp;Answer：
:: {{border |治療並非是要將孩子們標準化（一致化），而是一本教育的初衷，協助每一位孩子發掘、發揚自己的優點、並避免缺點。而且藥物可以減少過動、衝動、分心等核心症狀，提升孩子的自制力，讓他們有足夠的能力追尋自己的夢想。另外一方面，藥物並非控制過動症狀，而是治療腦部先天性功能缺陷。<ref name="Pingtung Hospital" />|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

* 問題&nbsp;Question:
: 「個案並無上述『注意力不足過動症（ADHD）』的所有特徵，所以他不是『注意力不足過動症（ADHD）』。」
:: 答覆&nbsp;Answer：
:: {{border |有無全部特徵牽涉到是否有其他共病存在且治療的主要目的在於協助患者避免缺點並發揚優點。注意力不足過動症的診斷係依據DSM-TR精神疾病診斷與統計手冊的標準並輔以其他相關醫學資料。|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}
* 問題&nbsp;Question:
: 「藥物會傷身？會成癮？」
:: 答覆&nbsp;Answer：
:: {{border |所有用來治療注意力不足過動症的藥物只要依照醫師指示用藥，都是相當安全的。|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}
* 問題&nbsp;Question:
: 「何謂過動?」
:: 答覆&nbsp;Answer：
:: {{border |過動，即為『過度』活躍。過度兩字意味著活躍的程度已經對生活造成不良的影響。|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}
* 問題&nbsp;Question:
: 「為什麼『中樞神經興奮劑』被列為<u>第三級別</u>『管制藥品』？」
:: 答覆&nbsp;Answer：
:: {{border |因為此藥的的藥理學作用是增加多巴胺在腦部中的濃度，而長期過多的多巴胺濃度將使得大腦逐漸對刺激源產生『生理依賴』。管制的目的在於限制患者能取得的[[注意力不足過動症#医药治疗|中樞神經刺激劑]]數量。級別的制定乃考量到藥物過量的後果（例如：產生幻覺等）及相關部門的意見。請參見[[管制藥品]]。|display=block |width=1px |style=dotted |style2=2nd style |color=SpringGreen |lh=line height}}

=== 美國 ===
雖然個案常常看起來似乎已經興奮過頭，然而其藥物雖被歸納為興奮劑類，但是它們確實有幫助患者們保持平靜的效果。<ref>{{cite web
| url =https://medlineplus.gov/ency/article/001551.htm
| title = Medical Encyclopedia → Attention deficit hyperactivity disorder
| date =2017-01-05
| website =medlineplus.gov
| access-date = January 2017
| quote = Psychostimulants (also known as stimulants) are the most commonly used medicines. Although these drugs are called stimulants, they actually have a calming effect in people with ADHD.}}</ref>
每個人或多或少都會有分心、過動或衝動等症狀，但這些症狀在ADHD患者上會更為頻繁的出現、症狀的嚴重度更高且影響生活、學業、工作等。一個現象是否達到疾病等級，必須考量到頻率及程度。<ref>{{cite web
| url =https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
| title =Signs and symptoms of Attention Deficit Hyperactivity Disorder, National Institute of Mental Health.
| date =March 2013
| website =nimh.nih.gov
| publisher=National Institute of mental health
| access-date = January 2017
| quote = It is normal to have some inattention, unfocused motor activity and impulsivity, but for people with ADHD, these behaviors/are more severe, occur more often, interfere with or reduce the quality of how they functions socially, at school, or in a job.}}</ref>

有些家長或孩童會以為使用藥物就像吃了「聰明藥」一切都解決了，而對於藥物過度依賴。卻忽略藥物只是提供孩子學習與接受指導的最佳時機，藉由此時建立起學習策略、人際互動、行為管理的技巧，才是孩子一生受用的能力，也有機會不靠藥物自我管理。<ref name="Collaboration_II">{{cite book
| author-link = 國立臺灣大學醫學院附設醫院精神醫學部
| title = 注意力不足過動症
| publisher = 衛生福利部
| series = 衛生福利部精神疾病衛教叢書
| volume = 02
| edition = First
| location = Taipei
| language = zh-tw
| date = June, 2015.
| page = 19-20
| doi =
| isbn = 9789860454154
| quote=面對長期失敗與挫折經驗的心理傷害，往往難以用其它替代方式彌補。此時使用藥物輔助孩童，開始建立正向的自我控制與適應經驗，將有助於未來長期發展。若只是著眼於一時可能的藥物生理副作用，反而因小失大。反之，有些家長或孩童會以為使用藥物就像吃了「聰明藥」一切都解決了，而對於藥物過度依賴。卻忽略藥物只是提供孩子學習與接受指導的最佳時機，藉由此時建立起學習策略、人際互動、行為管理的技巧，才是孩子一生受用的能力，也有機會不靠藥物自我管理。}}</ref>

== 當前之環境與方向 ==

=== 中華民國（台灣） ===
縱然台灣的精神醫療環境持續進步中，不過到目前為止仍存有一些需要改進的地方。

對於患者來說，應注意所接受的療法是否受到政府的密切監督以確保符合嚴謹的研究設計及是否奠基於嚴謹實證醫學科學證據、充分研究證據支持療效且符合台灣現行的[[法|法律規範]]；對於政府衛生醫療相關單位而言：應給予足夠資源，強化對[[弱勢群體|弱勢]]家庭的支持，包括提升[[家庭教育|親職]]功能以及家族治療等，以便提供患者更完整有效的醫療模式。<ref name="tscap4"/>

從學術研究的視角來探討，相較於鄰近國家對於注意力不足過動症、自閉症的研究諸如：注意力不足過動症、自閉症、孩童青少年[[情緒]][[行為]]問題之研究、[[臨床醫學|臨床醫療]]、[[校園]][[教育]]、[[家庭]]的實際整合評估介入、相關因素背後的成因{{tsl|en|Mechanism_(biology)|機轉}}、{{le|危險因子|Risk factor}}、多元介入的成效、病程預後等研究的支持（例如：挹注特別經費，成立自閉症及注意力不足過動症研究中心，以建立本土化之基礎研究、[[轉譯]]研究、臨床研究與服務之整合模式），台灣對上述研究的支持力道仍顯不足。<ref name="tscap4"/>

就臺灣的醫療層面探討：目前兒童青少年[[精神病學|精神醫療]]相關專業人力（比如說：兒童青少年[[精神科醫師|精神科專科醫師]]、[[臨床心理學|臨床心理]]師、[[社工]]師等）資源仍相當缺乏，城鄉差距仍然頗大，以致許多兒童青少年的[[精神]]醫療需求（當然包括ADHD）無法被滿足。究因包括:健保結構/給付制度不夠合理、整體醫療規畫不足等問題。故合理調整兒童青少年精神醫療相關健保給付，並更進一步完善規劃兒童青少年精神醫療合理人力配置與專業人員之培育，是刻不容緩的要務。<ref name="tscap4"/>

教育層面而言，在校園與教育場所中，有心理衛生需求或是有嚴重行為情緒問題的學生，在校園常無法得到友善、妥善、合理的對待，究因包括：社會文化對於心理問題的負面標記、教師教學不良、[[心理輔導]]相關之執行人力與經費資源不足。故積極提升師生心理健康人權之正確認知與辨識能力、落實校園心理健康促進、充實校園心理輔導人力與增加相關教育經費，是迫切需要的。<ref name="tscap4">
{{cite web
|url=http://www.tscap.org.tw/TW/News2/ugC_News_Detail.asp?hidNewsCatID=8&hidNewsID=122
|title=20160728公聽會-建議新聞稿
|date=2016-07-28
|publisher=臺灣兒童青少年精神醫學會}}</ref>

除此之外，根據衛生福利部心理與口腔衛生司的資料，台灣在精神醫療照護上存在的盲點另有：
* 治療模式發展及處遇效能尚待精進。<ref name="mohw"/>
* 社區居住與就學、就業服務需積極發展。<ref name="mohw"/>
* 權益保障及去污名化待精進。<ref name="mohw"/>
* 病人分級方式與連續性照護模式尚待改善。<ref name="mohw"/>
* 精神病人的社區化照護仍需加強發展。<ref name="mohw">
{{cite web
|title = 問題評析
|author = 諶立中
|publisher = 中華民國衛生福利部心理與口腔衛生司
|date=2016-10-13
|url=http://www.ttpc.mohw.gov.tw/public/news/handouts/31b80fb2d33c0d78091e21b9679784ad.pdf
|access-date=2017-03-05
}}</ref>

{{註解|ADHD的多元介入治療包含藥物治療、親職[[心理輔導|諮商]]訓練、[[特殊教育|學校資源教育]]及[[社交]]技巧訓練等各種模式，這些治療模式的效果都有嚴謹而完整的科學研究加以證實。|註}}

=== 中國大陸 ===

中國大陸地區“注意力疾病”的诊断和治疗尚不完備，很多不科学的方式和方法依然在社会上使用。<ref name="Mainland China" />

香港特別行政區則遇到特教需求的識別及輪流服務的等候時間過長、資源及服務不足、教師人手不足及培訓有待改善、醫校社合作不順暢以及政府未有整體支援特教學生的政策藍圖及願景的問題。目前正在推動特殊教育進行立法，以全面保障特殊教育需要學生的權利。<ref name"Hong Kong, China">{{cite web
| title=《立法是否保障特殊教育需要學生的出路？》論壇
| date= 2015年3月29日(日)
| url=http://www.adhd.org.hk/education-event-detail.aspx?id=26
| location=Hong Kong, China.
| author=專注不足/過度活耀協會
| access-date=2017-03-15
}}</ref>

=== 美國 ===

雖然精神醫療環境持續進步中，然而注意力不足過動症患者接受[[注意力不足過動症#行為治療|行為治療]]的比例仍然太低。
<ref name="Guidelines_May_Have_Helped_Curb_ADHD_Diagnoses_in_Preschoolers">{{cite web
| url =https://medlineplus.gov/news/fullstory_162041.html
| title =Guidelines May Have Helped Curb ADHD Diagnoses in Preschoolers
| date =Tuesday, November 15, 2016
| website =MedlinePlus.gov
| publisher =HealthDay
| access-date =January 2017
| archive-url=https://consumer.healthday.com/kids-health-information-23/attention-deficit-disorder-adhd-news-50/guidelines-may-have-helped-curb-adhd-diagnoses-in-preschoolers-716849.html
| archive-date = Tuesday, November 15th, 2016.
| quote = Still, too few with disorder receive behavior therapy, child psychologist says.}}</ref>

== 注释 ==
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== 参考文献 ==
== 参考文献 ==
=== 參考資料 ===
<div style = "height:800px; overflow:auto; padding:3px; border:1px solid #aaa;">
{{Reflist|2|refs=
}}


=== 書目 ===
=== 書目 ===
{{refbegin}}
{{refbegin|2}}
* {{cite book|author1=Edward M. Hallowell|author2=John J. Ratey|title=分心不是我的錯（增訂版）：正確診療ADD，重建有計畫的生活方式 Driven to Distraction|date=2015-09-01|publisher=遠流出版|isbn=978-957-32-7700-2}}

* {{cite book|author=高淑芬 |title=找回專注力：成人ADHD全方位自助手冊 |year=2016年 |publisher=心靈工坊 |location=台北 |isbn=9789863570592 |date=2016-05-09 |accessdate=2016-12-12|url=http://www.books.com.tw/products/0010714786 }}
* {{cite book|author1= Edward M. Hallowell, M.D.|author2=John J. Ratey, M.D.|others=丁凡譯|title=《分心也有好成績》|location=台北 |publisher=遠流出版社 |year=2006 |isbn=9573259311 |accessdate=2016-12-09}}
* {{cite book|author=高淑芬 |title=家有過動兒：幫助ADHD孩子快樂成長 |year=2013 |publisher=心靈工坊 |location=台北 |isbn=9789866112805 |date=2013-08-28 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010597713 }}
* {{cite book|url=http://www.books.com.tw/products/0010687149 |author=Edward M. Hallowell, M.D. & John J. Ratey, M.D.著，丁凡譯|title=《分心不是我的錯》|location= 台北 |publisher= 遠流出版社 |year=2015 |isbn=9789573277002 |date=2015-08-28 |accessdate=2016-12-09}}
* {{cite book|author= Edward M. Hallowell, M.D. & John J. Ratey, M.D.著，丁凡譯|title=《分心也有好成績》|location=台北 |publisher=遠流出版社 |year=2006 |isbn=9573259311 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010348843}}
*{{cite book
*{{cite book
| author1=高淑芬
| author-link = 國立臺灣大學醫學院附設醫院精神醫學部
| author2=陳劭芊
| title = 注意力不足過動症
| title=注意力不足過動症
| publisher = 衛生福利部
| series = 衛生福利部精神疾病衛教叢書
| publisher=[[中華民國衛生福利部]]
| series=衛生福利部精神疾病衛教叢書
| volume = 02
| edition = First
| date=2015-06
| isbn=9789860454154
| location = Taipei
| language = zh-tw
| language=zh-hant
| url=https://www.mohw.gov.tw/dl-1728-547a9d89-00e5-4e9e-b998-26cff0ee69e7.html
| date = June, 2015.
| archiveurl=https://web.archive.org/web/20170219181830/http://www.mohw.gov.tw/MOHW_Upload/doc/%E5%BF%83%E7%90%86%E8%A1%9B%E7%94%9F%E5%B0%88%E8%BC%AF/03%E6%B3%A8%E6%84%8F%E5%8A%9B%E4%B8%8D%E8%B6%B3%E9%81%8E%E5%8B%95%E7%97%87.pdf
| doi =
| archivedate=2017-02-19
| isbn = 9789860454154
| access-date=2018-02-27
| url= http://www.mohw.gov.tw/MOHW_Upload/doc/心理衛生專輯/03注意力不足過動症.pdf
| dead-url=no
| archive-url=http://www.mohw.gov.tw/MOHW_Upload/doc/心理衛生專輯/03注意力不足過動症.pdf
}}
| archive-date=February 19th, 2017.
| access-date=February 19th, 2017.}}
* {{cite book|author= 許正典 教授著|title=《大人也有閃神的時候：終止注意力不集中與3分鐘熱度的症頭！》|location=台北 |publisher=晶冠出版社 |year=2014 |isbn=9789865852252 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010630851}}
* {{cite book|author= Paul Hammerness, Md、Margaret Moore、John Hanc 著, 黃書儀 譯|title=《練好專注力，事情再多也不煩！哈佛專家帶你學會高效能心智，告別無效窮忙 Organize Your Mind Organize Your Life : Train Your Brain to Get More Done in Less Time》|location=台北 |publisher=大寫出版社 |year=2013 |isbn=9789866316760 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010586777}}
* {{cite book|author=Melissa Orlov著，丁凡譯 |title=《不是你不再有吸引力，是他缺乏注意力 The ADHD Effect on Marriage》 |year=2012 |publisher=遠流出版社 |location=台北 |isbn=9789573269335 |date=2012-02-01 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010531867/|archive-url=http://www.books.com.tw/products/F012056635|archive-date=2017-02-25 }}
* {{cite book|author=櫻井公子著，李姵蓉譯 |title=《為什麼我這麼容易分心，愛亂買，不會收拾：心理醫生寫給注意力缺乏症的13項生活指南》 |year=2010 |publisher=漫遊者文化出版社 |location=台北 |isbn=9789866272332 |date=2010-11-11 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010486829}}
* {{cite book|author=Hayashi Nariyuk, M.D.著，陳光棻譯|title=《大腦不喜歡你這樣：甩開七個壞習慣，解放你的腦潛力》 |year=2011 |publisher=天下文化出版社 |location=台北 |isbn=9789862167656 |date=2011-06-30 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010509688}}
* {{cite book|author=Kenneth W. Christian 著，連映程譯|title=《這輩子，只能這樣嗎？Your Own Worst Enemy: Breaking the Habit of Adult Underachievement》 |year=2009 |publisher=早安財經 出版社 |location=台北 |isbn=9789866613203 |date=2013-08-28 |accessdate=2016-12-09|url=http://www.books.com.tw/products/0010455253}}
* {{cite book|author=Diane M. Kennedy|title=The ADHD-Autism Connection: A Step Toward More Accurate Diagnoses and Effective Treatment|year=2002 |publisher=WaterBrook |location=US |isbn=1578564980 |date=2002-03-19 |accessdate=2016-12-09|url=https://www.amazon.com/ADHD-Autism-Connection-Diagnoses-Effective-Treatment/dp/1578564980}}


* {{cite book | author=[[台灣赤子心過動症協會]] | contributor=[[台北榮總]] 兒童青少年精神科 陳映雪主任、[[臺大醫院]] 兒童心理衛生中心 高淑芬醫師、[[嬌生股份有限公司楊森大藥廠]] | title=ADHD家長手冊 | url=http://www.sw.ntpc.gov.tw/archive/file/ADHD%E5%AE%B6%E9%95%B7%E6%89%8B%E5%86%8A.pdf | date=2012-08 | contribution=撥冗審訂、贊助印製 | accessdate=2017-04-11 | archiveurl=https://web.archive.org/web/20170412065152/http://www.sw.ntpc.gov.tw/archive/file/ADHD%E5%AE%B6%E9%95%B7%E6%89%8B%E5%86%8A.pdf | archivedate=2017-04-12 | deadurl=yes }}
* {{cite book|author1=陳錦宏|author2=黃國祐|author3=王心怡|author4=陳茉莉|author5=朱倍毅|author6=鍾麗珍|author7=魚媽|date=2016-12|publisher=[[社團法人台灣心動家族兒童青少年關懷協會]]|title=ADHD家長教育手冊|url=http://www.tc-adhd.com/|access-date=2021-02-06|archive-date=2016-03-19|archive-url=https://web.archive.org/web/20160319082249/http://www.tc-adhd.com/|dead-url=no}}
* {{Cite book | author=陳錦宏 | year=2016 | title=《ADHD注意力不足過動症家長手冊》 | location=[[台灣]] | publisher=[[台灣兒童青少年精神醫學會]] | archive-url=https://web.archive.org/web/20210514204809/https://www.airitibooks.com/Detail/Detail?PublicationID=P20170929075 | archive-date=2021-05-14 | url=http://www.airitibooks.com/Detail/Detail?PublicationID=P20170929075 | language=zh-hant | isbn=9789869350907 | access-date=2018-03-13 | dead-url=no }}
{{refend}}
{{refend}}


=== 引用 ===
== 外部連結==
{{commons|Category:Attention deficit hyperactivity disorder}}

{{div col|cols=2}}
<div style = "height:800px; overflow:auto; padding:3px; border:1px solid #aaa;">
* {{CDC|url=https://www.cdc.gov/ncbddd/adhd/behavior-therapy.html|article=Behavior therapy for young children with ADHD}}

* [https://www.ntuh.gov.tw/PSY/Healthy/Attention/default.aspx 注意力不足過動症治療及就醫問與答-國立臺灣大學附設醫學院精神醫學部 衛生教育天地] {{Wayback|url=https://www.ntuh.gov.tw/PSY/Healthy/Attention/default.aspx |date=20190618081357 }}
{{Reflist|2}}
* [http://www.tscap.org.tw/TW/NewsColumn/ugC_News.asp 兒童青少年常見精神疾病衛教(介紹)-台灣兒童青少年精神醫學會] {{Wayback|url=http://www.tscap.org.tw/TW/NewsColumn/ugC_News.asp |date=20160815211710 }}

* [http://www.drhallowell.com/ Dr Hallowell] {{Wayback|url=http://www.drhallowell.com/ |date=20190107132114 }} - 愛德華·哈洛威爾（Edward Hallowell）醫師的ADD治療機構 {{en icon}}
</div>
* [http://www.goodtv.tv/video/index.php/series/index/927/0/0/22571 影片-【轉轉發現愛：家有過動兒】] {{Wayback|url=http://www.goodtv.tv/video/index.php/series/index/927/0/0/22571 |date=20161120214533 }}

* [http://www.cdc.gov/ncbddd/adhd/ Introducing ADHD-美國疾病管制局 Center for Disease Control] {{Wayback|url=http://www.cdc.gov/ncbddd/adhd/ |date=20210128113807 }} {{en icon}}
== 参见 ==
* [https://www.nlm.nih.gov/medlineplus/attentiondeficithyperactivitydisorder.html MedlinePlus for ADHD, U.S National Library of medicine. ADHD介紹 美國官方國家醫學圖書館] {{Wayback|url=https://www.nlm.nih.gov/medlineplus/attentiondeficithyperactivitydisorder.html |date=20160704211850 }} {{en icon}}
{{div col|cols=3}}
* [https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml ADHD, National Institute of Mental Health, U.S 美國衛生署] {{Wayback|url=https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml |date=20161225231931 }} {{en icon}}

* [[流行病学]]
* [[對照組]]
* [[變因]]
* [[雙盲]] (Double-blind)
* [[認知神經科學]]
* [[生活]]與[[品質]]
* [[客觀能力]]
* {{tsl|en|Habit|習慣}}
* [[動物行為學]]
* [[心理學]]
* [[本能行為|本能]]
* [[學習]]
* [[行为科学]]
* [[动机]]
* [[组织行为学]]
* [[理智]]
* [[生活品質]]
* [[健康]]
* [[社會關係]]
* [[认知偏差]]
* [[行為]]

{{div col end}}
{{div col end}}

{{-}}
{{-}}
{{Medical resources
| ICD11 = {{ICD11|6A05|821852937}}
| ICD10 = {{ICD10|F90}}
| ICD9 = {{ICD9|314.00}}, {{ICD9|314.01}}
| OMIM = 143465
| DiseasesDB = 6158
| Curlie =https://dmoz-odp.org/Health/Mental_Health/Disorders/Neurodevelopmental/ADD_and_ADHD/
| MedlinePlus = 001551
| eMedicineSubj = med
| eMedicineTopic = 3103
| eMedicine_mult = {{eMedicine2|ped|177}}
| MeshID = D001289
| Scholia =Q181923
| SNOMED CT =406506008
|QID=Q181923}}
{{Attention-deficit_hyperactivity_disorder}}
{{ICD-11-06}}


{{Portal bar|醫學|神經科學|藥理學|心理學|身心障礙|分子與細胞生物學|遺傳學|社會學}}
== 外部連結 ==
{{refbegin|2}}


[[Category:教育心理学]]
* [http://www.tscap.org.tw/TW/News2/ugC_News.asp?hidNewsCatID=8 台灣兒童青少年精神醫學會&nbsp;&nbsp;-新聞稿、澄清稿]
[[Category:神經科學]]
* [http://www.adhd.club.tw/ ADHD入口網站-台灣兒童青少年精神醫學會]
[[Category:慢性病]]
* [https://www.ntuh.gov.tw/PSY/Healthy/Attention/default.aspx 注意力不足過動症治療及就醫問與答-國立臺灣大學附設醫學院精神醫學部 衛生教育天地]
[[Category:注意力不足過動症]]
* [https://www.youtube.com/channel/UCtbke8CMDeyxLDYHvEzF7ew 影片-台大醫院精神醫學部高淑芬醫師研究室YouTube衛教頻道]
* [http://www.tscap.org.tw/TW/NewsColumn/ugC_News.asp 兒童青少年常見精神疾病衛教(介紹)-台灣兒童青少年精神醫學會]
* [http://www.tc-adhd.com/ 社團法人台灣心動家族兒童青少年關懷協會]
* [http://www.drhallowell.com/ Dr Hallowell] - 愛德華·哈洛威爾（Edward Hallowell）醫師的ADD治療機構 {{en icon}}
* [http://www.goodtv.tv/video/index.php/series/index/927/0/0/22571 影片-【轉轉發現愛：家有過動兒】]
* [http://www.cdc.gov/ncbddd/adhd/ Introducing ADHD-美國疾病管制局 Center for Disease Control] {{en icon}}
* [https://www.nlm.nih.gov/medlineplus/attentiondeficithyperactivitydisorder.html MedlinePlus for ADHD, U.S National Library of medicine. ADHD介紹 美國官方國家醫學圖書館] {{en icon}}
* [https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml ADHD, National Institute of Mental Health, U.S 美國衛生署] {{en icon}}
* [https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml Mental Health Medications, NIH, U.S. 精神健康用藥 美國衛生署] {{en icon}}
* [https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Concerta 藥品仿單 from DailyMed, NIH, U.S 美國衛生署下轄DailyMed藥品仿單(說明書)網站] {{en icon}}


[[Category:兒童和青少年的情緒及行為疾病]]
{{refend}}
[[Category:學習障礙]]

[[Category:苯丙胺]]
{{ICD-10-F}}
[[Category:病因不明的疾病]]

{{portal bar|医学}}

[[Category:注意缺陷障碍]]
[[Category:心理疾病]]
[[Category:精神病]]
[[Category:特殊教育]]
[[Category:注意力]]
[[Category:教育心理学]]
[[Category:精神病学诊断]]

2024年12月8日 (日) 13:17的最新版本

「过动症」重定向至此。關於膀胱的疾病，請見「膀胱過動症」。
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。
注意力不足過動症（ADHD）
attention deficit hyperactivity disorder
又称注意力缺失症、注意力缺陷過動症、過度活躍症、hyperkinetic disorder (ICD-10)
注意力不足過動症的常見症狀
注意力不足過動症的常見症狀
症状容易分心（英语：attentional shift）（難以把專注力放對地方）、過度的活動、 難以控制行為和衝動[1][2]
起病年龄6 - 12歲左右[3][4]
病程多於6個月[3]
类型特殊性发育障碍、多动障碍[*]、疾病、神经发育障碍
病因遗传因素（遗传、新生變異（英语：De novo mutation）），較小程度是环境因素（怀孕期间接触生物危害、创伤性脑损伤）
診斷方法根據症狀並排除其他可能的致病原因。[1]
鑑別診斷品行障碍、對立反抗症、學習障礙、躁鬱症[5]、自閉症光譜、睡眠障礙[6]、焦慮症[6]、憂鬱症[6]
治療心理治療、改變生活方式、藥物[1]
藥物中樞神經刺激劑、阿托莫西汀、胍法辛[7][8]
患病率5,110萬（2015年）[9]
分类和外部资源
醫學專科精神醫學、兒童與青少年精神醫學
ICD-116A05
ICD-10F90.0
OMIM143465、​608903、​608904、​608905、​608906、​612311、​612312
DiseasesDB6158
MedlinePluswillem
eMedicine289350、​912633
[编辑此条目的维基数据]
「ADHD」的各地常用譯名
中国大陸注意缺陷多动障碍
臺灣注意力不足過動症
香港專注力失調/過度活躍症
澳門專注力失調/過度活躍症
日本注意欠陥・多動性障害
大韓民國注意力缺乏過多行動障礙
注意力缺乏 過剩行動 症候群
越南𦇒亂增動減注意

注意力不足過動症（英語：attention deficit hyperactivity disorder，縮寫为ADHD），是一种神經發展障礙[10][11]。主要表现为難以專注、過度活躍、做事不考慮後果等。除此之外，还存在不合年紀的行為且存在注意力缺失问题的患者也可能表現出情緒調節困難或執行功能方面的問題[1][12]。對於診斷來說，症狀應在患者12歲之前出現、持續超過六個月、至少發生於兩種情境下（如學校、家中、休閒活動等）[3][4]。兒童患者注意力不集中的問題可能導致學習成績不佳[1]，此外，此病症也跟其他心智障礙或藥物濫用有關[13]。雖然此病症（特別是在現代社會中）會造成一些「障礙」，但很多過動症者會對他們感興趣或認為有價值的任務保持持續的專注，此狀況被稱為過度專注[14][15]。

儘管此病症在小孩與青年的範圍中被大量的研究以及診斷，多數的例子中，仍然找不到精確的病因，他們認為基因的原因占了75%，在懷孕期間尼古丁的接觸也可能是一個導致病因的外部風險，似乎跟自律以及家庭風格沒有關係[16]。依照《精神障碍诊断与统计手册》第四版（DSM-IV）的準則，約有5–7%的兒童確診[12][17]，若依照《国际疾病分类》第十版ICD-10的準則，則有1–2%確診[18]。2015年估計全球有5110萬人受到注意力不足過動症的影響[9]。盛行率主要會受到診斷方式及判斷基準不同所影響[19]，男孩確診的比例是女孩的二倍以上[12]，不過因為女孩的症狀和男孩不同，因此常被忽略[20][21][22]。兒童期診斷到的注意力不足過動症，約到30–50%會持續到成年，成年人約有2–5%會有成人注意力不足過動症[23][24][25]。在成人注意力不足過動症中，過動的情形可能會被「內在的不安寧」所取代[26]。ADHD的症狀可能不太容易和其他疾病的症狀區分，也不太容易區分正常範圍的活力充沛以及過動的分界點在哪裡[4]。

建議治療的方法依國家不同而有所差異，一般都會以心理治療、生活方式調整以及藥物，這三種中的一種或多種方式來進行治療[1]。英國的醫學指南建議針對兒童，只有在症狀嚴重時，才建議使用藥物為第一線的療法，若兒童拒絕接受心理治療，或是接受治療後進展不大，需考慮用藥物進行治療，若針對成人，藥物為第一線的治療方式[27]。加拿大及美國則是建議第一線的治療應該是合併藥物治療及行為治療，只有一些學齡前的兒童例外[28][29]。在所有的醫學指南中，都不建議針對學齡前的兒童用興奮劑作為第一線的治療方式[27][29]。用興奮劑治療，在前十四個月的療效有研究資料可供佐證，不過不確定長期使用的療效[30][31][32]。患有ADHD的成人可能會發展出應對方法（英语：Coping_(psychology)），來處理症狀造成的部份或所有影響[33]。

18世紀起的醫學文獻中就有描述過類似注意力不足過動症的症狀[34]。自1970年起，就有出現有關注意力不足過動症疾病本身、其診斷及治療方式的爭議[35]，爭議和臨床醫師、教師、政策訂定者、家長及媒體有關。爭議焦點包括ADHD的病因，以及是否要用興奮劑來治療ADHD[36]。目前大部份的醫療人員都接受ADHD是兒童及成人的遺傳性疾病，科學界的爭議點則是在其診斷方式及治療方式[37][38][39]。此疾病在1980年至1987年的正式名稱是注意力缺失症（attention-deficit disorder，簡稱ADD），在更早期的名稱是兒童過度活躍的反應（hyperkinetic reaction of childhood）[40][41]。

名稱

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注意力不足過動症也译作注意力不集中/過動症（英語：Attention Deficit/Hyperactivity Disorder，簡稱AD/HD）、過度活躍症（英語：Hyperkinetic Disorder；於ICD 10中的名稱），俗称有多動症、多動障礙及大雄·胖虎症候群（日本）等。此病患的兒童習稱過動兒，也有醫療人士建議改稱為心動兒[42][43]。

症狀及體徵

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ADHD的症狀[44]
專注力失調 過動-衝動
  • 很難注意事情的細節
  • 不容易專注在一件事情上
  • 不容易針對事物或是活動進行規劃組織
  • 會遺忘一些需要的物品
  • 在日常活動中比較健忘
  • 注意力持續時間較短，較容易分心
  • 不容易處理較具結構性的學校功課
  • 難以完成繁瑣或需要花時間的任務
  • 沒辦法好好坐著
  • 在座位上坐立不安、動來動去
  • 會在不適當的時間點離開座位
  • 從事具風險性的事物，不太考慮後果
  • 時常處於活躍狀態、精力充沛、停不下來
  • 說話的頻率及時間會比其他人要多
  • 問題未說完就搶著說答案
  • 不容易輪流等候
  • 在對話中常常插嘴或是打斷別人說話

注意力不足過動症的常見情形有不專心、過動（在成人則會以不安來表現）、破壞行為及衝動[45][46]。在人際關係及學業上都容易出現問題[45]，不過其症狀不容易定義，因為很難介定一般情形下的不專心、過動及衝動會到什麼程度，到什麼情形下才需要介入治療[47]。

依照《精神疾病診斷與統計手冊》（DSM）第五版（DSM-5）的定義，注意力不足過動症的症狀需出現超過六個月，或是其情形要比同年齡的要明顯很多[12]，而且其症狀已造成至少二個情境（例如社交、學校/工作、家庭）的問題[12]，這些條件需在12歲以前就出現[12]，若是17歲以下者，在專注力失調或是過動/衝動上的症狀，至少需要有六項符合，17歲以上者則需要至少五項符合[12]。

子類型

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注意力不足過動症可分為三個子類型[12][47]:

若是以注意力不足（專注力失調）為主的兒童或青少年，會有以下大部份甚至全部的症狀，且非由其他醫學疾病或藥物直接造成[12][48]：

  • 容易分心、粗心、忘記事情、且經常從一件事情切換至另一件事情。
  • 很難持續專注在同一件事情上。
  • 除非進行自身有興趣的事務，不然進行幾分鐘後就覺得無聊。
  • 難以對組織（規劃）事情、完成一個任務保持專注。
  • 很難完成回家作業，或是如期繳交，常會遺失一些要完成作業或是其他活動需要的東西（例如鉛筆、玩具、作業等）*
  • 當別人在和患者說話時，似乎沒有在聽對方說話。
  • 作白日夢、很感到困惑、動作緩慢。
  • 不容易像其他非注意力不足過動症患者一樣，快速且準確的處理資訊。
  • 難以遵從指示
  • 不容易認知細節，常忽略細節。

若是以過動為主的兒童或青少年，會有以下大部份甚至全部的症狀且非由其他醫學疾病或藥物直接造成[12][48]：

  • 常常煩躁及坐立不安
  • 不停地講話
  • 四處東奔西跑、碰觸或玩弄視野內的任一或每一個物體。
  • 難以在上課時間、吃飯時間、做功課的時間乖乖坐好。
  • 不停的動來動去。
  • 不容易進行安靜的活動或是工作。
  • 沒有耐心
  • 脫口說出不恰當的話語、毫無掩飾地流露內心的想法，且行事不顧後果。
  • 難耐在遊戲中因輪流所產生的等待時間。
  • 經常打斷他人的對話或活動。

若注意力不足過動症患者的症狀符合上述二類，則屬於合併型的注意力不足過動症。

ADHD的女性比較不會有過動及衝動的症狀，比較會有注意力不集中及分心的症狀[49]。注意力不足過動症中有關過動的症狀，可能會隨著年齡增長而漸漸消退，而轉變為青少年及成人階段的「內在不安寧」[23]。

注意力不足過動症的兒童、青少年及成年比較容易有社交技巧上的問題，例如社交互動、發展友誼及建立友誼。有半數的注意力不足過動症患者曾受到同儕社會排斥的情形，而沒有注意力不足過動症的人被社會排斥的比例約為10%至15%。患有注意力不足過動症的人比較不容易處理口語及非語言的訊息，比較容易在社交互動上有負面的影響，也比較容易在對話時離題、忽略到一些社交的資訊、也比較不容易學習社交技能[50]。

注意力不足過動症的兒童比較常有不容易控制情緒的問題[51]，其寫字（英语：handwriting）能力也比較弱[52]，在語言、說話及運動上的發展都比較晚[53][54]。雖然注意力不足過動症會造成許多的不便，不過若注意力不足過動症的兒童針對有興趣的主題及事物，其專注力持續時間和其他兒童相當，甚至比其他兒童要好[15]。

可能有關的疾病

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在注意力不足過動症患者中，大約會有三分之二的機率會伴隨其他的疾病或特徵[15]。常見的共病或特徵如下：

  • 癫痫[55]
  • 妥瑞症[55]
  • 自閉症光譜（ASD）：此疾病會影響社交技巧、溝通能力，也會出現固定興趣和重複行為[55]。
  • 在注意力不足過動症患者中，較常出現有焦虑症的情形[56]。
  • 間歇性暴怒症[12]
  • 在注意力不足過動症的兒童中，有20%至30%有學習障礙的情形。學習障礙可能包括發展障礙、語言障礙以及學習技巧的障礙[57]。注意力不足過動症本身不是一種學習障礙，不過常常會造成其他學業上的困難[57]。
  • 强迫症（OCD）常和注意力不足過動症一起出現，其中也有許多相同的特徵[58]。
  • 智能障礙[12]
  • 反應性依附疾患（英语：Reactive attachment disorder）[12]
  • 物質使用疾患。注意力不足過動症的兒童及成人在物質濫用上的風險較高[23]。最常見的是酒或是大麻[23]。物質使用疾患的原因可能和注意力不足過動症造成的大腦回饋酬賞迴路（英语：reward pathway）改變有關[23]。若注意力不足過動症和物質使用疾患一起出現，這會讓注意力不足過動症的評估及治療更加困難。如果ADHD合併「嚴重的」物質濫用問題，基於往後衍生的風險大小之考量，會優先治療物質濫用問題[59][60]。
  • 睡眠障碍常和ADHD一起出現。這也可能是治療ADHD的副作用。對於注意力不足過動症的兒童而言，失眠是最常見的睡眠障碍，一般會用行為療法來進行治療[61][62]。 ADHD患者常伴隨著不容易入睡的問題，而他們也會睡的比較熟，因此早上不容易起床[63]，有時會針對不容易入睡的兒童用褪黑素治療[64]。
  • ADHD的患者約有50%有對立反抗症（ODD），有20%有行為規範障礙（CD）[65]，其特性是反社會的行為，例如心態固執、有攻擊性、常常鬧脾氣（英语：temper tantrums）、說謊和偷竊等[58]。若有對立反抗症或行為規範障礙的ADHD患者，長大成人後出現反社会人格障碍的機率約有一半[66]。根據腦部造影，可確認ADHD和行為規範障礙是兩種不同的疾病[67]。
  • 有關注意力的原發型疾病，其症狀是注意力不佳，不容易專注，也不容易維持清醒。這類兒童常會坐立不安、打呵欠及伸展身體，這些動作看似過動，但其實是為了讓自己維持警覺以及有活力的狀態[68]。
  • 遲緩的認知速率（英语：Sluggish cognitive tempo）（SCT）是許多症狀的總稱，其中不少症狀可能也包括了注意力不足的問題。在ADHD的個案中，不論其子類型如何，有30%至50%符合這些症狀[69]。
  • 刻板的慣性動作症（英语：Stereotypic movement disorder）[12]
  • 情感障礙（特別是躁鬱症及重度抑郁症）。診斷患有混合子類型ADHD的男孩較容易有情感障礙[56]。有ADHD的成人有時也會有躁鬱症，需要很仔細的評估來診斷及治療這兩種疾病[70]。
  • 注意力不足過動症的患者較常有不寧腿綜合症，一般是因為缺鐵性貧血所造成[71][72]。不過不寧腿綜合症也可能是注意力不足過動症症狀的一部份，因此需要進行詳細的診斷，區分不寧腿綜合症和注意力不足過動症[73]。
  • 注意力不足過動症的患者出現夜遺尿的風險較高[74]。

有一個2016年的系統回顧發現注意力不足過動症和肥胖、哮喘及睡眠障礙有有著直接的關聯，和乳糜泻和偏頭痛也有一些關係[75]。不過同一年的另一篇系統回顧認為注意力不足過動症和乳糜泻沒有明確關係[76]。

智力

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有研究發現患有注意力不足過動症的人其智商（IQ）測試的結果會比沒有注意力不足過動症的人要低[77]，不過有關此研究結果的重要性，目前仍有爭議，因為很難區分影響是因為ADHD的症狀（例如分心）所造成還是ADHD本身對於智力有影響[77]。

有一份成人ADHD的研究指出有關ADHD患者在智力上的差異，沒有統計上的意義，也可以用其他相關的疾病來解釋[78]。

有一份最新的研究報告指出，智能障礙的病患罹患ADHD的機率相比其他人較為提高；而若親屬中有人為智能障礙者的話，家族中其他成員罹患ADHD的機率（相比於親屬中沒有智能障礙者）也較高。根據擬和模型的分析，造成這種情況的原因有91%的可能性與基因有關。[79]

診斷

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主条目：注意力不足過動症的診斷

注意力不足過動症的診斷是根據患者的行為和心理發展的評鑑並且排除毒品、藥物的影響、或其他生理或心理的可能造成類似ADHD症狀的因素而成。[59]診斷過程通常會將個案的父母意見及師長意見列入考量。[4] 大多數的診斷都是因為個案的教師首先對於孩子的健康提出關切，經轉介後而成。[80] 注意力不足過動症的症狀可能會被認為是人類個性光譜的極端或是其中一環而已。[81] 對於ADHD的藥物反應結果，無法就此確認診斷或排除診斷。迄今為止ADHD與非ADHD病患腦部構造的差異方面，學界尚未達成一致結論，因此腦部造影只被用於對於複雜的人腦進一步的研究，尚未能應用於診斷ADHD。[82]使用量化腦波（英语：quantitative electroencephalography） (QEEG) 診斷ADHD是學界中正在研究的領域之一，然而迄今為止，腦波經過量化後的數值與ADHD之間的關係仍然不明。[83][84]

注意力不足過動症又可細分為以下三種類型：注意力不足（專注力失調）為主型、過動-衝動為主型、或注意力不足（專注力失調）且過動-衝動的混合型。[85]過動，即為「過度」活躍。過度兩字意味著活躍的程度已經對生活造成不良的影響。[86]即便個案並無上述注意力不足過動症的所有特徵，他仍有可能是ADHD患者，有無全部特徵牽涉到是否有其他共病存在且治療的主要目的在於協助患者避免缺點並發揚優點。成人及兒童青少年的注意力不足過動症的診斷依據《精神疾病診斷與統計手冊》的標準、患者的歷史經歷（個案史）[85]、門診病人的主訴、症狀學、發展史、家族史、共病、生理評估、心理測驗（例如：工作記憶、執行功能：計畫與決策等、視覺記憶、空間記憶、理智等等[87]）及各種醫師評估後認為需要進一步的檢查等。[6][88][87]

ADHD隸屬於神經發育所致之精神疾患[11][23]。 除此之外，ADHD也隸屬於紊亂行為症候群（英语：disruptive behavior disorder），同樣隸屬於紊亂行為症候群的心理疾病有：對立反抗症、品行障碍、和反社会人格障碍[89]。ADHD的診斷並不暗指任何一個神經系統疾病（英语：neurological disorder）[90]。

醫師在診斷過程中必須衡量個案的焦慮、憂鬱程度、及對立反抗症、品行障碍、及學習和語言障礙。其他需要考量的問題包括：其他神經發育障礙、抽动综合症、和睡眠呼吸暂停[91]。

自我評量表，例如：ADHD 評量表（英语：ADHD rating scale）和Vanderbilt ADHD診斷評量表（英语：Vanderbilt ADHD diagnostic rating scale）會在診斷和評估ADHD的過程中使用。[92]

病因學

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ADHD患者的腦部與非ADHD患者（Typically developing controls）的腦部造影顯示的大腦發育成熟度的差異[93][94]。

迄今為止，注意力不足過動症是兒童精神病學，獲得最多且最深入研究的領域，然而絕大多數ADHD的確切成因目前並沒有定論[95]，最有可能是基因、環境和社會等因素交互作用導致。[96][97][98][99]

有些個案的成因可能與腦部的疾病感染和腦部創傷有關。[96][97][98]根據研究統計，注意力不足過動症具有相當高的遺傳率。[96][97]除了基因外，一些環境及社會因子也可能是注意力不足過動症的致病因素。[100][101][90]

基因遺傳

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双生子研究指出此疾病常常是遺傳得來的，佔了所有案例的75%[90][102][103]。若一兒童的兄弟姊妹中有患有ADHD，其自己身罹患ADHD的機率，是兄弟姊妹都沒有ADHD的兒童的三至四倍[104]。一般也認為基因因素會決定ADHD的症狀是否會持續到成年[105]。

一般來說，ADHD和許多基因有關，特別是和會影響多巴胺神經傳導的基因有關[106][107]。和多巴胺有關的有多巴胺轉運體（DAT）、多巴胺受体D4（DRD4）、多巴胺受体D5（英语：DRD5）、痕量胺相關受體1（英语：TAAR1）、單胺氧化酶A（英语：MAOA）、儿茶酚-O-甲基转移酶（COMT）及多巴胺β羟化酶（DBH）[107][108][109]，其他和ADHD有關的有血清素轉運體（SERT）、HTR1B（英语：HTR1B）、SNAP25（英语：SNAP25）、GRIN2A（英语：GRIN2A）、ADRA2A（英语：ADRA2A）、TPH2（英语：TPH2）及脑源性神经营养因子（BDNF）[106][107]。有一種常見的Latrophilin 3（英语：Latrophilin 3）基因變異，估計造成9%的ADHD，若有這種變異時，會對興奮劑藥物格外有反應[110]。DRD4 7R變體基因會增強多巴胺造成的抑制作用，也和ADHD有關。DRD4受體是G蛋白偶联受体，會抑制腺苷酸环化酶。DRD4-7R變異會造成許多行為上的表型，包括反映了注意力分散的ADHD症狀[111]。

演化也可能是造成ADHD高比率的原因，特別是男性過動以及衝動的傾向[112]，有人曾提出假說，認為女性比較容易被會冒險的男性所吸引，因此增加了基因庫中愛好衝動及冒險的基因的比率[113]。其他人則認為這種傾向有助於男性面對有壓力或是危險的環境（例如更有衝勁，從事探索行為）[112][113]。在特定情境下，ADHD傾向雖然對個體是有害的，但是對群體是有益的[112][113][114]。ADHD雖然對個體可能不利，但其高比例以及異質性也有利於群體的生殖健康，並且可以增加基因庫的多樣性，對群體有益[114]。在特定環境下，ADHD也可能對個體有利，例如對捕食者的反應更快，以及較好的狩獵技巧（英语：Hunter vs. farmer hypothesis）等[115]。

患有唐氏综合征的人比較容易患有ADHD[116]。

環境因素

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除了基因外，一些環境因子也可能是注意力不足過動症的致病因素[117]。例如：在懷孕期間攝取酒精可能導致胎兒酒精譜系障礙，可能包括了注意力不足過動症，或是有類似症狀[118]。暴露在特定有毒物質，例如：鉛或多氯聯苯等，可能會產生類似注意力不足過動症的中毒症狀[16][119]。暴露在磷酸酯的殺蟲劑毒死蜱及烷基磷酸酯（英语：Alkyl phosphate）中，也可能會增加患病的風險，不過此一論點尚未受到廣泛認可[120]。在懷孕過程中吸菸，將不利於胚胎的腦部神經發育，並將增加罹患注意力不足過動症的機率[16][121]。

新生兒極度早產、体重過輕、極端疏於照料、遭受凌虐、缺乏社會的互動也會增加ADHD的風險[16][122]。母親在懷孕期間、兒童在出生時或成長初期遭受一些疾病的感染都可能提高致病率（例如麻疹、, 帶狀皰疹（英语：Varicella zoster virus）、脑炎、風疹、EV71等）[123]。長時間於妊娠期間使用對乙醯胺酚與孩子出生後帶有ADHD，有統計上的相關性[124][125]。創傷性腦損傷的兒童中，後來至少有30%有ADHD的症狀[126]，其中約有5%是因為腦部損傷[127]。

一些研究發現，人工食用色素或防腐劑可能與少部分兒童出現類似ADHD的症狀，或者是與ADHD的流行率增加有關[16][128]，但是這些研究的證據力薄弱，而且可能只適用於有食物敏感的孩子[128][129][130]。英国及欧洲联盟已針對這些疑慮發布相關食品管理措施[131]。對於某些食物的食物過敏或食物不耐症，可能會惡化少數孩子既有的ADHD症狀[132]。

截至2018年11月，研究並不支持注意力不足過動症是因為攝取過多的精緻糖、看太多電視、教養方式（英语：parenting）、貧窮或家庭吵吵鬧鬧所造成，不過這些可能會讓一些注意力不足過動症的症狀更加惡化[46]。

社會

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有些情形下，ADHD的患者不是其自身的問題，而是反映了家庭機能不全或是教育系統的不足[133]。也有一種情形，診斷出ADHD表示其他人對其課業期待的增加，因為在一些國家，診斷是一種讓家長取得更多對小孩經濟及教育支持的方式[127]。一般有經歷過暴力或是情感虐待的兒童比較容易出現ADHD的行為[90]。

ADHD的社會建構理論（英语：social construct theory of ADHD）認為評斷正常及異常的標準是社會建構的（是由社會中的所有人建立並且使其有效的，特別是医生、病患、家長、教師等），然後再主觀的評估及判斷要使用哪一種準則，以及有多少人會因此受到影響[134]。他們認為這是依DSM-IV標準診斷到的ADHD人數會是由ICD-10標準所診斷人數三至四倍的原因[22]。湯瑪士·薩斯是ADHD社會建構理論的支持者，他認為ADHD是「發明出來的，之後取了這個名字」[135]。

班上裡年齡最小的兒童比較容易診斷為ADHD，原因可能是他們的發展本來就比其他年齡略長幾個月到一年的同學要晚一些[136][137][138]，在許多國家都有出現這種情形[138]，他們使用ADHD藥物的比例也是其他同學的兩倍左右[139]。

病理生理學

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主条目：注意力不足過動症的病理生理學
ADHD的左前額葉通常與控制組（非ADHD患者）顯著不同[140][141]。

注意力不足過動症被認為是肇因於部分腦內的神經傳導物質系統的損傷（特別是與多巴胺和正腎上腺素有關的神經傳導系統），進而對患者的腦部執行功能產生不良的影響[142][140]。多巴胺與正腎上腺素的腦內神經傳導物質通道系統（英语：Neural_pathway）大多起源自腦內的腹側被蓋區和藍斑核，並由此投射至不同的腦區且管理許多認知的流程（與認知功能相關的處理流程）。[142][143]特別是那些投射至前額葉和紋狀體的腦內多巴胺神經傳導通道系統（英语：dopaminergic pathway）和腦內正腎上腺素通道系統/藍斑核系統。它們主要的工作就是負責調節執行功能（認知和行為的功能與管理）、動機、 酬賞/報償的感受能力、和運動神經的功能[註 1]。[142][140][143]以上是目前已知在注意力不足過動症的病理生理學中扮演主要角色的幾條腦內神經傳導物質通道系統。也已經有人提議強化對於注意力不足過動症更全面的概觀以及更多可能與之相關的腦內神經傳導物質通道系統之探究。[140][144][145]

而研究也發現，注意力不足過動症是由一種發生於腦前額葉的遺傳性的多巴胺新陳代謝失常引致。更近期的研究認為正腎上腺素的新陳代謝亦會對病情有所影響 [146] [147] [148]。

截至2019年8月底，已知ADHD也與 血清素傳導系統（英语：serotonin pathways）（5hydroxytryptamine [5-HT]）、 乙酰胆碱傳導系統（英语：acetylcholine pathways）（ACH）、鴉片類傳導系統（英语：opioid pathways）、和谷氨酸傳導系統（英语：glutamate pathways）（GLU）的失調有關。[149][150][151]

治療

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主条目：注意力不足過動症的治療

注意力不足過動症的治療方式包括心理治療、行為治療及藥物，也有可能是用幾種方式一起進行。治療對病症會有長期的改善，但是無法完全根除病症的影響[152]。藥物包括有興奮劑、阿托莫西汀、腎上腺素受體α2（英语：alpha-2 adrenergic receptor）拮抗劑，有時也會包括抗抑鬱藥物[56][153]。若時無法專注在長期獎勵上的人，有許多的正增强方式可以提昇其工作表現[154]。ADHD藥物中的興奮劑也可以提昇患者的毅力及工作表現[140][154]。

行為治療

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有關行為治療在ADHD上的應用，有許多良好的實證，若是針對學齡前，或是症狀輕微的病患，一般會建議用行為治療為第一線的療法[155][156]。心理療法包括有心理教育、行為治療、认知行为疗法（CBT）、人際取向心理治療、家庭治療、學校介入、社交技巧訓練、行為方面的同儕介入、機構培訓[157]、父母管理訓練[90]。父母管理訓練可以改善包括反對行為以及不合常規行為在內的一些行為問題[158]。心理療法也包括神經反饋（英语：neurofeedback）訓練[159]，目前還不清楚是否有效[160]。

有關家庭治療的效果，目前還很少足夠品質的證據可以佐證。目前證據認為家庭治療的效果類似群體照顧（community care），效果比安慰劑要好[161]。有許多注意力不足過動症支持組織可以提供相關資訊，並且協助家庭適應ADHD的情形[162]。

有關社交技巧的訓練、行為調整以及藥物的對病患的好處可能有限。要減少後續心理及精神問題（例如重度抑郁症、犯罪、學校學習失敗、物質使用疾患）的主要因素是和沒有從事偏差行為的人建立友誼[163]。

規律的體能鍛煉，特別是有氧运动，對於患有ADHD的兒童及成人而言也是有效的附加療法（英语：adjunct therapy），特別是配合興奮劑藥物治療時更是如此，不過針對改善症狀，最理想的運動種類及強度還不清楚[164][165][166]。長期規律有氧運動對ADHD患者的好處是提昇行為及運動能力、提昇管控功能（包括專注、抑制控制、計劃等）、較快的資訊處理速度，記憶力也會比較好[164][165][166]。家長及教師針對ADHD兒童規律有氧运动對行為及以社交-情緒上的改善有：全身整體機能較佳、減少ADHD症狀、自尊感較好、減少焦慮及抑鬱的程度、較少身體症狀、課業成績及教室行為較佳，社交行為也有改善[164]。若在有使用興奮劑治療時進行運動，會增加興奮劑藥物對執行功能的影響[164]，一般認為運動的短期效果是因為運動時大腦突触多巴胺和去甲腎上腺素濃度的增加所造成[164]。

藥物

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針對注意力不足過動症，可以用中樞神經刺激劑（也稱為兴奋剂）藥物進行治療[167][168][已过时]，對於症狀至少會有一些效果，短期而言，約有80%會有效果[36][169][168]。家長及教師反應哌甲酯比較可以改善其症狀[36][170]，中樞神經刺激劑也可以減少ADHD兒童意外事故的風險[171]。針對ADHD的中樞神經刺激劑藥物除了哌甲酯外，還有苯丙胺、甲基苯丙胺等。

針對ADHD的非中樞神經刺激劑藥物有許多種，包括阿托莫西汀、安非他酮、胍法辛及可乐定，這些可以作為主要藥物治療，或是配合中樞神經刺激劑藥物一起使用[167][172]。目前有關各藥物之間的比較，還沒有說服力足夠的研究結果可以佐證，不過在副作用上似乎差不多[173]。中樞神經刺激劑藥物比較可以提昇課業表現，阿托莫西汀則無此效果[174]。阿托莫西汀比較不會有成癮問題，因此若有娛樂性藥物或是強迫性藥物使用風險的人，比較建議使用阿托莫西汀[23]。有關藥物對社交行為上的影響，目前的資料也還不充份[173]。截至2015年6月年 (2015年6月-Missing required parameter 1=month!)，還沒有完全確定ADHD藥物的長期影響[175][176]。核磁共振成像 研究推測長期用苯丙胺或哌甲酯治療，會減少因為ADHD造成的大腦功能及結構異常[177][178][179]。2018年的文獻回顧發現若考慮短期效果，哌甲酯對兒童最有效，苯丙胺對成人最有效[180]。

什麼情形要用胍法辛治療會依國家而不同，英國國家健康照護專業組織（英语：National Institute for Health and Care Excellence）（NICE）針對成人是第一線藥物，若針對兒童，只建議在病情嚴重時才使用，而大部份美國的醫學指南會建議可以針對各年齡層使用[28]。針對學齡前的兒童，一般不建議用藥物治療[90][181]。若治療用的中樞神經刺激劑劑量不足，可能會有沒有藥效的情形[182]，這尤其常出現在青少年及成人身上，因為核可的劑量是針對學齡兒童的，因此有些醫療人員會依體重或是依其他因素給藥[183][184][185]。

一般而言，在正常治療劑量的哌甲酯及中樞神經刺激劑是安全的，不過有其副作用以及禁忌症[167]。若哌甲酯給兒童及青少年使用，有研究發現這和一些嚴重或不嚴重的有害副作用有關，不過證據品質還不充份[186]。若針對兒童開立這類藥物，需仔細的監測兒童的情形[186]。若ADHD的中樞神經刺激劑嚴重過量，可能會和興奮性精神病（英语：stimulant psychosis）或是狂躁的症狀[187]。若是治療用的劑量，出現類似情形的機率非常低，只有0.1%，會在開始用中樞神經刺激劑藥物治療後的前幾週出現[187][188][189]，若也使用抗精神病药，可以有效緩解急性苯丙胺精神病的症狀[187]，若長期治療，需要定期的監測[190]。興奮劑的藥物治療需要定期停藥，評估是否還需要用藥、減少發育遲緩的情形，並且減低抗藥性[191][192]。若是長期使用超過ADHD治療劑量的興奮劑藥物濫用，一般會和成瘾及物質依賴有關[193][194]。不過未治療的ADHD，會提高物質濫用以及行為規範障礙的風險[193]。興奮劑藥物的使用，可能可以降低風險，但也有可能沒有此效果[23][175][193]。還不清楚懷孕時服用這些藥物是否安全[195]。

飲食

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飲食的調整可能對少部份的ADHD兒童有幫助[196]。一份2013年的統合分析針對有ADHD症狀，而且有補充游離脂肪酸或是減少食用有人工色素食品的兒童的相關研究發現，只有不到三分之一的兒童在症狀上有改善[129]。這方面的助益有可能只是對有食物敏感的兒童有幫助，也有可能是因為這些兒童同時也在接受ADHD的治療[129]。這些文獻也指出目前已有的證據無法支持減少食用特定食物來治療ADHD的療法[129]。2014年發表的文獻也發現排除飲食在治療ADHD上的成效有限[132]。另一篇2016年文獻回顧指出，根據研究結果，「無麩質飲食在未來成為ADHD的標準療法」之機率是微乎其微[76]。

2017的文獻回顧指出有一些排除飲食的方式對於非常小，無法用藥的幼童，以及對藥物沒有反應的患者可能有用，不過不鼓勵用補充游離脂肪酸或是減少食用有人工色素食品作為ADHD的正規治療方式[197] 。長期鐵、鎂及碘等礦物質的不足可能可以讓ADHD的症狀加劇[198]，也有少數證據指出組織內锌含量過低和ADHD有關[199]。不過除非證實有鋅不足（英语：zinc deficiency）的情形（目前多半是開發中國家才會有鋅不足的情形），一般不建議用鋅補充劑（英语：zinc supplementation）治療[200]。不過若鋅礦物質和苯丙胺類藥物同時使用的話，可以減低苯丙胺藥物的最小有效劑量，也就是可以服用較少的藥物而達到相同的效果[201]。另有證據指出Ω-3脂肪酸對於病情會有些許的改善，不過不建議取代醫學治療[202][203]。

流行病學

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主条目：注意力不足過動症的流行病學
注意力不足過動症各子類型的比例分布（紫色為混合型；藍色為注意力缺陷為主型；粉紅色為過動—衝動為主型）[204][205]

注意力不足過動症是童年階段最常見的發育疾患[206]。根據2015年發表的研究，依照DSM-III, DSM-III-R及DSM-IV的標準，國際ADHD流行率中位數，兒童為6-8%[207][17]。若使用ICD-10的標準，同年齡兒童的流行率則為1–2% [18]。

美國的成人注意力不足過動症的流行率為4-5%[208][209]。根據《找回專注力：成人ADHD全方位自助手冊》，成人ADHD在台灣的流行率推估為3-4%[96]:24-25。ADHD是全球性的[210][211][212][213]。世界各地ADHD流行率的差異主要是因為世界各地使用的ADHD診斷方法不同。[214] 若使用相同的診斷方法，則世界各地所得出的ADHD流行率將介於伯仲之間。[215]

在亞洲，台灣[216][217]、日本[218]、韓國[219]、越南[220]、中國大陸[221]、港澳[222][223]等地的未成年之ADHD流行率均介於6-8%之間。

英國和美國的ADHD診斷率和治療率自1970年代起逐年增加至今[224]。學界的共識認為這個現象是因為診斷方法的變遷[224]以及人們逐漸願意利用藥物來治療ADHD所致[18]，並非ADHD的流行率真的增加了。[214][225]

學界共識認為，2013年起，DSM的版本從DSM 4TR 推進到 DSM 5 會使得ADHD的診斷數增加（特別是成人注意力不足過動症的診斷數） [226]。

歷史

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主條目：「注意力不足/過動症」的歷史由來（英语：History of ADHD）
關於ADHD治療、診斷標準及流行率的時間軸 （英文）

1798年時蘇格蘭醫師亞歷山大·克里奇頓（英语：Alexander Crichton）在其著作《對精神紊亂的性質和起源的探究》（An inquiry into the nature and origin of mental derangement）中提到了精神不安[227][228]，1902年，英國兒科醫生George Still（英语：George Frederic Still）首次描述一項與注意力不足過動症近似的病徵[229][224]。

不同的時期，描述注意力不足過動症的名詞也有所不同：在1952年的DSM-I稱為微細腦功能失常，在1968年的DSM-II則稱為兒童活动亢进，在1980年的DSM-III稱為注意力不足症（可能伴隨過動，也可能沒有）英文為 attention-deficit disorder (ADD) with or without hyperactivity[224]，在1987年的DSM-III-R更名為注意力不足過動症，在1994年的DSM-IV將注意力不足過動症分為注意力散渙主導型（英语：Attention deficit hyperactivity disorder predominantly inattentive）、活動量過多型以及混合型[230]，在2013年的DSM-5仍延用此一分類[12]。其他的名詞有在1930年代使用的微細腦創傷[231]，但因為不少病童都沒有發覺有受過任何創傷，因此後來改名為微細腦功能失常。

1937年時，神經刺激劑開始用在注意力不足過動症的治療[232]。1934年時美國許可將安非他命用在注意力不足過動症治療，是美國第一個許可的苯丙胺類藥物[233]，1950年代開始使用哌甲酯（商品名稱為利他能），1970年代則開始使用对映异构的右旋苯丙胺[224]。

預後

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孩童的ADHD有30–50%的機率持續到其成人時期，[234][235][236] 那些持續被ADHD影響的成人可能會在成長過程中發展出一些技巧彌補部分ADHD的症狀。[33] 帶有ADHD的兒童與青少年相較於不帶有ADHD的兒童與青少年，有較高的風險發生意外受傷等事故。[171]

ADHD藥物能改善（非治癒）患者在生活中許多方面的功能性損傷（functional impairment ；可理解為應對能力的損傷）和生活品質（英语：Quality of life (healthcare)）（例如：發生意外事故的風險）。但是ADHD患者的學習障礙和執行功能缺損（例如時間管理、生活秩序以及組織能力[237]）等症狀，即便在服用ADHD藥物後，這些症狀的改善程度極其有限或幾乎沒有效果。[238]

考科藍協作組織於2015年發表的系統性文獻回顧指出，雖然中樞神經刺激劑不會令服用者產生嚴重的副作用，但他們較常出現失眠、食慾不振等較為輕微、影響較輕的副作用，並衍生出長期預後的不確定因素，因此未來的研究重點將會聚焦於探討解決前述的副作用的方法。與此同時，未來亦需要深入地研究「非藥物治療方式」以及可能的「非藥物治療方式」之隨機對照試驗[239][240]。

迄今為止，對於ADHD的長期追蹤調查主要都是小規模的，代表性有限。唯一規模較大也較具有代表性的美國衛生及公共服務部MTA（多模式治療）研究發現，那些曾在1990年代參加MTA的兒童ADHD，六到八年後進入青春期，他們在許多方面的應對能力，取決於他們小時候治療前呈現的症狀、共病、疾病的嚴重度以及治療後對於MTA四種治療模式的任意一種模式的契合度高低等因素。[241]

當MTA追蹤這些受試者長達十六年，直到受試者的平均年齡到達25歲的時候，發現這些患者生活中各領域的應對能力取決於ADHD的症狀是否持續到成年、ADHD的症狀嚴重度、和共病等因素。[242][243][244]

社會與文化

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美國電影電視演員伊丽莎·杜什库鼓勵大眾認識ADHD[245]

注意力不足過動症患者常被錯誤認為「只是懶惰或缺乏意志力」、「診斷只不過是用來為患者們的問題找藉口罷了」等。有ADHD患童因長期遭到霸凌，於獨處時結束生命。[246][247][248]台灣醫師的研究發現，在台灣，注意力不足過動症患者具有顯著較高的「因傷致死」機率，起因來自：自殺、意外和謀殺。[249]

一些家庭對過度活躍症認識不深，不了解、誤解為弱智、低能，大部份會選擇以暴易暴的方法解決問題。有些會選擇送去智能庇護所，因為專業人員不懂得審查過度活躍症與智障無關，患者會被送去孤兒院、保良局及兒童之家。

許多國家或地區都程度不等的在「精神醫療及心理衛生」方面遭遇資源不足以面對現實所需的情況。[250][251][252]以美國為例，美國精神醫療環境即便先進且持續進步中，然而注意力不足過動症患者接受行為治療的比例仍被當地學者專家認為仍然太低。 [252] 2017年美國政府撥出一億美金用於支持兒童與青少年常見精神疾病的研究：如何提供自閉症者更好的治療、其他兒童心理精神疾病（包括ADHD在內）的病理學及生理學等。[253]

治療方式的爭議

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主条目：注意力不足過動症的爭議

自1970年代開始，注意力不足過動症疾病本身、其診斷及醫療在歐美就已經是有爭議性的議題。爭議和臨床醫師、教師、政策訂定者、家長及媒體有關。世界衛生組織也認可治療ADHD兒童時，先進行非藥物治療再進行藥物治療的作法[254][255]，但各觀點對注意力不足過動症的認知差異很大。

有的觀點認為注意力不足過動症是正常行為的範圍內，也有的假定注意力不足過動症是一種遺傳疾病。其他有關注意力不足過動症的爭議包括對兒童用（合理劑量的）中樞神經刺激劑（俗稱興奮劑）藥物進行治療、診斷的方式，以及是否有過度診斷（英语：Overdiagnosis）的情形。有些宗教對治療方式也會有不同的認知，例如公民人權委員會（山達基在1969年成立的反精神醫學團體）曾在1980年代提出反對使用利他能的運動，目前該組織的立場仍是不主張用中樞神經刺激劑處方治療ADHD[256]。

中國大陸、香港

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目前注意力不足過動症的治療策略（涵蓋藥物及非藥物治療）已成為中國大陸的相關醫學指南 [257]，中國大陸的多动症关爱协会指出：「中國大陸对『注意力缺陷多动障碍』的诊断、治疗尚不规范，家长的认知亦不够全面，导致社会上仍有很多不科学的治疗方式和训练方法在被家长们使用。」

香港特別行政區則遇到特教需求的識別及輪流服務的等候時間過長、資源及服務不足、教師人手不足及培訓有待改善、醫校社合作不順暢以及政府未有整體支援特教學生的政策藍圖及願景的問題。目前正在推動特殊教育進行立法，以全面保障特殊教育需要學生的權利。[251]另外，香港的一項問卷調查發現，有特殊教育需要的學生受欺凌的比率極高，在小學環境下有33%遭受欺凌，在中學環境下有47%。而於國際學生能力評估計劃的調查亦顯示，香港中學生遭到欺凌的比率為32.3%。即使家長們想尋求協助亦因資源問題，大部分服務需要自費，而基層家長較為難以負擔。另外，亦有社工指出服務缺乏系統整理，而大部分學校都缺乏動機正面處理事件[258]。

備註

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  1. ^ 台灣兒童與青少年精神科醫師高淑芬在其著作《找回專注力：成人ADHD全方位自助手冊》提到，雖然「過動-衝動型」和「混合型」的ADHD從小就非常好動，坐不住，老是跑跑跳跳、追逐打鬧，精力無窮，但其實這類孩子的運動協調性可能不太好，運動協調性較弱的表象為：肢體動作較大、動作較粗魯。[96]

参考文献

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參考資料

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  1. ^ 1.0 1.1 1.2 1.3 1.4 1.5 Attention Deficit Hyperactivity Disorder. National Institute of Mental Health. 2016-03 [2016-03-05]. （原始内容存档于2016-07-23）. 
  2. ^ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th. Arlington: American Psychiatric Publishing. 2013: 59–65. ISBN 978-0-89042-555-8. 
  3. ^ 3.0 3.1 3.2 Symptoms and Diagnosis. Attention-Deficit / Hyperactivity Disorder (ADHD). Division of Human Development, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention. 2014-09-29 [2014-11-03]. （原始内容存档于2014-11-07）. 
  4. ^ 4.0 4.1 4.2 4.3 Dulcan MK, Lake M. Axis I Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence: Attention-Deficit and Disruptive Behavior Disorders. Concise Guide to Child and Adolescent Psychiatry 4th illustrated. American Psychiatric Publishing. 2011: 34. ISBN 978-1-58562-416-4 –通过Google Books. 
  5. ^ Ferri, Fred F. Ferri's differential diagnosis : a practical guide to the differential diagnosis of symptoms, signs, and clinical disorders 2nd ed. Philadelphia, PA: Elsevier/Mosby. 2010: Chapter A. ISBN 0323076998. 
  6. ^ 6.0 6.1 6.2 6.3 CDC. ADHD Symptoms and Diagnosis. Centers for Disease Control and Prevention. 2017-08-31 [2018-07-15]. （原始内容存档于2014-11-07）. Deciding if a child has ADHD is a several-step process. This page gives you an overview of how ADHD is diagnosed. There is no single test to diagnose ADHD, and many other problems, like sleep disorders, anxiety, depression, and certain types of learning disabilities, can have similar symptoms. 
  7. ^ Coghill DR, Banaschewski T, Soutullo C, Cottingham MG, Zuddas A. Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder. European Child & Adolescent Psychiatry. 2017-11, 26 (11): 1283–1307. ISSN 1018-8827. PMC 5656703 可免费查阅. PMID 28429134. doi:10.1007/s00787-017-0986-y. 
  8. ^ Jain R, Katic A. Current and Investigational Medication Delivery Systems for Treating Attention-Deficit/Hyperactivity Disorder. The Primary Care Companion for CNS Disorders. 2016-08, 18 (4). PMID 27828696. doi:10.4088/PCC.16r01979. 
  9. ^ 9.0 9.1 GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 2016-10-08, 388 (10053): 1545–1602. PMC 5055577 可免费查阅. PMID 27733282. doi:10.1016/S0140-6736(16)31678-6. 
  10. ^ Sroubek A, Kelly M, Li X. Inattentiveness in attention-deficit/hyperactivity disorder. Neuroscience Bulletin. 2013-02, 29 (1): 103–10. PMC 4440572 可免费查阅. PMID 23299717. doi:10.1007/s12264-012-1295-6. 
  11. ^ 11.0 11.1 Caroline SC (编). Encyclopedia of Cross-Cultural School Psychology. Springer Science & Business Media. 2010: 133 [2017-11-02]. ISBN 9780387717982. （原始内容存档于2020-12-22）. 
  12. ^ 12.00 12.01 12.02 12.03 12.04 12.05 12.06 12.07 12.08 12.09 12.10 12.11 12.12 12.13 12.14 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th. Arlington: American Psychiatric Publishing. 2013: 59–65. ISBN 0890425558. 
  13. ^ Erskine HE, Norman RE, Ferrari AJ, Chan GC, Copeland WE, Whiteford HA, Scott JG. Long-Term Outcomes of Attention-Deficit/Hyperactivity Disorder and Conduct Disorder: A Systematic Review and Meta-Analysis. Journal of the American Academy of Child and Adolescent Psychiatry. 2016-10, 55 (10): 841–50. PMID 27663939. doi:10.1016/j.jaac.2016.06.016. 
  14. ^ Kooij, J.J.S.; Bijlenga, D. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry. 2019-02, 56: 14–34. PMID 30453134. doi:10.1016/j.eurpsy.2018.11.001. 
  15. ^ 15.0 15.1 15.2 Walitza S, Drechsler R, Ball J. [The school child with ADHD] [The school child with ADHD]. Therapeutische Umschau. Revue Therapeutique. 2012-08, 69 (8): 467–73. PMID 22851461. doi:10.1024/0040-5930/a000316 （德语）. 
  16. ^ 16.0 16.1 16.2 16.3 16.4 NIMH. Attention Deficit Hyperactivity Disorder (Easy-to-Read). National Institute of Mental Health. 2013 [2016-04-17]. （原始内容存档于2016-04-14）. 
  17. ^ 17.0 17.1 Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012-07, 9 (3): 490–9. PMC 3441936 可免费查阅. PMID 22976615. doi:10.1007/s13311-012-0135-8. 
  18. ^ 18.0 18.1 18.2 Cowen, Philip; Harrison, Paul; Burns, Tom. Drugs and other physical treatments. Shorter Oxford Textbook of Psychiatry 6th. Oxford University Press. 2012: 546. ISBN 978-0-19-960561-3. 
  19. ^ Faraone SV. Ch. 25: Epidemiology of Attention Deficit Hyperactivity Disorder. Tsuang MT, Tohen M, Jones P (编). Textbook of Psychiatric Epidemiology 3rd. John Wiley & Sons. 2011: 450 [2018-09-16]. ISBN 9780470977408. （原始内容存档于2020-12-22）. 
  20. ^ Crawford, Nicole. ADHD: a women's issue. Monitor on Psychology. 2003-02, 34 (2): 28 [2019-11-21]. （原始内容存档于2017-04-09）. 
  21. ^ Emond V, Joyal C, Poissant H. [Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)] [Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)]. L'Encephale. 2009-04, 35 (2): 107–14. PMID 19393378. doi:10.1016/j.encep.2008.01.005 （法语）. 
  22. ^ 22.0 22.1 Singh I. Beyond polemics: science and ethics of ADHD. Nature Reviews. Neuroscience. 2008-12, 9 (12): 957–64. PMID 19020513. doi:10.1038/nrn2514. 
  23. ^ 23.0 23.1 23.2 23.3 23.4 23.5 23.6 23.7 Kooij SJ, Bejerot S, Blackwell A, Caci H, Casas-Brugué M, Carpentier PJ, et al. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry. 2010-09, 10: 67. PMC 2942810 可免费查阅. PMID 20815868. doi:10.1186/1471-244X-10-67. 
  24. ^ Bálint S, Czobor P, Mészáros A, Simon V, Bitter I. [Neuropsychological impairments in adult attention deficit hyperactivity disorder: a literature review] [Neuropsychological impairments in adult attention deficit hyperactivity disorder: A literature review]. Psychiatria Hungarica. 2008, 23 (5): 324–35. PMID 19129549 （匈牙利语）. 
  25. ^ Ginsberg Y, Quintero J, Anand E, Casillas M, Upadhyaya HP. Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. The Primary Care Companion for CNS Disorders. 2014, 16 (3). PMC 4195639 可免费查阅. PMID 25317367. doi:10.4088/PCC.13r01600. Reports indicate that ADHD affects 2.5%–5% of adults in the general population,5–8 compared with 5%–7% of children.9,10 ... However, fewer than 20% of adults with ADHD are currently diagnosed and/or treated by psychiatrists.7,15,16 
  26. ^ National Collaborating Centre for Mental Health (UK). Attention deficit hyperactivity disorder : diagnosis and management of ADHD in children, young people, and adults. National Collaborating Centre for Mental Health (Great Britain), National Institute for Health and Clinical Excellence (Great Britain), British Psychological Society., Royal College of Psychiatrists. Leicester: British Psychological Society. 2009: 17. ISBN 9781854334718. OCLC 244314955. PMID 22420012. 
  27. ^ 27.0 27.1 National Collaborating Centre for Mental Health. Pharmacological Treatment. Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines 72. Leicester: British Psychological Society. 2009: 303–307 [2017-06-22]. ISBN 978-1-85433-471-8. （原始内容存档于2016-01-13） –通过NCBI Bookshelf. 
  28. ^ 28.0 28.1 Canadian ADHD Practice Guidelines (PDF). Canadian ADHD Alliance. [2011-02-04]. （原始内容存档 (PDF)于2021-01-21）. 
  29. ^ 29.0 29.1 Attention-Deficit / Hyperactivity Disorder (ADHD): Recommendations. Centers for Disease Control and Prevention. 2015-06-24 [2015-07-13]. （原始内容存档于2015-07-07）. 
  30. ^ NIMH » The Multimodal Treatment of Attention Deficit Hyperactivity Disorder Study (MTA):Questions and Answers. NIMH » Home. [2019-01-01]. （原始内容存档于2021-01-30）. Why were the MTA medication treatments more effective than community treatments that also usually included medication? Answer: There were substantial differences in quality and intensity between the study-provided medication treatments and those provided in the community care group. 
  31. ^ Huang YS, Tsai MH. Long-term outcomes with medications for attention-deficit hyperactivity disorder: current status of knowledge. CNS Drugs. 2011-07, 25 (7): 539–54. PMID 21699268. doi:10.2165/11589380-000000000-00000. 
  32. ^ Arnold LE, Hodgkins P, Caci H, Kahle J, et al. Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder: a systematic review. PLOS One. 2015-02, 10 (2): e0116407. PMC 4340791 可免费查阅. PMID 25714373. doi:10.1371/journal.pone.0116407. 
  33. ^ 33.0 33.1 Gentile JP, Atiq R, Gillig PM. likelihood that the adult with ADHD has developed coping mechanisms to compensate for his or her impairment. Psychiatry. 2006-08, 3 (8): 25–30 [2019-01-02]. PMC 2957278 可免费查阅. PMID 20963192. （原始内容存档于2020-12-22）. 
  34. ^ Lange KW, Reichl S, Lange KM, Tucha L, Tucha O. The history of attention deficit hyperactivity disorder. Attention Deficit and Hyperactivity Disorders. 2010-12, 2 (4): 241–55. PMC 3000907 可免费查阅. PMID 21258430. doi:10.1007/s12402-010-0045-8. 
  35. ^ Parrillo VN. Encyclopedia of Social Problems. SAGE. 2008: 63 [2009-05-02]. ISBN 9781412941655. 
  36. ^ 36.0 36.1 36.2 Mayes R, Bagwell C, Erkulwater J. ADHD and the rise in stimulant use among children. Harvard Review of Psychiatry. 2008, 16 (3): 151–66. PMID 18569037. doi:10.1080/10673220802167782. 
  37. ^ Sim MG, Hulse G, Khong E. When the child with ADHD grows up (PDF). Australian Family Physician. 2004-08, 33 (8): 615–8 [2019-01-01]. PMID 15373378. （原始内容存档 (PDF)于2015-09-24）. 
  38. ^ Silver LB. Attention-deficit/hyperactivity disorder 3rd. American Psychiatric Publishing. 2004: 4–7. ISBN 978-1-58562-131-6. 
  39. ^ Schonwald A, Lechner E. Attention deficit/hyperactivity disorder: complexities and controversies. Current Opinion in Pediatrics. 2006-04, 18 (2): 189–95. PMID 16601502. doi:10.1097/01.mop.0000193302.70882.70. 
  40. ^ Weiss LG. WISC-IV clinical use and interpretation scientist-practitioner perspectives 1st. Amsterdam: Elsevier Academic Press. 2005: 237 [2019-01-01]. ISBN 978-0-12-564931-5. （原始内容存档于2021-01-16）. 
  41. ^ ADHD: The Diagnostic Criteria. PBS. Frontline. [2016-03-05]. （原始内容存档于2016-04-20）. 
  42. ^ 陳錦宏. 台灣心動家族兒童青少年關懷協會理事長陳錦宏醫師 敬上. Tc-adhd.com. 2015-04-18 [2016-12-09]. （原始内容存档于2018-02-24） （中文（臺灣））. 理事長的話：在這場演講，協會提出第一個主張，我們主張將ADHD原本「過動兒」的中文稱呼改為「心動兒」，因為ADHD包含沒有過動症狀的不專心兒童，「過動兒」常令人混淆，另外過動兒文字本身即包含負面意涵，而心動兒無此字義上的問題。 
  43. ^ 陳錦宏. 過動兒現象如何避免被以偏概全. 康健雜誌. 2017-01-25 [2018-04-14]. （原始内容存档于2017-09-24） （中文）. 
  44. ^ ADHD: Symptoms and Diagnosis. Centers for Disease Control and Prevention (2017). 2017-08-31. （原始内容存档于2014-11-07）. 
  45. ^ 45.0 45.1 Dobie C. Diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents: 79. 2012 [2012-10-10]. （原始内容存档于2013-03-01）. 
  46. ^ 46.0 46.1 CDC, Facts About ADHD, Centers for Disease Control and Prevention, 2016-01-06 [2016-03-20], （原始内容存档于2016-03-22） 
  47. ^ 47.0 47.1 Ramsay JR. Cognitive behavioral therapy for adult ADHD. Routledge. 2007: 4, 25–26. ISBN 978-0-415-95501-0. 
  48. ^ 48.0 48.1 National Institute of Mental Health. Attention Deficit Hyperactivity Disorder (ADHD). National Institutes of Health. 2008 [2019-12-03]. （原始内容存档于2013-01-19）. 
  49. ^ Gershon J. A meta-analytic review of gender differences in ADHD. Journal of Attention Disorders. 2002-01, 5 (3): 143–54. PMID 11911007. doi:10.1177/108705470200500302. 
  50. ^ Coleman WL. Social competence and friendship formation in adolescents with attention-deficit/hyperactivity disorder. Adolescent Medicine. 2008-08, 19 (2): 278–99, x. PMID 18822833. 
  51. ^ ADHD Anger Management Directory. Webmd.com. [2014-01-17]. （原始内容存档于2013-11-05）. 
  52. ^ Racine MB, Majnemer A, Shevell M, Snider L. Handwriting performance in children with attention deficit hyperactivity disorder (ADHD). Journal of Child Neurology. 2008-04, 23 (4): 399–406. PMID 18401033. doi:10.1177/0883073807309244. 
  53. ^ F90 Hyperkinetic disorders, International Statistical Classification of Diseases and Related Health Problems 10th Revision, World Health Organisation, 2010 [2014-11-02], （原始内容存档于2014-11-02） 
  54. ^ Bellani M, Moretti A, Perlini C, Brambilla P. Language disturbances in ADHD. Epidemiology and Psychiatric Sciences. 2011-12, 20 (4): 311–5. PMID 22201208. doi:10.1017/S2045796011000527. 
  55. ^ 55.0 55.1 55.2 ADHD Symptoms. nhs.uk. 2017-10-20 [2018-05-15]. （原始内容存档于2021-02-01）. 
  56. ^ 56.0 56.1 56.2 Wilens TE, Spencer TJ. Understanding attention-deficit/hyperactivity disorder from childhood to adulthood. Postgraduate Medicine. 2010-09, 122 (5): 97–109. PMC 3724232 可免费查阅. PMID 20861593. doi:10.3810/pgm.2010.09.2206. 
  57. ^ 57.0 57.1 Bailey, Eileen. ADHD and Learning Disabilities: How can you help your child cope with ADHD and subsequent Learning Difficulties? There is a way.. Remedy Health Media, LLC. [2013-11-15]. （原始内容存档于2013-12-03）. 
  58. ^ 58.0 58.1 Krull, KR. Evaluation and diagnosis of attention deficit hyperactivity disorder in children需要付费订阅. Uptodate. Wolters Kluwer Health. 2007-12-05 [2008-09-12]. （原始内容存档于2009-06-05）. 
  59. ^ 59.0 59.1 National Collaborating Centre for Mental Health. Attention Deficit Hyperactivity Disorder. Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines 72. Leicester: British Psychological Society. 2009: 18–26, 38 [2017-06-22]. ISBN 978-1-85433-471-8. （原始内容存档于2016-01-13） –通过NCBI Bookshelf. 
  60. ^ Wilens TE, Morrison NR. The intersection of attention-deficit/hyperactivity disorder and substance abuse. Current Opinion in Psychiatry. 2011-07, 24 (4): 280–5. PMC 3435098 可免费查阅. PMID 21483267. doi:10.1097/YCO.0b013e328345c956. 
  61. ^ Corkum P, Davidson F, Macpherson M. A framework for the assessment and treatment of sleep problems in children with attention-deficit/hyperactivity disorder. Pediatric Clinics of North America. 2011-06, 58 (3): 667–83. PMID 21600348. doi:10.1016/j.pcl.2011.03.004. 
  62. ^ Tsai MH, Huang YS. Attention-deficit/hyperactivity disorder and sleep disorders in children. The Medical Clinics of North America. 2010-05, 94 (3): 615–32. PMID 20451036. doi:10.1016/j.mcna.2010.03.008. 
  63. ^ Brown TE. ADD/ADHD and Impaired Executive Function in Clinical Practice. Current Psychiatry Reports. 2008-10, 10 (5): 407–11. PMID 18803914. doi:10.1007/s11920-008-0065-7. 
  64. ^ Bendz LM, Scates AC. Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder. The Annals of Pharmacotherapy. 2010-01, 44 (1): 185–91. PMID 20028959. doi:10.1345/aph.1M365. 
  65. ^ McBurnett K, Pfiffner LJ. Treatment of aggressive ADHD in children and adolescents: conceptualization and treatment of comorbid behavior disorders. Postgraduate Medicine. 2009-11, 121 (6): 158–65. PMID 19940426. doi:10.3810/pgm.2009.11.2084. 
  66. ^ Hofvander B, Ossowski D, Lundström S, Anckarsäter H. Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition (PDF). International Journal of Law and Psychiatry. 2009, 32 (4): 224–34 [2019-12-03]. PMID 19428109. doi:10.1016/j.ijlp.2009.04.004. （原始内容存档 (PDF)于2020-11-28）. 
  67. ^ Rubia K. "Cool" inferior frontostriatal dysfunction in attention-deficit/hyperactivity disorder versus "hot" ventromedial orbitofrontal-limbic dysfunction in conduct disorder: a review. Biological Psychiatry. 2011-06, 69 (12): e69–87. PMID 21094938. doi:10.1016/j.biopsych.2010.09.023. 
  68. ^ Weinberg WA, Brumback RA. Primary disorder of vigilance: a novel explanation of inattentiveness, daydreaming, boredom, restlessness, and sleepiness. The Journal of Pediatrics. 1990-05, 116 (5): 720–5. PMID 2329420. doi:10.1016/s0022-3476(05)82654-x. 
  69. ^ Barkley RA. Sluggish cognitive tempo (concentration deficit disorder?): current status, future directions, and a plea to change the name (PDF). Journal of Abnormal Child Psychology. 2014-01, 42 (1): 117–25 [2018-03-12]. PMID 24234590. doi:10.1007/s10802-013-9824-y. （原始内容存档 (PDF)于2017-08-09）. 
  70. ^ Baud P, Perroud N, Aubry JM. [Bipolar disorder and attention deficit/hyperactivity disorder in adults: differential diagnosis or comorbidity]. Revue Medicale Suisse. 2011-06, 7 (297): 1219–22. PMID 21717696 （法语）. 
  71. ^ Merino-Andreu M. [Attention deficit hyperactivity disorder and restless legs syndrome in children] [Attention deficit hyperactivity disorder and restless legs syndrome in children]. Revista de Neurologia. 2011-03,. 52 Suppl 1: S85–95. PMID 21365608 （西班牙语）. 
  72. ^ Picchietti MA, Picchietti DL. Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment. Sleep Medicine. 2010-08, 11 (7): 643–51. PMID 20620105. doi:10.1016/j.sleep.2009.11.014. 
  73. ^ Karroum E, Konofal E, Arnulf I. [Restless-legs syndrome]. Revue Neurologique. 2008, 164 (8–9): 701–21. PMID 18656214. doi:10.1016/j.neurol.2008.06.006 （法语）. 
  74. ^ Shreeram S, He JP, Kalaydjian A, Brothers S, Merikangas KR. Prevalence of enuresis and its association with attention-deficit/hyperactivity disorder among U.S. children: results from a nationally representative study. Journal of the American Academy of Child and Adolescent Psychiatry. 2009-01, 48 (1): 35–41. PMC 2794242 可免费查阅. PMID 19096296. doi:10.1097/CHI.0b013e318190045c. 
  75. ^ Instanes JT, Klungsøyr K, Halmøy A, Fasmer OB, Haavik J. Adult ADHD and Comorbid Somatic Disease: A Systematic Literature Review. Journal of Attention Disorders (Systematic Review). 2018-02, 22 (3): 203–228 [2021-02-06]. PMC 5987989 可免费查阅. PMID 27664125. doi:10.1177/1087054716669589. （原始内容存档于2017-02-07）. 开放获取
  76. ^ 76.0 76.1 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) 
  77. ^ 77.0 77.1 Frazier TW, Demaree HA, Youngstrom EA. Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology. 2004-07, 18 (3): 543–55. PMID 15291732. doi:10.1037/0894-4105.18.3.543. 
  78. ^ Bridgett DJ, Walker ME. Intellectual functioning in adults with ADHD: a meta-analytic examination of full scale IQ differences between adults with and without ADHD. Psychological Assessment. 2006-03, 18 (1): 1–14. PMID 16594807. doi:10.1037/1040-3590.18.1.1. 
  79. ^ 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. 
  80. ^ Mayes R, Bagwell C, Erkulwater JL. Medicating Children: ADHD and Pediatric Mental Health illustrated. Harvard University Press. 2009: 4–24. ISBN 978-0-674-03163-0. 
  81. ^ National Collaborating Centre for Mental Health. Diagnosis. Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines 72. Leicester: British Psychological Society. 2009: 116–7, 119 [2017-06-22]. ISBN 978-1-85433-471-8. （原始内容存档于2016-01-13） –通过NCBI Bookshelf. 
  82. ^ MerckMedicus Modules: ADHD –Pathophysiology. 2002-08 [2018-07-18]. （原始内容存档于2010-05-01）. 
  83. ^ Sand T, Breivik N, Herigstad A. [Assessment of ADHD with EEG]. Tidsskrift for Den Norske Laegeforening. 2013-02, 133 (3): 312–6. PMID 23381169. doi:10.4045/tidsskr.12.0224 （挪威语）. 
  84. ^ Millichap JG, Millichap JJ, Stack CV. Utility of the electroencephalogram in attention deficit hyperactivity disorder. Clinical EEG and Neuroscience. 2011-07, 42 (3): 180–4. PMID 21870470. doi:10.1177/155005941104200307. 
  85. ^ 85.0 85.1 American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: DSM-IV-TR®. American Psychiatric Association. 2000 [2017-02-17]. ISBN 978-0-89042-025-6. （原始内容存档于2020-09-23）. 
  86. ^ 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. 
  87. ^ 87.0 87.1 引用错误：没有为名为NIMH_ADHD_basic的参考文献提供内容
  88. ^ 陳錦宏. 心動家族:注意力不足過動症ＡＤＨＤ的第三條路. 台灣心動家族兒童青少年關懷協會. Tc-adhd.com. 2016-12-13 [2017-02]. （原始内容存档于2018-02-24） （中文（臺灣））. 
  89. ^ Wiener JM, Dulcan MK. Textbook Of Child and Adolescent Psychiatry illustrated. American Psychiatric Publishing. 2004 [2014-11-02]. ISBN 978-1-58562-057-9. （原始内容存档于2020-12-22）. 
  90. ^ 90.0 90.1 90.2 90.3 90.4 90.5 National Collaborating Centre for Mental Health. Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE Clinical Guidelines 72. Leicester: British Psychological Society. 2009 [2017-06-22]. ISBN 978-1-85433-471-8. （原始内容存档于2016-01-13） –通过NCBI Bookshelf. 
  91. ^ Wolraich M, Brown L, Brown RT, DuPaul G, Earls M, Feldman HM, Ganiats TG, Kaplanek B, Meyer B, Perrin J, Pierce K, Reiff M, Stein MT, Visser S. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011-11, 128 (5): 1007–22. PMC 4500647 可免费查阅. PMID 22003063. doi:10.1542/peds.2011-2654. 
  92. ^ Smith BJ, Barkley RA, Shapiro CJ. Attention-Deficit/Hyperactivity Disorder. Mash EJ, Barkley RA (编). Assessment of Childhood Disorders 4th. New York, NY: Guilford Press. 2007: 53–131. ISBN 978-1-59385-493-5. 
  93. ^ 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
  94. ^ Brain Matures a Few Years Late in ADHD, But Follows Normal Pattern. National Institutes of Health (NIH). 2015-10-06 [2018-12-29]. （原始内容存档于2020-12-22）. 
  95. ^ Attention Deficit/Hyperactivity Disorder. ScienceDirect: 42–58. 2015-01-01 [2018-09-19]. doi:10.1016/B978-0-12-398270-4.00004-5. （原始内容存档于2021-02-09）. Despite being the most studied disorder in child psychiatry, the pathophysiology of ADHD remains elusive. 
  96. ^ 96.0 96.1 96.2 96.3 96.4 高淑芬. 找回專注力：成人ADHD全方位自助手冊. 台北: 心靈工坊. 2016-05-09 [2016-12-12]. ISBN 9789863570592 （中文（臺灣））. 
  97. ^ 97.0 97.1 97.2 高淑芬. 家有過動兒：幫助ADHD孩子快樂成長. 台北: 心靈工坊. 2013-08-28. ISBN 9789866112805. 
  98. ^ 98.0 98.1 Millichap, J. Gordon. Chapter 2: Causative Factors. Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD 2nd. New York, NY: Springer Science. 2010: 26 [2021-02-06]. ISBN 978-1-4419-1396-8. LCCN 2009938108. doi:10.1007/978-104419-1397-5. （原始内容存档于2020-12-22）. 
  99. ^ Thapar A, Cooper M, Eyre O, Langley K. What have we learnt about the causes of ADHD?. J Child Psychol Psychiatry. 2013-01, 54 (1): 3–16. PMC 3572580 可免费查阅. PMID 22963644. doi:10.1111/j.1469-7610.2012.02611.x. 
  100. ^ CDC, Attention-Deficit / Hyperactivity Disorder (ADHD), Centers for Disease Control and Prevention, 2016-03-16 [2016-04-17], （原始内容存档于2016-04-14） 
  101. ^ Mental health of children and adolescents (PDF). 2005-01-15 [2011-10-13]. （原始内容存档 (PDF)于2009-10-24）. 
  102. ^ Psychiatric GWAS Consortium: ADHD Subgroup, Neale BM, Medland SE, Ripke S, Asherson P, Franke B, et al. Meta-analysis of genome-wide association studies of attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry. 2010-09, 49 (9): 884–97. PMC 2928252 可免费查阅. PMID 20732625. doi:10.1016/j.jaac.2010.06.008. 
  103. ^ Burt SA. Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychological Bulletin. 2009-07, 135 (4): 608–37. PMID 19586164. doi:10.1037/a0015702. 
  104. ^ Nolen-Hoeksema S. Abnormal Psychology Sixth. 2013: 267. ISBN 978-0-07-803538-8. 
  105. ^ Franke B, Faraone SV, Asherson P, Buitelaar J, Bau CH, Ramos-Quiroga JA, et al. The genetics of attention deficit/hyperactivity disorder in adults, a review. Molecular Psychiatry. 2012-10, 17 (10): 960–87. PMC 3449233 可免费查阅. PMID 22105624. doi:10.1038/mp.2011.138. 
  106. ^ 106.0 106.1 Gizer IR, Ficks C, Waldman ID. Candidate gene studies of ADHD: a meta-analytic review. Human Genetics. 2009-07, 126 (1): 51–90. PMID 19506906. doi:10.1007/s00439-009-0694-x. 
  107. ^ 107.0 107.1 107.2 Kebir O, Tabbane K, Sengupta S, Joober R. Candidate genes and neuropsychological phenotypes in children with ADHD: review of association studies. Journal of Psychiatry & Neuroscience. 2009-03, 34 (2): 88–101. PMC 2647566 可免费查阅. PMID 19270759. 
  108. ^ 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 可免费查阅. 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. 
  109. ^ Sotnikova TD, Caron MG, Gainetdinov RR. Trace amine-associated receptors as emerging therapeutic targets. Molecular Pharmacology. 2009-08, 76 (2): 229–35. PMC 2713119 可免费查阅. PMID 19389919. doi:10.1124/mol.109.055970. 
  110. ^ Arcos-Burgos M, Muenke M. Toward a better understanding of ADHD: LPHN3 gene variants and the susceptibility to develop ADHD. Attention Deficit and Hyperactivity Disorders. 2010-11, 2 (3): 139–47. PMC 3280610 可免费查阅. PMID 21432600. doi:10.1007/s12402-010-0030-2. 
  111. ^ Nikolaidis A, Gray JR. ADHD and the DRD4 exon III 7-repeat polymorphism: an international meta-analysis. Social Cognitive and Affective Neuroscience. 2010-06, 5 (2–3): 188–93. PMC 2894686 可免费查阅. PMID 20019071. doi:10.1093/scan/nsp049. 
  112. ^ 112.0 112.1 112.2 Glover V. Annual Research Review: Prenatal stress and the origins of psychopathology: an evolutionary perspective. Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2011-04, 52 (4): 356–67. PMID 21250994. doi:10.1111/j.1469-7610.2011.02371.x. 
  113. ^ 113.0 113.1 113.2 Williams J, Taylor E. The evolution of hyperactivity, impulsivity and cognitive diversity. Journal of the Royal Society, Interface. 2006-06, 3 (8): 399–413. PMC 1578754 可免费查阅. PMID 16849269. doi:10.1098/rsif.2005.0102. 
  114. ^ 114.0 114.1 Cardo E, Nevot A, Redondo M, Melero A, de Azua B, García-De la Banda G, Servera M. [Attention deficit disorder and hyperactivity: a pattern of evolution?] [Attention deficit disorder and hyperactivity: a pattern of evolution?]. Revista de Neurologia. 2010-03,. 50 Suppl 3: S143–7. PMID 20200842 （西班牙语）. 
  115. ^ Adriani W, Zoratto F, Laviola G. Brain Processes in Discounting: Consequences of Adolescent Methylphenidate Exposure. Stanford C, Tannock R (编). Behavioral neuroscience of attention deficit hyperactivity disorder and its treatment. Current Topics in Behavioral Neurosciences. Volume 9. New York: Springer. 2012-01-13: 132–134 [2019-12-03]. ISBN 978-3-642-24611-1. （原始内容存档于2020-12-22）. 
  116. ^ Ekstein S, Glick B, Weill M, Kay B, Berger I. Down syndrome and attention-deficit/hyperactivity disorder (ADHD). Journal of Child Neurology. 2011-10, 26 (10): 1290–5 [2021-02-06]. PMID 21628698. doi:10.1177/0883073811405201. （原始内容存档于2015-11-20）. 
  117. ^ CDC, Attention-Deficit / Hyperactivity Disorder (ADHD), Centers for Disease Control and Prevention, 2016-03-16 [2016-04-17], （原始内容存档于2016-04-14） 
  118. ^ Burger PH, Goecke TW, Fasching PA, Moll G, Heinrich H, Beckmann MW, Kornhuber J. [How does maternal alcohol consumption during pregnancy affect the development of attention deficit/hyperactivity syndrome in the child]. Fortschritte der Neurologie-Psychiatrie (Review). 2011-09, 79 (9): 500–6. PMID 21739408. doi:10.1055/s-0031-1273360 （德语）. 
  119. ^ Eubig PA, Aguiar A, Schantz SL. Lead and PCBs as risk factors for attention deficit/hyperactivity disorder. Environmental Health Perspectives (Review. Research Support, N.I.H., Extramural. Research Support, U.S. Gov't, Non-P.H.S.). 2010-12, 118 (12): 1654–67. PMC 3002184 可免费查阅. PMID 20829149. doi:10.1289/ehp.0901852. 
  120. ^ de Cock M, Maas YG, van de Bor M. Does perinatal exposure to endocrine disruptors induce autism spectrum and attention deficit hyperactivity disorders? Review. Acta Paediatrica (Review. Research Support, Non-U.S. Gov't). 2012-08, 101 (8): 811–8. PMID 22458970. doi:10.1111/j.1651-2227.2012.02693.x. 
  121. ^ Abbott LC, Winzer-Serhan UH. Smoking during pregnancy: lessons learned from epidemiological studies and experimental studies using animal models. Critical Reviews in Toxicology (Review). 2012-04, 42 (4): 279–303. PMID 22394313. doi:10.3109/10408444.2012.658506. 
  122. ^ Thapar A, Cooper M, Jefferies R, Stergiakouli E. What causes attention deficit hyperactivity disorder?. Archives of Disease in Childhood (Review. Research Support, Non-U.S. Gov't). 2012-03, 97 (3): 260–5. PMC 3927422 可免费查阅. PMID 21903599. doi:10.1136/archdischild-2011-300482. 
  123. ^ Millichap JG. Etiologic classification of attention-deficit/hyperactivity disorder. Pediatrics (Review). 2008-02, 121 (2): e358–65. PMID 18245408. doi:10.1542/peds.2007-1332. 
  124. ^ Ystrom E, Gustavson K, Brandlistuen RE, Knudsen GP, Magnus P, Susser E, Davey Smith G, Stoltenberg C, Surén P, Håberg SE, Hornig M, Lipkin WI, Nordeng H, Reichborn-Kjennerud T. Prenatal Exposure to Acetaminophen and Risk of ADHD. Pediatrics. 2017-11, 140 (5): e20163840. PMC 5654387 可免费查阅. PMID 29084830. doi:10.1542/peds.2016-3840. hdl:11250/2465905. 
  125. ^ Wolraich ML. An Association Between Prenatal Acetaminophen Use and ADHD: The Benefits of Large Data Sets. Pediatrics. 2017-11, 140 (5): e20172703. PMID 29084834. doi:10.1542/peds.2017-2703. 
  126. ^ Eme R. ADHD: an integration with pediatric traumatic brain injury. Expert Review of Neurotherapeutics (Review). 2012-04, 12 (4): 475–83. PMID 22449218. doi:10.1586/ern.12.15. 
  127. ^ 127.0 127.1 Mayes R, Bagwell C, Erkulwater JL. Medicating Children: ADHD and Pediatric Mental Health illustrated. Harvard University Press. 2009: 4–24. ISBN 978-0-674-03163-0. 
  128. ^ 128.0 128.1 Millichap JG, Yee MM. The diet factor in attention-deficit/hyperactivity disorder. Pediatrics. 2012-02, 129 (2): 330–7 [2019-12-03]. PMID 22232312. doi:10.1542/peds.2011-2199. （原始内容存档于2015-09-11）. 
  129. ^ 129.0 129.1 129.2 129.3 Sonuga-Barke EJ, Brandeis D, Cortese S, Daley D, Ferrin M, Holtmann M, Stevenson J, Danckaerts M, van der Oord S, Döpfner M, Dittmann RW, Simonoff E, Zuddas A, Banaschewski T, Buitelaar J, Coghill D, Hollis C, Konofal E, Lecendreux M, Wong IC, Sergeant J. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. The American Journal of Psychiatry. 2013-03, 170 (3): 275–89. PMID 23360949. doi:10.1176/appi.ajp.2012.12070991. Free fatty acid supplementation and artificial food color exclusions appear to have beneficial effects on ADHD symptoms, although the effect of the former are small and those of the latter may be limited to ADHD patients with food sensitivities... 
  130. ^ Tomaska LD, Brooke-Taylor S. Food Additives – General. Motarjemi Y, Moy GG, Todd EC (编). Encyclopedia of Food Safety 3 1st. Amsterdam: Elsevier/Academic Press: 449. 2014. ISBN 978-0-12-378613-5. OCLC 865335120. 
  131. ^ FDA, Background Document for the Food Advisory Committee: Certified Color Additives in Food and Possible Association with Attention Deficit Hyperactivity Disorder in Children (PDF), U.S. Food and Drug Administration, 2011-03 [2019-12-03], （原始内容存档 (PDF)于2015-11-06） 
  132. ^ 132.0 132.1 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 可免费查阅. 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. 
  133. ^ Mental health of children and adolescents (PDF). 2005-01-15 [2011-10-13]. （原始内容存档 (PDF)于2009-10-24）. 
  134. ^ Parens E, Johnston J. Facts, values, and attention-deficit hyperactivity disorder (ADHD): an update on the controversies. Child and Adolescent Psychiatry and Mental Health. 2009-01, 3 (1): 1. PMC 2637252 可免费查阅. PMID 19152690. doi:10.1186/1753-2000-3-1. 
  135. ^ Szasz T. Psychiatric Medicine: Disorder. Pharmacracy: medicine and politics in America. Westport, CT: Praeger. 2001: 101. ISBN 978-0-275-97196-0 –通过Google Books. Mental diseases are invented and then given a name, for example attention deficit hyperactivity disorder (ADHD). 
  136. ^ Holland, Josephine; Sayal, Kapil. Relative age and ADHD symptoms, diagnosis and medication: a systematic review. European Child & Adolescent Psychiatry. 2018-10-06 [2019-12-03]. ISSN 1435-165X. PMID 30293121. doi:10.1007/s00787-018-1229-6. （原始内容存档于2020-05-13）. 
  137. ^ Parritz R. Disorders of Childhood: Development and Psychopathology. Cengage Learning. 2013: 151. ISBN 978-1-285-09606-3. 
  138. ^ 138.0 138.1 [110] Stimulants for ADHD in children: Revisited | Therapeutics Initiative. 2018-05-28 [2018-07-06]. （原始内容存档于2021-01-30）. 
  139. ^ Stockman JA. Year Book of Pediatrics 2014 E-Book. Elsevier Health Sciences. 2016: 163 [2019-12-03]. ISBN 9780323265270. （原始内容存档于2020-12-22） （英语）. 
  140. ^ 140.0 140.1 140.2 140.3 140.4 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. 
  141. ^ Krain AL, Castellanos FX. Brain development and ADHD. Clin Psychol Rev. 2006-08, 26 (4): 433–444. PMID 16480802. doi:10.1016/j.cpr.2006.01.005. 
  142. ^ 142.0 142.1 142.2 Chandler DJ, Waterhouse BD, Gao WJ. New perspectives on catecholaminergic regulation of executive circuits: evidence for independent modulation of prefrontal functions by midbrain dopaminergic and noradrenergic neurons. Front. Neural Circuits. 2014-05, 8: 53. PMC 4033238 可免费查阅. PMID 24904299. doi:10.3389/fncir.2014.00053. 
  143. ^ 143.0 143.1 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)
  144. ^ Castellanos FX, Proal E. Large-scale brain systems in ADHD: beyond the prefrontal-striatal model. Trends Cogn. Sci. (Regul. Ed.). 2012-01, 16 (1): 17–26. PMC 3272832 可免费查阅. PMID 22169776. doi:10.1016/j.tics.2011.11.007. Recent conceptualizations of ADHD have taken seriously the distributed nature of neuronal processing [10,11,35,36]. Most of the candidate networks have focused on prefrontal-striatal-cerebellar circuits, although other posterior regions are also being proposed [10]. 
  145. ^ Cortese S, Kelly C, Chabernaud C, Proal E, Di Martino A, Milham MP, Castellanos FX. Toward systems neuroscience of ADHD: a meta-analysis of 55 fMRI studies. Am J Psychiatry. 2012-10, 169 (10): 1038–1055. PMC 3879048 可免费查阅. PMID 22983386. doi:10.1176/appi.ajp.2012.11101521. 
  146. ^ Dresel, S; Krause, J; Krause, KH; LaFougere, C; Brinkbäumer, K; Kung, HF; Hahn, K; Tatsch, K. Attention deficit hyperactivity disorder: binding of [99mTc]TRODAT-1 to the dopamine transporter before and after methylphenidate treatment.. European journal of nuclear medicine. 2000, 27 (10): 1518–24. ISSN 0340-6997. PMID 11083541. 
  147. ^ Krause, KH; Dresel, SH; Krause, J; la Fougere, C; Ackenheil, M. The dopamine transporter and neuroimaging in attention deficit hyperactivity disorder.. Neuroscience and biobehavioral reviews. 2003, 27 (7): 605–13. ISSN 0149-7634. PMID 14624805. 
  148. ^ Bymaster, F. Atomoxetine Increases Extracellular Levels of Norepinephrine and Dopamine in Prefrontal Cortex of Rat A Potential Mechanism for Efficacy in Attention Deficit/Hyperactivity Disorder. Neuropsychopharmacology (Springer Nature). 2002, 27 (5): 699–711 [2017-02-17]. doi:10.1016/s0893-133x(02)00346-9. The selective norepinephrine (NE) transporter inhibitor atomoxetine (formerly called tomoxetine or LY139603) has been shown to alleviate symptoms in Attention Deficit/Hyperactivity Disorder (ADHD). 
  149. ^ 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). 
  150. ^ Cortese S. The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): what every clinician should know. European Journal of Paediatric Neurology. 2012-09, 16 (5): 422–33. PMID 22306277. doi:10.1016/j.ejpn.2012.01.009. 
  151. ^ 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. 
  152. ^ Shaw M, Hodgkins P, Caci H, Young S, Kahle J, Woods AG, Arnold LE. A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Medicine. 2012-09, 10: 99. PMC 3520745 可免费查阅. PMID 22947230. doi:10.1186/1741-7015-10-99. 
  153. ^ Bidwell LC, McClernon FJ, Kollins SH. Cognitive enhancers for the treatment of ADHD. Pharmacology Biochemistry and Behavior. 2011-08, 99 (2): 262–74. PMC 3353150 可免费查阅. PMID 21596055. doi:10.1016/j.pbb.2011.05.002. 
  154. ^ 154.0 154.1 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. 
  155. ^ Fabiano GA, Pelham WE, Coles EK, Gnagy EM, Chronis-Tuscano A, O'Connor BC. A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review. 2009-03, 29 (2): 129–40. PMID 19131150. doi:10.1016/j.cpr.2008.11.001. 
  156. ^ Kratochvil CJ, Vaughan BS, Barker A, Corr L, Wheeler A, Madaan V. Review of pediatric attention deficit/hyperactivity disorder for the general psychiatrist. The Psychiatric Clinics of North America. 2009-03, 32 (1): 39–56. PMID 19248915. doi:10.1016/j.psc.2008.10.001. 
  157. ^ Evans SW, Owens JS, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology. 2014, 43 (4): 527–51. PMC 4025987 可免费查阅. PMID 24245813. doi:10.1080/15374416.2013.850700. 
  158. ^ Daley D, Van Der Oord S, Ferrin M, Cortese S, Danckaerts M, Doepfner M, Van den Hoofdakker BJ, Coghill D, Thompson M, Asherson P, Banaschewski T, Brandeis D, Buitelaar J, Dittmann RW, Hollis C, Holtmann M, Konofal E, Lecendreux M, Rothenberger A, Santosh P, Simonoff E, Soutullo C, Steinhausen HC, Stringaris A, Taylor E, Wong IC, Zuddas A, Sonuga-Barke EJ. Practitioner Review: Current best practice in the use of parent training and other behavioural interventions in the treatment of children and adolescents with attention deficit hyperactivity disorder (PDF). Journal of Child Psychology and Psychiatry, and Allied Disciplines. 2017-10, 59 (9): 932–947 [2019-11-21]. PMID 29083042. doi:10.1111/jcpp.12825. （原始内容 (PDF)存档于2019-04-04）. 
  159. ^ 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. 
  160. ^ 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. 
  161. ^ 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. 
  162. ^ Turkington, Carol; Harris, Joseph. attention deficit hyperactivity disorder (ADHD). The Encyclopedia of the Brain and Brain Disorders. Infobase Publishing: 47. 2009. ISBN 978-1-4381-2703-3 –通过Google Books. 
  163. ^ Mikami AY. The importance of friendship for youth with attention-deficit/hyperactivity disorder. Clinical Child and Family Psychology Review. 2010-06, 13 (2): 181–98. PMC 2921569 可免费查阅. PMID 20490677. doi:10.1007/s10567-010-0067-y. 
  164. ^ 164.0 164.1 164.2 164.3 164.4 Den Heijer AE, Groen Y, Tucha L, Fuermaier AB, Koerts J, Lange KW, Thome J, Tucha O. Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review. Journal of Neural Transmission. 2017-02, 124 (Suppl 1): 3–26. PMC 5281644 可免费查阅. PMID 27400928. doi:10.1007/s00702-016-1593-7. Beneficial chronic effects of cardio exercise were found on various functions as well, including executive functions, attention and behavior. 
  165. ^ 165.0 165.1 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 
  166. ^ 166.0 166.1 Rommel AS, Halperin JM, Mill J, Asherson P, Kuntsi J. Protection from genetic diathesis in attention-deficit/hyperactivity disorder: possible complementary roles of exercise. Journal of the American Academy of Child and Adolescent Psychiatry. 2013-09, 52 (9): 900–10. PMC 4257065 可免费查阅. PMID 23972692. doi:10.1016/j.jaac.2013.05.018. The findings from these studies provide some support for the notion that exercise has the potential to act as a protective factor for ADHD. 
  167. ^ 167.0 167.1 167.2 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. 
  168. ^ 168.0 168.1 Castells X, Ramos-Quiroga JA, Bosch R, Nogueira M, Casas M. Castells X , 编. Amphetamines for Attention Deficit Hyperactivity Disorder (ADHD) in adults. The Cochrane Database of Systematic Reviews. 2011-06, (6): CD007813. PMID 21678370. doi:10.1002/14651858.CD007813.pub2. 
  169. ^ Parker J, Wales G, Chalhoub N, Harpin V. The long-term outcomes of interventions for the management of attention-deficit hyperactivity disorder in children and adolescents: a systematic review of randomized controlled trials. Psychology Research and Behavior Management. 2013-09, 6: 87–99. PMC 3785407 可免费查阅. PMID 24082796. doi:10.2147/PRBM.S49114. Results suggest there is moderate-to-high-level evidence that combined pharmacological and behavioral interventions, and pharmacological interventions alone can be effective in managing the core ADHD symptoms and academic performance at 14 months. However, the effect size may decrease beyond this period. ... There is high level evidence suggesting that pharmacological treatment can have a major beneficial effect on the core symptoms of ADHD (hyperactivity, inattention, and impulsivity) in approximately 80% of cases compared with placebo controls, in the short term.22 
  170. ^ Storebø OJ, Ramstad E, Krogh HB, Nilausen TD, Skoog M, Holmskov M, et al. Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). The Cochrane Database of Systematic Reviews. 2015-11, 11 (11): CD009885. PMID 26599576. doi:10.1002/14651858.CD009885.pub2. 
  171. ^ 171.0 171.1 Ruiz-Goikoetxea M, Cortese S, Aznarez-Sanado M, Magallón S, Alvarez Zallo N, Luis EO, de Castro-Manglano P, Soutullo C, Arrondo G. Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews. 2018-01, 84: 63–71. PMID 29162520. doi:10.1016/j.neubiorev.2017.11.007. 
  172. ^ Childress AC, Sallee FR. Revisiting clonidine: an innovative add-on option for attention-deficit/hyperactivity disorder. Drugs of Today. 2012-03, 48 (3): 207–17. PMID 22462040. doi:10.1358/dot.2012.48.3.1750904. 
  173. ^ 173.0 173.1 McDonagh MS, Peterson K, Thakurta S, Low A. Drug Class Review: Pharmacologic Treatments for Attention Deficit Hyperactivity Disorder. Drug Class Reviews. United States Library of Medicine. 2011-12 [2019-11-21]. PMID 22420008. （原始内容存档于2016-08-31）. 
  174. ^ 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. 
  175. ^ 175.0 175.1 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. 
  176. ^ 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. 
  177. ^ Hart H, Radua J, Nakao T, Mataix-Cols D, Rubia K. Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: exploring task-specific, stimulant medication, and age effects. JAMA Psychiatry. 2013-02, 70 (2): 185–98. PMID 23247506. doi:10.1001/jamapsychiatry.2013.277. 
  178. ^ Spencer TJ, Brown A, Seidman LJ, Valera EM, Makris N, Lomedico A, Faraone SV, Biederman J. Effect of psychostimulants on brain structure and function in ADHD: a qualitative literature review of magnetic resonance imaging-based neuroimaging studies. The Journal of Clinical Psychiatry. 2013-09, 74 (9): 902–17. PMC 3801446 可免费查阅. PMID 24107764. doi:10.4088/JCP.12r08287. 
  179. ^ 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. 
  180. ^ Cortese, Samuele; Adamo, Nicoletta; Del Giovane, Cinzia; Mohr-Jensen, Christina; Hayes, Adrian J; Carucci, Sara; Atkinson, Lauren Z; Tessari, Luca; Banaschewski, Tobias; Coghill, David; Hollis, Chris; Simonoff, Emily; Zuddas, Alessandro; Barbui, Corrado; Purgato, Marianna; Steinhausen, Hans-Christoph; Shokraneh, Farhad; Xia, Jun; Cipriani, Andrea. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2018-09, 5 (9): 727–738. doi:10.1016/S2215-0366(18)30269-4. 
  181. ^ Greenhill LL, Posner K, Vaughan BS, Kratochvil CJ. Attention deficit hyperactivity disorder in preschool children. Child and Adolescent Psychiatric Clinics of North America. 2008-04, 17 (2): 347–66, ix. PMID 18295150. doi:10.1016/j.chc.2007.11.004. 
  182. ^ Stevens JR, Wilens TE, Stern TA. Using stimulants for attention-deficit/hyperactivity disorder: clinical approaches and challenges. The Primary Care Companion for CNS Disorders. 2013, 15 (2). PMC 3733520 可免费查阅. PMID 23930227. doi:10.4088/PCC.12f01472. 
  183. ^ Young, Joel L. Individualizing Treatment for Adult ADHD: An Evidence-Based Guideline. Medscape. 2010 [2016-06-19]. （原始内容存档于2015-05-08）. 
  184. ^ 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.     
  185. ^ Kessler S. Drug therapy in attention-deficit hyperactivity disorder. Southern Medical Journal. 1996-01, 89 (1): 33–8. PMID 8545689. doi:10.1097/00007611-199601000-00005. 
  186. ^ 186.0 186.1 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. 
  187. ^ 187.0 187.1 187.2 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.     
  188. ^ 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. 
  189. ^ 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. 
  190. ^ 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. 
  191. ^ 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. 
  192. ^ Ibrahim K, Donyai P. Drug Holidays From ADHD Medication: International Experience Over the Past Four Decades. Journal of Attention Disorders. 2015-07, 19 (7): 551–68 [2019-11-21]. PMID 25253684. doi:10.1177/1087054714548035. （原始内容存档 (PDF)于2016-06-30）. 
  193. ^ 193.0 193.1 193.2 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 
  194. ^ Oregon Health & Science University. Black box warnings of ADHD drugs approved by the US Food and Drug Administration. Portland, Oregon: United States National Library of Medicine. 2009 [2014-01-17]. （原始内容存档于2017-09-08）. 
  195. ^ Ashton H, Gallagher P, Moore B. The adult psychiatrist's dilemma: psychostimulant use in attention deficit/hyperactivity disorder. Journal of Psychopharmacology. 2006-09, 20 (5): 602–10 [2019-11-21]. PMID 16478756. doi:10.1177/0269881106061710. （原始内容存档于2009-08-15）. 
  196. ^ Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. Journal of the American Academy of Child and Adolescent Psychiatry. 2012-01, 51 (1): 86–97.e8. PMC 4321798 可免费查阅. PMID 22176942. doi:10.1016/j.jaac.2011.10.015. 
  197. ^ Pelsser LM, Frankena K, Toorman J, Rodrigues Pereira R. Diet and ADHD, Reviewing the Evidence: A Systematic Review of Meta-Analyses of Double-Blind Placebo-Controlled Trials Evaluating the Efficacy of Diet Interventions on the Behavior of Children with ADHD. PLoS One (Systematic Review). 2017-01, 12 (1): e0169277. PMC 5266211 可免费查阅. PMID 28121994. doi:10.1371/journal.pone.0169277. 开放获取
  198. ^ 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. 
  199. ^ Arnold LE, DiSilvestro RA. Zinc in attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology. 2005-08, 15 (4): 619–27. PMID 16190793. doi:10.1089/cap.2005.15.619. hdl:1811/51593. 
  200. ^ Bloch MH, Mulqueen J. Nutritional supplements for the treatment of ADHD. Child and Adolescent Psychiatric Clinics of North America. 2014-10, 23 (4): 883–97. PMC 4170184 可免费查阅. PMID 25220092. doi:10.1016/j.chc.2014.05.002. 
  201. ^ 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. 
  202. ^ Bloch MH, Qawasmi A. Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry. 2011-10, 50 (10): 991–1000. PMC 3625948 可免费查阅. PMID 21961774. doi:10.1016/j.jaac.2011.06.008. 
  203. ^ Königs A, Kiliaan AJ. Critical appraisal of omega-3 fatty acids in attention-deficit/hyperactivity disorder treatment. Neuropsychiatric Disease and Treatment. July 2016, 12: 1869–82. PMC 4968854 可免费查阅. PMID 27555775. doi:10.2147/NDT.S68652. 
  204. ^ Approximate Prevalence Distribution of the Subtypes of ADHD as cited by Cognitive-Behavioral Therapy for Adult ADHD. New York, NY: Routledge. 2008.
  205. ^ Ramsay, J. Cognitive-behavioral therapy for adult ADHD : an integrative psychosocial and medical approach. New York: Routledge. 2015. ISBN 0-415-81591-6. OCLC 876336915. 
  206. ^ 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]. 
  207. ^ Thomas, R.; Sanders, S.; Doust, J.; Beller, E.; Glasziou, P. Prevalence of Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis. PEDIATRICS (secondary source or tertiary source) (American Academy of Pediatrics (AAP)). 2015, 135 (4): e994–e1001 [2017-04-21]. doi:10.1542/peds.2014-3482. 7.2% (95% confidence interval: 6.7 to 7.8) 
  208. ^ Kessler, Ronald C.; Adler, Lenard; Barkley, Russell; Biederman, Joseph; Conners, C. Keith; Demler, Olga; Faraone, Stephen V.; Greenhill, Laurence L.; Howes, Mary J.; Secnik, Kristina; Spencer, Thomas; Ustun, T. Bedirhan; Walters, Ellen E.; Zaslavsky, Alan M. The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. The American journal of psychiatry. 1963-06-08, 163 (4) [2018-09-26]. PMID 16585449. doi:10.1176/appi.ajp.163.4.716. （原始内容存档于2021-05-25）. 
  209. ^ RC, Kessler; Al., Et. The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. - PubMed. NCBI. 2018-09-26 [2018-09-26]. （原始内容存档于2020-05-19）. 
  210. ^ TSCAP. 臺灣兒童青少年精神醫學會新聞稿20160603. Tscap.org.tw. [2016-12-27]. （原始内容存档于2016-11-30）. 
  211. ^ Norén Selinus, E.; Molero, Y.; Lichtenstein, P.; Anckarsäter, H.; Lundström, S.; Bottai, M.; Hellner Gumpert, C. Subthreshold and threshold attention deficit hyperactivity disorder symptoms in childhood: psychosocial outcomes in adolescence in boys and girls. Acta Psychiatrica Scandinavica (Wiley-Blackwell). 2016-10-07, 134 (6): 533–545. ISSN 0001-690X. doi:10.1111/acps.12655. 
  212. ^ Biederman, Joseph; Faraone, Stephen V. Attention Deficit Hyperactivity Disorder. The Journal of Nervous and Mental Disease (Ovid Technologies (Wolters Kluwer Health)). 2004, 192 (7): 453–454. ISSN 0022-3018. doi:10.1097/01.nmd.0000131803.68229.96. 
  213. ^ Polanczyk, Guilherme; de Lima, Maurício Silva; Horta, Bernardo Lessa; Biederman, Joseph; Rohde, Luis Augusto. The Worldwide Prevalence of ADHD: A Systematic Review and Metaregression Analysis. American Journal of Psychiatry (American Psychiatric Publishing). 2007, 164 (6): 942–948. ISSN 0002-953X. doi:10.1176/ajp.2007.164.6.942. 
  214. ^ 214.0 214.1 Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. The American Journal of Psychiatry. 2007-06, 164 (6): 942–8. PMID 17541055. doi:10.1176/appi.ajp.164.6.942. 
  215. ^ Jones, edited by Ming Tsuang, Mauricio Tohen, Peter B. Textbook of psychiatric epidemiology 3rd. Chichester, West Sussex: Wiley-Blackwell. : 450 [2018-09-16]. ISBN 9780470977408. （原始内容存档于2020-12-22）. 
  216. ^ 全民健康保險研究資料庫 National Health Insurance Research Database. Taiwan, Republic of China.开放获取. [2017-03-17]. （原始内容存档于2017-02-15）. 
  217. ^ 注意力不足過動症ＡＤＨＤ的第三條路：心動家族. 康健雜誌. 2016-10-04 [2017-06-21]. （原始内容存档于2020-11-25） （中文）. 「台灣對這個疾病的知識不足，網路民間常流竄1-20年前過時的資料，而真正接受過此疾病診斷及整合式治療訓練的專科醫師如兒心科醫師又少之又少。」、「ADHD全世界平均盛行率為7.2%，台灣社區研究為7.5%，而台灣健保資料庫研究顯示只有2.3%接受診斷，1.6%用藥，1%的人接受足夠時間完整的治療，所以可了解有許多人求助無門因而情況日益惡化。 」 
  218. ^ Domenic Greco, PhD. Is Prevalence of ADD/ADHD the Same in the U.S., Europe, and Japan?. 2012-09-10 [2017-04-22]. （原始内容存档于2020-07-03）. Japan reports a 7% of school-aged children have ADD/ADHD. 
  219. ^ 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). 
  220. ^ 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. 
  221. ^ Wang, Tingting; Liu, Kaihua; Li, Zhanzhan; Xu, Yang; Liu, Yuan; Shi, Wenpei; Chen, Lizhang. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis. BMC Psychiatry (systematic review, meta-analysis (secondary source)). 2017, 17 (1). ISSN 1471-244X. doi:10.1186/s12888-016-1187-9. 
  222. ^ 陳國齡. Child with Attention Deficit/Hyperactivity Disorder (ADHD) 認識注意力不足 /過度活躍症 (PDF). 中華人民共和國香港特別行政區政府教育局 The government of Hong Kong Special Administrative Region of People's Republic of China. [2017-04-22]. （原始内容存档 (PDF)于2017-03-29）. 
  223. ^ Davis, J. Mark; Lao, Ian Leong. Comparison of the Level and Prevalence of ADHD Symptoms in Macao (China) and U.S. University Students. International Journal of School & Educational Psychology (Informa UK Limited). 2013, 1 (4): 269–277 [2017-04-21]. doi:10.1080/21683603.2013.804469. 
  224. ^ 224.0 224.1 224.2 224.3 224.4 ADHD Throughout the Years (PDF). Center For Disease Control and Prevention. [2013-08-02]. （原始内容存档 (PDF)于2013-08-07）. 
  225. ^ National Institute for Health and Clinical Excellence. CG72 Attention deficit hyperactivity disorder (ADHD): full guideline (PDF). NHS. 2008-09-24 [2018-12-26]. （原始内容存档 (PDF)于2014-02-25）. 
  226. ^ Dalsgaard, S. Attention-deficit/hyperactivity disorder (ADHD).. European child & adolescent psychiatry. 2013-02,. 22 Suppl 1: S43–8. PMID 23202886. doi:10.1007/s00787-012-0360-z. 
  227. ^ Palmer ED, Finger S. An early description of ADHD (inattentive subtype): Dr Alexander Crichton and 'Mental restlessness' (1798). Child and Adolescent Mental Health. 2001-05, 6 (2): 66–73. doi:10.1111/1475-3588.00324. 
  228. ^ Crichton A. An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects. United Kingdom: AMS Press. 1798: 271 [2014-01-17]. ISBN 9780404082123. （原始内容存档于2020-12-22）. 
  229. ^ 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)
  230. ^ Millichap, J. Gordon. Chapter 1: Definition and History of ADHD. Attention Deficit Hyperactivity Disorder Handbook: A Physician's Guide to ADHD 2nd. Springer Science. 2010: 2–3 [2021-02-06]. ISBN 978-1-4419-1396-8. LCCN 2009938108. doi:10.1007/978-104419-1397-5. （原始内容存档于2020-12-22）. 
  231. ^ Weiss M. ADHD in Adulthood: A Guide to Current Theory, Diagnosis, and Treatment. JHU Press. 2010 [2014-01-17]. ISBN 9781421401317. （原始内容存档于2020-09-06）. 
  232. ^ Patrick KS, Straughn AB, Perkins JS, González MA. Evolution of stimulants to treat ADHD: transdermal methylphenidate. Human Psychopharmacology. 2009-02, 24 (1): 1–17. PMC 2629554 可免费查阅. PMID 19051222. doi:10.1002/hup.992. 
  233. ^ Rasmussen N. Making the first anti-depressant: amphetamine in American medicine, 1929–1950. J . Hist. Med. Allied Sci. 2006-07, 61 (3): 288–323. PMID 16492800. doi:10.1093/jhmas/jrj039. 
  234. ^ Barkley, Russell A; Fischer, Mariellen; Smallish, Lori; Fletcher, Kenneth. Young Adult Outcome of Hyperactive Children: Adaptive Functioning in Major Life Activities. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2006, 45 (2): 192–202. ISSN 0890-8567. PMID 16429090. doi:10.1097/01.chi.0000189134.97436.e2. 
  235. ^ BIEDERMAN, JOSEPH; MONUTEAUX, MICHAEL C.; MICK, ERIC; SPENCER, THOMAS; WILENS, TIMOTHY E.; SILVA, JULIE M.; SNYDER, LINDSEY E.; FARAONE, STEPHEN V. Young adult outcome of attention deficit hyperactivity disorder: a controlled 10-year follow-up study. Psychological medicine (Cambridge University Press (CUP)). 2006-01-18, 36 (02): 167. ISSN 0033-2917. PMID 16420713. doi:10.1017/s0033291705006410. 
  236. ^ Mannuzza, Salvatore; Klein, Rachel G.; Bessler, Abrah; Malloy, Patricia; LaPadula, Maria. Adult Psychiatric Status of Hyperactive Boys Grown Up. The American journal of psychiatry (American Psychiatric Publishing). 1998, 155 (4): 493–498. ISSN 0002-953X. PMID 9545994. doi:10.1176/ajp.155.4.493. 
  237. ^ Biederman, Joseph; Mick, Eric; Fried, Ronna; Wilner, Nicole; Spencer, Thomas J.; Faraone, Stephen V. Are stimulants effective in the treatment of executive function deficits? Results from a randomized double blind study of OROS-methylphenidate in adults with ADHD. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology (Elsevier BV). 2011, 21 (7): 508–515. ISSN 0924-977X. PMID 21303732. doi:10.1016/j.euroneuro.2010.11.005. 
  238. ^ Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos-Quiroga JA, Rohde LA, Sonuga-Barke EJ, Tannock R, Franke B. Attention-deficit/hyperactivity disorder (PDF). Nature Reviews. Disease Primers (Review). 2015-08, 1: 15020 [2018-12-31]. CiteSeerX 10.1.1.497.1346 可免费查阅. PMID 27189265. doi:10.1038/nrdp.2015.20. （原始内容存档 (PDF)于2020-07-28）. 
  239. ^ Storebø, Ole Jakob; Ramstad, Erica; Krogh, Helle B.; Nilausen, Trine Danvad; Skoog, Maria; Holmskov, Mathilde; Rosendal, Susanne; Groth, Camilla; Magnusson, Frederik L; Moreira-Maia, Carlos R; Gillies, Donna; Buch Rasmussen, Kirsten; Gauci, Dorothy; Zwi, Morris; Kirubakaran, Richard; Forsbøl, Bente; Simonsen, Erik; Gluud, Christian, Storebø, Ole Jakob , 编, Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD), The Cochrane database of systematic reviews (systematic review) (Chichester, UK: John Wiley & Sons, Ltd), 2015-11-25, (11), PMID 26599576, doi:10.1002/14651858.cd009885.pub2 
  240. ^ Mannuzza, S; Klein, RG. Long-term prognosis in attention-deficit/hyperactivity disorder.. Child and adolescent psychiatric clinics of North America. 2000, 9 (3): 711–26. ISSN 1056-4993. PMID 10944664. 
  241. ^ Molina, Brooke S.G.; Hinshaw, Stephen P.; Swanson, James M.; Arnold, L. Eugene; Vitiello, Benedetto; Jensen, Peter S.; Epstein, Jeffery N.; Hoza, Betsy; Hechtman, Lily; Abikoff, Howard B.; Elliott, Glen R.; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Wells, Karen C.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan; Houck, Patricia R. The MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2009, 48 (5): 484–500. ISSN 0890-8567. PMC 3063150 可免费查阅. PMID 19318991. doi:10.1097/chi.0b013e31819c23d0. 
  242. ^ Hechtman, Lily; Swanson, James M.; Sibley, Margaret H.; Stehli, Annamarie; Owens, Elizabeth B.; Mitchell, John T.; Arnold, L. Eugene; Molina, Brooke S.G.; Hinshaw, Stephen P.; Jensen, Peter S.; Abikoff, Howard B.; Perez Algorta, Guillermo; Howard, Andrea L.; Hoza, Betsy; Etcovitch, Joy; Houssais, Sylviane; Lakes, Kimberley D.; Nichols, J. Quyen; Vitiello, Benedetto; Severe, Joanne B.; Jensen, Peter S.; Arnold, L. Eugene; Hoagwood, Kimberly; Richters, John; Vereen, Donald; Hinshaw, Stephen P.; Elliott, Glen R.; Wells, Karen C.; Epstein, Jeffery N.; Murray, Desiree W.; Conners, C. Keith; March, John; Swanson, James; Wigal, Timothy; Cantwell, Dennis P.; Abikoff, Howard B.; Hechtman, Lily; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Molina, Brooke; Hoza, Betsy; Pelham, William E.; Gibbons, Robert D.; Marcus, Sue; Hur, Kwan; Kraemer, Helena C.; Hanley, Thomas; Stern, Karen. Functional Adult Outcomes 16 Years After Childhood Diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA Results. Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2016, 55 (11): 945–952.e2. ISSN 0890-8567. PMC 5113724 可免费查阅. PMID 27806862. doi:10.1016/j.jaac.2016.07.774. 
  243. ^ Roy, Arunima; Hechtman, Lily; Arnold, L. Eugene; Swanson, James M.; Molina, Brooke S.G.; Sibley, Margaret H.; Howard, Andrea L.; Vitiello, Benedetto; Severe, Joanne B.; Jensen, Peter S.; Arnold, L. Eugene; Hoagwood, Kimberly; Richters, John; Vereen, Donald; Hinshaw, Stephen P.; Elliott, Glen R.; Wells, Karen C.; Epstein, Jeffery N.; Murray, Desiree W.; Conners, C. Keith; March, John; Swanson, James; Wigal, Timothy; Cantwell, Dennis P.; Abikoff, Howard B.; Hechtman, Lily; Greenhill, Laurence L.; Newcorn, Jeffrey H.; Molina, Brooke; Hoza, Betsy; Pelham, William E.; Gibbons, Robert D.; Marcus, Sue; Hur, Kwan; Kraemer, Helena C.; Hanley, Thomas; Stern, Karen. Childhood Predictors of Adult Functional Outcomes in the Multimodal Treatment Study of Attention-Deficit/Hyperactivity Disorder (MTA). Journal of the American Academy of Child and Adolescent Psychiatry (Elsevier BV). 2017, 56 (8): 687–695.e7. ISSN 0890-8567. PMC 5555165 可免费查阅. PMID 28735698. doi:10.1016/j.jaac.2017.05.020. 
  244. ^ 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. 
  245. ^ CELEBRATION: Love & Bliss FLOW WITH ME..! 4/14/14. Eliza Dushku's official website. [2016-10-15]. 
  246. ^ 林瑩真. 過動男童遭霸凌一年半　學校上吊輕生「妹目睹崩潰痛哭」. TVBS. 2018-09-26 [2018-09-28]. （原始内容存档于2018-09-29） （中文）. 
  247. ^ 紅豆Q粉粿. 放學前先遮傷口！過動症男孩瞞著父母獨忍霸凌　自殺當天微笑上學. 鍵盤大檸檬. 2018-09-14 [2018-09-28]. （原始内容存档于2018-09-29） （中文）. 
  248. ^ 'Bullied' schoolboy, 14, was found hanged in school toilet by his sister as dad calls for headteacher's resignation. The Sun. 2018-09-20 [2018-09-29]. （原始内容存档于2018-09-29）. 
  249. ^ Chen, Vincent Chin-Hung; Chan, Hsiang-Lin; Wu, Shu-I; Lee, Meng; Lu, Mong-Liang; Liang, Hsin-Yi; Dewey, Michael E.; Stewart, Robert; Lee, Charles Tzu-Chi. Attention-Deficit/Hyperactivity Disorder and Mortality Risk in Taiwan. JAMA network open (American Medical Association (AMA)). 2019-08-07, 2 (8): e198714. ISSN 2574-3805. PMID 31390039. doi:10.1001/jamanetworkopen.2019.8714. 
  250. ^ 呂苡榕. 健保給付制度造成醫療資源分配傾斜. Taiwan: 端傳媒. 2017-04-25 [2017-04-25]. （原始内容存档于2017-05-01）. 健保給付制度困境令孩童就醫難\ 除了診斷的時間受到侷限，行為治療、親職教育等資源更是少得可憐。醫院的親子團體治療每一期排隊至少要排上四個月到半年才有可能有名額...... 
  251. ^ 251.0 251.1 專注不足/過度活耀協會. 《立法是否保障特殊教育需要學生的出路？》論壇. Hong Kong, China. 2015-03-29 [2017-03-15]. （原始内容存档于2017-03-05）. 
  252. ^ 252.0 252.1 Guidelines May Have Helped Curb ADHD Diagnoses in Preschoolers. MedlinePlus.gov. HealthDay. 2016-11-15 [2017-01-01]. （原始内容存档于2016-12-25）. Still, too few with disorder receive behavior therapy, child psychologist says. 
  253. ^ 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.     
  254. ^ WHO. Pharmacological and nonpharmacological interventions for children with attention-deficit hyperactivity disorder (ADHD). 世界衛生組織 Wolrd Health Organization. [2017-02-22]. （原始内容存档于2017-01-08） （美国英语）. 
  255. ^ 世界卫生组织. 注意缺陷多动障碍儿童的药物和非药物介入/干预. 世界卫生组织. [2017-02-22]. （原始内容存档于2016-11-29） （中文（简体））. 
  256. ^ 亞洲不應使用西方精神科對於注意力不足過動症（ADHD）的診斷，及興奮劑處方的治療. [2017-09-02]. （原始内容存档于2017-09-02）. 
  257. ^ 鄭毅; 刘靖. 《中国注意缺陷多动障碍防治指南》第二版解读. 中华精神科杂志. 2016, 0 (3): p.132–135 [2017-03-04]. （原始内容存档于2017-03-04）. 
  258. ^ 【校園欺凌】產後抑鬱媽媽：過度活躍的七歲兒子，最怕他自殺. 明周文化. 2018-03-19 [2018-03-31]. （原始内容存档于2018-03-29） （中文）. 

書目

[编辑]
  • Edward M. Hallowell; John J. Ratey. 分心不是我的錯（增訂版）：正確診療ADD，重建有計畫的生活方式 Driven to Distraction. 遠流出版. 2015-09-01. ISBN 978-957-32-7700-2. 
  • Edward M. Hallowell, M.D.; John J. Ratey, M.D. 《分心也有好成績》. 丁凡譯. 台北: 遠流出版社. 2006. ISBN 9573259311. 
  • 高淑芬; 陳劭芊. 注意力不足過動症. 衛生福利部精神疾病衛教叢書. 中華民國衛生福利部. 2015-06 [2018-02-27]. ISBN 9789860454154. （原始内容存档 (PDF)于2017-02-19） （中文（繁體））. 

外部連結

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维基共享资源中相关的多媒体资源：注意力不足過動症
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