是誰偷走了專注力 ?
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97-11-05
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TVBS :2008/10/18 18:29
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ADHDAttention Deficit Hyperactivity Disorder
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Timeline of names from industry set. (Courtesy of Novartis Pharmaceuticals.).
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ADHD
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. , . . ,.
Maybe You Know My Kid. Mary Fowler.
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? (ADD/ADHD) ADHD ADHD ADHD ADHD
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ADHD
Rief S. The ADD/ADHD Checklist, 1998
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ADHD
Rief S. The ADD/ADHD Checklist, 1998
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ADHD/ Rief S. The ADD/ADHD Checklist, 1998
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ADHD/ ( ) Rief S. The ADD/ADHD Checklist, 1998
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:DSM-IVICD-10 (290~319)DSM-IV:--,-:--(GAF0-100):,
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DSM-IV--
8
- 314.01 - (62)- (2)- - GAF40
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ADHD--
prevention or cure hope for preventive efforts and better treatments
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ADHD Tic disorder ADHD
Tourettes disorder :50%ADHD 60% 50%
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J.O.M.A.C. () TicsConvulsionEpilepsy
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,,Tics Convulsion Epilepsy
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ADHD
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: 3I.sIndependent : dependent IndependentIdentity : begin to figure out who they are forming their own identityIntimacy : to learn to relate adults like an adult creating intimacy
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Course of different ADHD symptoms over the life span. Hyperactivity tends to wane with maturity, being replaced by a feeling of restlessness. Impulsivity also tends to wane except for a possible blip in adolescence under the influence of raging hormones. The most persistent cluster of symptoms is inattentiveness, with the main adult manifestations being disorganization, difficulty managing money, keeping schedules, and sticking with a relationship or job. (Reproduced from Arnold LE, Contemporary Diagnosis and Management of ADHD. Newtown, PA: , 2004, with permission).
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ADHD
Ingram S. Mental Retardation and Development Disabilities Research Reviews. 1999;5:243.Weiss M, Jain U. ADHD Report. 2000;8:4-10.
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ADHD 50% of ADHD 50% (Oppositional Defiant Disorder) (Conduct Disorder) 40% 20% 30% (Substance Use Disorder , , , ) 50% ADHD Biederman J et al. Am J Psychiatry. 1991;148:564-577.Pomerleau OF et al. J Subst Abuse. 1995;7:373-378.
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ADHD
Biederman J et al. Am J Psychiatry. 1991;148:564-577. -for boys, as a means of control and power -for girls, as a means of gaining attention and acceptance
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ADHD ADHD ()
Nadeua K et al. Understanding Girls with ADHD, 1999.
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-ADHDADHD ADHDADHD
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ADHD a anxiety, depressionb c d - -handling anger passive aggression -ADHD
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1.2.3.4.___________________________________Understanding the total ADHD case in his or her total world and full clinical pictures comprehensive treatment plans.
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93.09.0196.05.0196.09.01 Neurologic drugsmethylphenidate HCLConcerta Extended Release Tablets(93/9/1)DSMICD Neurologic drugsmethylphenidate HClConcerta Extended Release Tabletsatomoxetine HClStrattera Hard capsules(93/9/1) (96/5/1)()DSMICDmethylphenidate(Ritalin)atomoxetine HCl1methylphenidate HClConcerta Extended ReleaseTabletsatomoxetine HClStrattera Hard capsules93/9/196/5/196/9/1()DSMICDmethylphenidateRitalinatomoxetine HCl1
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(Amobarbital) (Brotizolam) (Buprenorphine) (Butalbital)(Cathine) (Cyclobarbital) (Glutethimide) (Methylphenidate) (Nalbuphine) (Nalorphine) (Pentobarbital) (Phenmetrazine) (Secobarbital) (Tramadol) ()(Triazolam) (Codeine)100(100)1.05.0 (Flunitrazepam)(Zipeprol)
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StratteraAtomoxetine HCI
(selective norepinephrine reuptake inhibitor)
, FDA
Methylphenidate (20-30%)
, , , ,
MPH
(tics)(20%)
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Utah Criteria for Adult Attention-Deficit/ Hyperactivity Disorder (ADHD) Retrospective childhood ADHD diagnosis Narrow criterion: met DSM-IV criteria in childhood by parent interviewa Broad criterion: both (1) and (2) are met as reported by patientb Childhood hyperactivity Childhood attention deficitsAdult characteristics: five additional symptoms, including ongoing difficulties with inattentiveness and hyperactivity and at least three other symptoms: Inattentiveness Hyperactivity Mood lability Irritability and hot temper Impaired stress tolerance Disorganization ImpulsivityExclusions: not diagnosed in presence of severe depression, psychosis, or severe personality disorder*Paul Wenderin1970s
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() ADHDADHD
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ADHD T.E.A.M. (Together Everyone Achieves Management)ADHD T.E.A.M./
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ADHD T.E.A.M.() ADHD T.E.A.M.
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ADHD !
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ADHD T.E.A.M. ADHD /
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ADHD
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Rief S. The ADD/ADHD Checklist, 1998.
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U ADHD ADHD ADHD ADHD
Rief S. The ADD/ADHD Checklist, 1998.
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/ ()
Rief S. The ADD/ADHD Checklist, 1998.
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ADHD Rief S. The ADD/ADHD Checklist, 1998.
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ADHD ADHD ADHD T.E.A.M. ADHD
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ADHD ADHD
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ADHD (intervention)
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T.E.A.M. () () ADHD
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ADHD ADHD - ADHD
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ADHD : ADHD ADHD()
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ADHD : ADHD ()Barkley R. Sci Am. 1998;279:66-71.Faraone S et al. Harv Rev Psychiatry. 1994;1:271-287.
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ADHD : 20 ADHD (25%) , ADHD: ADHD
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ADHD 30% 30% 25% 35% 26% 55% (; ; )
Rief S. The ADD/ADHD Checklist, 1998. Satterfield J et al. J Am Acad Clin Adolesc Psychiatry. 1994;33:185-190. Biederman J et al. J Am Clin Adolesc Psychiatry. 1997;36:1682-1687.
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: ADHD(MTA Study): 1) , 2) ADHD,
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: ADHDADHD, , ADHD,
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: Stimulant () 50 ADHD 55%Biederman J et al. Biol Psychiatry. 1998;44:269-273.
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ADHD Stimulant ()/American Academy of Pediatrics. Pediatrics. 2001;108:1033-1044.
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: ADHDADHD (50%)
6% 5%
Barkley RA et al. J Am Acad Child Adolesc Psychiatry. 1990;29:546-557.Murphy K, Barkley RA. Compr Psychiatry. 1996;37:393-401.
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ADHD1.Life disability: affecting all aspects of individuals life.2.Lifetime disability: affects on each stage of psychological and social development.3.Family tendency : ADHDADHD 4.Learning disability : 30-40%ADHDlearning disability 5.Complex problem:
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92-11-25Tourettes syndromeFIQ85
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ADHD ? [] ADHD ADHD ADHD ADHD (educational interventions) T.E.A.M. (Together Everyone Achieves Management ) ADHD ADHD T.E.A.M.
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ADHD ADHD T.E.A.M. T.E.A.M. ADHD ADHD ADHD ADHD (The Child Development Center at the University at Irvine CDC-UCI) ADHD ADHD CDC-UCI 80% 20% ADHD (reinforcers) T.E.A.M. , U ADHD ADHD ADHD
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