hansem668 2012-4-11 19:46
ADHD勿輕忽 療不嫌晚
<p style="TEXT-ALIGN: right; LINE-HEIGHT: 150%; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all" class="MsoNormal" align="right"><span style="LINE-HEIGHT: 150%; FONT-FAMILY: '新細明體','serif'; COLOR: dimgray; FONT-SIZE: 10pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">【</span><span style="LINE-HEIGHT: 150%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: dimgray; FONT-SIZE: 10pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">Upaper</span><span style="LINE-HEIGHT: 150%; FONT-FAMILY: 細明體; COLOR: dimgray; FONT-SIZE: 10pt; mso-bidi-font-family: 細明體; mso-font-kerning: 0pt" lang="EN-US">╱</span><span style="LINE-HEIGHT: 150%; FONT-FAMILY: '新細明體','serif'; COLOR: dimgray; FONT-SIZE: 10pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">文</span><span style="LINE-HEIGHT: 150%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: dimgray; FONT-SIZE: 10pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">∕</span><span style="LINE-HEIGHT: 150%; FONT-FAMILY: '新細明體','serif'; COLOR: dimgray; FONT-SIZE: 10pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">記者何雅玲】</span><span style="LINE-HEIGHT: 150%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: dimgray; FONT-SIZE: 10pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"><o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">國小</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">3</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">年級的</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">Kevin</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">可說是小兒科門診的常客,經多次檢查仍找不出身體病痛的原因,經跨科會診才發現,</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">Kevin</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">其實是因</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">而影響學習及行為,導致課業成績排名落後且經常與同學起衝突,在師長嚴厲指責及父母打罵等不適當的管教下,經常自覺身體病痛而求診小兒科,後經醫師會診發現,</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">Kevin</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">出現</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">明顯的核心問題,在確診、治療下好轉並考上大學。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體"> <span lang="EN-US"><o:p></o:p></span></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">諸如</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">Kevin</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">的轉診病例,近年來愈來愈多。臺大醫院精神部主任醫師高淑芬教授表示,注意力不足過動症(英文簡稱</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">)為早發型兒童神經精神疾病之一,近幾年來在醫學不斷研究下,對行為背後的機制等病症相關,有了更多瞭解,發現不單是孩童,也可能延伸到青少年、甚至成年。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"><o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">另外,臨床經驗也觀察到,</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">專注力等核心問題而產生的自信不足、情緒失控等症狀,初始易被以為是憂鬱、躁鬱等其它精神方面的問題,透過其它科別轉介到</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">門診的情形日益增加。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"><o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">對個人學業、工作及人際關係,甚至家庭壓力和社會經濟,都造成極大的衝擊,所幸經數百個國際知名的研究及台灣研究證明,可透過藥物治療的方式,加上親職教育、行為治療及學校補救教學的治療策略。雖說及早發現、掌握孩童黃金治療期,但非指晚治療即無救。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"><o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">高淑芬醫師表示,</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">主因是來自腦部額葉皮質下迴路的功能異常,造成不專心、衝動、坐不住、情緒和動作的控制失調、及組織計畫的能力不佳等問題。依據研究,學齡期孩子的盛行率大約是</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">5~10%</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">(台灣</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">7</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">%)、成人</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">ADHD</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">的盛行率約為</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">4%</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"><o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; WORD-BREAK: break-all; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">孩童時期症狀不復雜,多半僅核心症狀,加上較聽父母話,經投藥治療效果顯著易見。青少年時期才被發現或治療,可能因注意力不足、過動、衝動等</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">3</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">大核心症狀,產生自我放棄、憂鬱症、強迫症等併發其他多元精神疾病,加上有升學壓力、正處叛逆期,配合度較差,只要孩童及家長、老師多花些心力,減少管教、增加鼓勵、配合用藥。到了成人,過動及衝動症狀自然減緩,持續影響的是專注力的問題,不過因求診有動機、配合度佳,仍為時不晚。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"><o:p></o:p></span></p>