[國考] 申覆 醫學四 74
有關ADHD敘述何者錯誤?
A第一線治療為行為治療
B3歲以前很難診斷ADHD，因為正常小孩也可能有相同行為
C約一半的人到青春期或成人仍有症狀
D第一線藥物為中樞神經刺激劑，主要副作用為食慾降低及失眠
公布答案:A
申覆答案:建議送分
理由:
對於學齡前兒童(4-5歲)，建議第一線治療為行為治療
對於學齡兒童(6-11歲)，建議第一線為行為治療，或，藥物治療，最好併行
對於青少年(12-18歲)，建議第一線藥物治療，或可以行為治療，最好併行
參考資料:CDC ADHD guideline
http://www.cdc.gov/ncbddd/adhd/guidelines.html
全文:
Recommendations for treatment of children and youth with ADHD vary depending
on the patient’s age:
For preschool-aged children (4–5 years of age), the primary care
clinician should prescribe evidence-based parent- and/or teacher-administered
behavior therapy as the first line of treatment and may prescribe
methylphenidate if the behavior interventions do not provide significant
improvement and there is moderate-to severe continuing disturbance in the
child’s function. In areas where evidence-based behavioral treatments are
not available, the clinician needs to weigh the risks of starting medication
at an early age against the harm of delaying diagnosis and treatment.
For elementary school–aged children (6–11 years of age), the primary
care clinician should prescribe US Food and Drug Administration–approved
medications for ADHD and/or evidence-based parentand/or teacher-administered
behavior therapy as treatment for ADHD, preferably both. The evidence is
particularly strong for stimulant medications and sufficient but less strong
for atomoxetine, extended-release guanfacine, and extended-release clonidine
(in that order). The school environment, program, or placement is a part of
any treatment plan.
For adolescents (12–18 years of age), the primary care clinician should
prescribe Food and Drug Administration–approved medications for ADHD with
the assent of the adolescent and may prescribe behavior therapy as treatment
for ADHD, preferably both.
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