1、从DSM-5开始，咬文嚼字话多动厦门市仙岳医院儿童青少年心理科王晨旭The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.何为DSM和DSM-5？英文全称：Diagnostic and Statistical Manu
2、al of Mental Disorders，DSM。DSM系列是美国精神病学会 1952年公布的精神疾病诊断和统计手册，从1952年至今已有5版。第2版开始把儿童、青少年列入类别中。DSM-5就是其最新版。The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th
3、CPC Central Committee.为什么说多动症要列其中，要从其历史说起。发现历史：始于100多年前Still描述孩子无法控制自己的动作与活动量。后被后辈学者定为轻微脑功能失调（MBD）。直到美国的DSM-3开始使用ADDH，后DSM-5更名为ADHD。改革开放后，ADHD的名称被我国广泛使用。The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Co
4、ngress and the third Plenary session of the 16th CPC Central Committee.作为一个精神神科医生怎么诊断精神类疾病呢？遵从SSD原则：Symptoms-Syndrome-Diagnostics。症状 .很多症状症状群根据症状群，参考诊断标准下诊断。The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC Nationa
5、l Congress and the third Plenary session of the 16th CPC Central Committee.Attention-Deficit/Hyperactivity Disorder（ADHD）Attention n.注意力 Deficit n.来源一个经济词汇，赤字，不足。Hyper-activity n.极度活跃的 Hyper adj.亢奋的 activity n.活动 Disorder n.疾病神经发育（Neuro-developmental disorder）The guiding ideology should be guided by
6、 Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of
7、 the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Cent
8、ral Committee.1.续f.经常回避、厌恶或不情愿在精神上需要持久注意力的任务（avoid、dislike、reluctant）home work 对于大龄的多动症患者：准备报告、阅读冗长的文章g.经常丢失任务或活动中所需的物品（钥匙、钱包、眼镜等）h.经常被外界刺激所分神i.经常在日常中忘记事情（比如做家务、回电话）对于大龄的多动症患者可能忘记约会、付账单等。The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the
9、spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.2.Hyperactivity and impulsivity至少同时满足一下六种症状并且持续至少六个月a.经常轻拍双手（taps hands or feet），squirm in seat（在座位上扭动）或者坐立不安（fidget）b.被期待坐在座位上但是却经常离座。c.经常在不适当的场所跑来跑去或爬来爬去d.无法安静地玩耍或从事休闲活动e.经常忙个不停（On the go）就像被安装
10、了发动机一样（driven by a motor）f.经常讲个不停g.经常再没讲完问题之前，把答案脱口而出。（接别人的话或无法耐心等待交谈顺序）The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.2.续h.经常对于等
11、待到他的时候是很困难的（比如：排队）i.经常打扰到其他人 butts into conversation（插入别人的对话）may start using other peoples things without asking or receiving（未经允许拿别 人的东西）对于青少年（adolescents and adult）侵 扰别人的事The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the
12、16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.从以上可以看出，多动症的分型。根据DSM-5数据总体人口：5%儿童和2.5%成人儿童：2:1（男：女）成人：1.6:1（同上）分型：三种，1.混合型（45%55%男女均可见）2.注意障碍为主型（25%35%女生较多见）3.多动/冲动为主型（10%20%男生多见）The guiding ideology should be guided by Deng Xiaopings theory,the important t
13、hought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.预后以及存在风险取决于症状的严重度、类型、共病程度、学习能力、智力水平以及心理社会因素 部分随年龄增长，症状消失，转归良好高达50%的多动症儿童症状将持续到成年期The guiding ideology should be guided by Deng Xiaopings theory,the important th
14、ought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.预后良好的基础智商较高，人际关系好。家庭良好支持系统，被同伴接纳老师关心和鼓励相反，那些智商低于平均值或边缘智力，家庭缺乏良好的支持系统，人际关系差，被同伴排斥，缺乏老师关心和鼓励，共患其他精神障碍比如：抽动症、精神发育迟滞和有遗传病或遗传病史则预后The guiding ideology should be guide
15、d by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.DSM-5提出的与预后相关因素1.喜怒无常的性格（Temperamental）2.环境（Environmental）3.遗传和生物学（Genetic and physiological）4.其他：家庭成员之间的影响不会导致多动症的发生但是会影响多动症的发展。The guiding ideology should be guided by Deng Xiaopings theory,the important thought of three represents and the spirit of the 16th CPC National Congress and the third Plenary session of the 16th CPC Central Committee.谢谢！
