Title Poremećaji hiperaktivnosti i deficita pažnje u odraslih
Title (english) Attention-deficit/hyperactivity disorder in adults
Author Ivan Kušić
Mentor Miroslav Herceg (mentor)
Committee member Neven Henigsberg (predsjednik povjerenstva)
Committee member Dražen Begić (član povjerenstva)
Committee member Miroslav Herceg (član povjerenstva)
Granter University of Zagreb School of Medicine Zagreb
Defense date and country 2024-09-11, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Psychiatry
Abstract Poremećaj hiperaktivnosti i deficita pažnje (eng. attention-deficit/hyperactivity disorder, ADHD) je stanje karakterizirano konzistentnim manjkom pažnje i hiperaktivnošću-impulzivnošću izraženima do razine koja ometa funkcioniranje ili razvoj pacijenta. Radi se o jednom od najčešćih neuropsihijatrijskih poremećaja s prevalencijom od 3-5 % u dječjoj dobi, a može se također nastaviti i u odrasloj dobi. Procjenjuje se da je prevalencija ADHD-a među odraslima 2,5-4,5 %. Razvoj ADHD-a veže se uz brojne genetske, neurofiziološke i okolišne čimbenike, primjerice, genetsko naslijeđe, izloženost djeteta štetnim tvarima u prenatalnom razdoblju i ranom životu i štetne događaje tijekom trudnoće i poroda.
Simptomi ADHD-a posljedica su anomalija bijele i sive moždane tvari te poremećaja dopaminergičkog i noradrenergičkog neurotransmitorskog sustava. Klinički, ADHD u odraslih karakteriziran je glavnim simptomima hiperaktivnosti, impulzivnosti, manjka pažnje, emocionalne disregulacije i teškoća sa spavanjem. Često mogu biti prisutni i brojni psihijatrijski i nepsihijatrijski komorbiditeti. Dijagnoza ADHD-a postavlja se prema kriterijima opisanim u Dijagnostičkom i statističkom priručniku za duševne poremećaje (5. izdanje) kojeg izdaje Američka psihijatrijska udruga.
U odrasloj dobi, često dolazi do smanjena izražaja simptoma ADHD-a, no funkcionalna oštećenja i negativan utjecaj na brojne aspekte života se nastavlja. Liječenje ADHD-a u odraslih uključuje farmakološke i nefarmakološke metode te njihovu kombinaciju, a temelji se na multimodalnom i multidisciplinarnom pristupu. Lijekovi koji se koriste u liječenju ADHD-a se mogu svrstati u stimulanse (metilfenidat i amfetamini) i nestimulanse (atomoksetin, bupropion, triciklički antidepresivi, klonidin, gvanfacin), dok je primjer nefarmakološke metode liječenja kognitivno-bihevioralna terapija. Pri liječenju odraslih pacijenata s ADHD-om potrebno je osobitu pažnju obratiti na specifičnosti liječenja trudnica i starijih osoba te na mogućnost zlouporabe lijekova i strategije prevencije zlouporabe.
Abstract (english) Attention deficit/hyperactivity disorder (ADHD) is a condition characterized by persistent inattention and hyperactivity-impulsivity, expressed to a degree that interferes with a patient's functioning or development. It is one of the most common neuropsychiatric disorders, with a prevalence of 3-5 % in childhood, and it can also persist into adulthood. The prevalence of ADHD among adults is estimated to be 2.5-4.5 %. The development of ADHD is linked to various genetic, neurophysiological and environmental factors, such as genetic inheritance, the child's exposure to harmful substances in the prenatal period and early life and adverse events during pregnancy and childbirth.
The symptoms of ADHD result from anomalies in white and gray brain matter and dysfunctions of the dopaminergic and noradrenergic neurotransmitter systems. Clinically, ADHD in adults is characterized by main symptoms of hyperactivity, impulsivity, attention deficit, emotional dysregulation and sleep difficulties. Numerous psychiatric and non-psychiatric comorbidities are often present as well. The diagnosis of ADHD is made according to the criteria described in the Diagnostic and Statistical Manual of Mental Disorders (5th edition) published by the American Psychiatric Association.
In adulthood, there is often a reduced expression of ADHD symptoms, but the functional impairment and negative impact on numerous aspects of life continues. Treatment of ADHD in adults includes pharmacological and non-pharmacological methods and their combination, and is based on a multimodal and multidisciplinary approach. Drugs used in the treatment of ADHD can be classified into stimulants (methylphenidate and amphetamines) and non-stimulants (atomoxetine, bupropion, tricyclic antidepressants, clonidine, guanfacine), while an example of a non-pharmacological method of treatment is cognitive behavioral therapy. When treating adult patients with ADHD, special attention must be paid to the specifics of treatment for pregnant women and the elderly, as well as the potential for drug abuse and strategies for abuse prevention.
Keywords
ADHD
odrasli
hiperaktivnost
pažnja
liječenje
Keywords (english)
ADHD
adults
hyperactivity
attention
treatment
Language croatian
URN:NBN urn:nbn:hr:105:177857
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-09-02 12:01:35