Attention-deficit hyperactivity disorder (ADHD), like other psychiatric disorders, represents an evolving construct that has been refined and developed over the past several decades in response to research into its clinical nature and structure. The clinical presentation and course of the disorder have been extensively characterised. Efficacious medication-based treatments are available and widely used, often alongside complementary psychosocial approaches. However, their effectiveness has been questioned because they might not address the broader clinical needs of many individuals with ADHD, especially over the longer term. Non-pharmacological approaches to treatment have proven less effective than previously thought, whereas scientific and clinical studies are starting to fundamentally challenge current conceptions of the causes of ADHD in ways that might have the potential to alter clinical approaches in the future. In view of this, we first provide an account of the diagnosis, epidemiology, and treatment of ADHD from the perspective of both the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the eleventh edition of the International Classification of Diseases. Second, we review the progress in our understanding of the causes and pathophysiology of ADHD on the basis of science over the past decade or so. Finally, using these discoveries, we explore some of the key challenges to both the current models and the treatment of ADHD, and the ways in which these findings can promote new perspectives.

中文翻译：

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注意缺陷多动障碍。

与其他精神疾病一样，注意力缺陷多动障碍 (ADHD) 代表了一种不断发展的结构，在过去几十年中，随着对其临床性质和结构的研究，该结构得到了改进和发展。该疾病的临床表现和病程已被广泛描述。有效的基于药物的治疗是可用的并且被广泛使用，通常与补充的心理社会方法一起使用。然而，它们的有效性受到质疑，因为它们可能无法满足许多 ADHD 患者更广泛的临床需求，尤其是从长远来看。事实证明，非药物治疗方法不如以前认为的有效，而科学和临床研究开始从根本上挑战当前关于 ADHD 原因的概念，其方式可能有可能在未来改变临床方法。有鉴于此，我们首先从《精神疾病诊断与统计手册》第五版和《国际疾病分类》第十一版的角度，对多动症的诊断、流行病学和治疗进行阐述。其次，我们回顾了过去十年左右我们在科学基础上对多动症病因和病理生理学认识的进展。最后，利用这些发现，我们探讨了当前模型和 ADHD 治疗面临的一些关键挑战，以及这些发现可以促进新观点的方式。