ABSTRACT

The purpose of this article is to discuss the Royal College of Psychiatrists' Report 230, “Attention deficit hyperactivity disorder (ADHD) in individuals with intellectual disability,„ which aims to reduce the frequent misdiagnosis of this condition in people with ID, as shown in the case vignette that begins our commentary. The College Report is a helpful resource for clinicians and providers in using evidence-based practices to support and treat ADHD in persons with ID, filling a gap that was previously critically underserved. However, it contains certain methodological and content flaws that should be addressed in future revisions. The evaluation of the available evidence was not carried out through a validated grading system and it is unclear what procedure was used to achieve a consensus on the various recommendations. Furthermore, there is a lack of information on psychopathological aspects that cross diagnostic categories and are frequently encountered in daily practice, and the level of detail and precision of clinical indications is low, especially in relation to the numerous patients with marked cognitive and communication difficulties. Future updates of the Report should take into account differential diagnosis, including semeiological details and explicit references to a wide range of psychiatric, neurologic, physical, and developmental issues.

摘要

本文的目的是讨论皇家精神病学院的报告 230，“智力障碍个体的注意力缺陷多动障碍 (ADHD)，”旨在减少 ID 患者对这种情况的频繁误诊，如图所示开始我们评论的案例小插曲。学院报告是临床医生和提供者使用循证实践来支持和治疗智障人士多动症的有用资源，填补了以前严重不足的空白。但是，它包含某些方法和内容缺陷，应在未来的修订中解决。对现有证据的评估不是通过经过验证的分级系统进行的，并且不清楚使用什么程序来就各种建议达成共识。此外，缺乏跨诊断类别并在日常实践中经常遇到的精神病理学方面的信息，临床指征的详细程度和精确度较低，尤其是在众多具有明显认知和沟通困难的患者方面。报告的未来更新应考虑鉴别诊断，包括符号学细节和对广泛的精神病学、神经学、身体和发育问题的明确提及。