(声明：刊用《中国新闻周刊》稿件务经书面授权) (statement：use《The China news weekly》The manuscript affairs written authorization)

成人也有多动症？ Adults have attention deficit disorder？

社会上总有很多“失意者”，是因为他们不聪明，还是不努力？儿童多动症患者中有接近一半的人症状会持续到成年。 Always have a lot of society“The frustrated”，Because they don't smart，Still don't work hard？Children in patients with attention deficit disorder is close to half of the people the symptoms will continue to adulthood。

医学家认为，成人多动症是破坏人们工作和生活质量的元凶；社会学家则对这种把社会问题“医学化”的倾向表示担忧 Medical think，Adult hyperactivity is destroy people to work and the quality of life the culprit；Social scientists is to the social problems“Of medical”Worried about the tendency

文/苌清 Wen/paragonimus clear

　　20多年前，那些调皮捣蛋、注意力涣散、行为鲁莽的“差生”们突然找到了冠冕堂皇的“借口”。医学从那时候起开始承认，有一种病叫做“儿童多动症”，这种当时还令人难以置信的病，能够为差生们的种种“劣迹”做注脚。在世界卫生组织的疾病诊断标准里，这种病的正式名称叫做“活动过度障碍”。他们逃过了父母的“棍棒教育”，转而求助于“灵丹妙药”。美国精神疾病统计与诊断手册则把这种病称为“注意力缺陷多动障碍”(ADHD)——这个名称在医学界被更广泛地采用。

More than 20 years ago，The naughty boy、Attention and lax、Reckless behavior“difference”Suddenly found the grandstanding“excuse”。Medical since then began to admit that，There is a disease called“Hyperactivity in children”，This was an incredible disease，For all the way out to“sleaze”Do footnote。At the world health organization's disease diagnosis standard，The formal name of the disease called“Activity is excessive obstacles”。They escaped the parents“Sticks education”，Turn to“elixir”。The American spirit disease statistics and diagnostic manual is put the disease called“Attention deficit hyperactivity disorder”(ADHD)-the name was the medical community used more widely。

　　医学界发现，有超过一半的儿童在成人以后多动症得到缓解，但也有很多人症状一直持续到成年。在人生的不同阶段里，有些人不能完成学业、频繁地跳槽和失去工作、家庭破裂、人际关系紧张，这些人的智力没有问题，但是在人生道路上不断碰壁。

Medicine found that，More than half the children in adult later hyperactivity eased，But there are also many people continued to adulthood symptoms。At different stages of life，Some people can't finish school、Frequent job-hopping and lose the job、Family breakdown、Interpersonal tension，These people intelligence is not problem，But in life road constantly go to the wall。

　　医学界一直也试图为成人社会的“失意者”们背书。行为医学认为，“多动症”就像隐藏在很多人内心里的一股潜流，损害他们的学习、工作和生活，却不为人所知。来自美国官方的数据显示，4.4%的成年人患有注意力缺陷障碍(ADD，为ADHD的亚型之一)，在这些总数超过1000万的成年患者中，对自己的问题有认识的还不到四分之一。而在中国，目前还看不到任何对成人注意力缺陷(多动)问题的系统研究和数据，为此而求医者也寥寥无几。

The medical profession has also tried to the adult society“The frustrated”Endorsed the。Behavior medicine thinks，“hyperactivity”In a lot of people are like hidden inside a gushing，Damage their learning、Work and life，But not known。From the U.S. official figures show，4.4% of the adults had attention deficit disorder(add，For one of the ADHD subtype)，In the more than half 10 million in adult patients，Of his own problems have less than a quarter of the knowledge。But in China，At present still cannot see any adult attention defect(Moved more)Research and data of the system，For this and QiuYiZhe also very few。

争议“多动症” dispute“hyperactivity”

　　按照对成人注意力缺陷障碍症状的描述：容易分心；坐立不安；缺乏耐性；比较冲动；做事拖拉；不能很好地安排生活；不容易集中精力完成任务。如果对照这一组症状，可能有很多人都会 “躺着中枪”。而在现实中，成人发现自己患有多动症的最常见的情形，是在带孩子看病的时候，对照各项诊断指标，偶然发现自己也有“多动症”“注意力障碍”等问题。

According to the adult attention deficit disorder symptoms description：Easily distracted；restless；Lack patience；Impulse is；Work drag；Can not very well arrange life；Not easy to focus on the completion tasks。If a group of symptoms contrast，Maybe there are a lot of people would be “Lay shot in the”。But in reality，Adults find themselves with the attention deficit disorder, the most common of the case，Is with children in the doctor，Control the diagnosis index，Accidentally discovered that they have“hyperactivity”“Attention disorders”problems。

　　26岁的卓宇在周围人看来是个聪明的人，但是他却由于难以完成研究生的课题而两次延期毕业。每当要看书之前，他都会想起很多事情要做：修理电灯、看一看为何电扇有杂音、把两扇窗帘之间的缝隙拉到最合适、去趟厕所？当他安顿下来的时候，他的室友都快做完功课了。当医生提醒他是否患有“注意力缺陷多动症”的时候，卓宇想起来小时候父亲就对他说过，“多动症纯粹是为懒惰的孩子找的一个借口”。

At the age of 26 ZhuoYu around people seems to be a wise man，But he was because of the subject and difficult to complete graduate two extension to graduate。Whenever must read before，He will think of a lot of things to do：Repair electric light、Take a look at why fans have noise、The two fan curtain the gaps between the pull to the most appropriate、Went to the toilet？When he settled down，His roommates are fast finished my homework。When the doctor remind whether he had“Attention deficit hyperactivity”when，ZhuoYu want to up to his father as a child said，“Hyperactivity is purely lazy boy looking for an excuse”。

　　美国社会学家左拉发现，“越来越多的社会问题被转换成医学问题”。多动症就是左拉考察的一个重要课题。对于多动症诊断适用的目标人群不断扩大，从儿童发展到成人，社会学家提出担忧：人类日常生存中更多的方面正在被“医学化。”实际上，即使是医学界，对多动症的问题也一直有争议。一些人认为，由于没有足够的经验丰富的医生，太多的人被随意诊断为ADHD，并接受不必要的药物治疗；而另一些专家则认为，有很多多动症患者未被发现，使他们失去了得到药物治疗的机会。

American sociologist Emile zola found，“The more and more many social problems is converted to a medical problem”。The investigation of attention deficit disorder is zola an important issue。For attention deficit disorder is diagnosed the target people growing，From children's development to adults，Social scientists are also raising：Our survival in more aspects are being“Of medical。”In fact，Even the medical profession，The problem has been to attention deficit disorder also has the dispute。Some people think that，As there were not enough experienced doctors，Too many people are optional diagnosis for ADHD，And accept unnecessary medical treatment；And others say that，Many patients with attention deficit disorder have not been found，That they lost the opportunity to get medical treatment。

　　围绕着多动症问题的种种争论，很大程度上都缘于它的诊断方法。和其他精神疾病一样，多动症的诊断既没有血液检查指标，也无法通过大脑扫描而得以确诊。而通过对照精神疾病诊断标准进行评估的诊断方法，其准确性很大程度上依赖于医生的专业水平。另外一个复杂的因素在于，成人的注意力缺陷障碍常伴有抑郁、焦虑等心理疾病，而这些心理疾病和ADD“谁先谁后”的因果关系，常常难以厘清。一种常见的情形是，医生只顾为病人治疗抑郁症、焦虑症，而没有意识到ADD才是更深层的病因。这些长期得不到认识和治疗的ADD患者，通常面临酗酒、学习障碍、失去工作、家庭解体等后果。

Around the problem of much debate in the attention deficit disorder，To a large extent due to all of it diagnosis method。And other mental illnesses，The diagnosis of attention deficit disorder is no blood test index，Also can't through the brain scan and be able to diagnose。And through the contrast mental disease diagnosis standard of evaluation diagnosis method，Its accuracy depends heavily on the doctor's professional level。Another factor is the complex，Adult attention deficit disorder often associated with depression、Anxiety and other mental illness，And these mental illness and add“Who should”Cause-and-effect relationship，Often difficult to clarify。A common situation is，The doctor for patients who treatment of depression、anxiety，Without consciousness to add is deeper causes。These long-term not know and treatment of patients with add，Typically face drinking、Learning disabilities、Lost work、Family disintegration and consequences。

　　其实，多动症也并非都是破坏性的。平时的观察就可以发现，容易分心的人通常也聪明、精力充沛、创造力强。有注意力障碍的人往往都具备这些优点，但是他们的问题是，只能在自己感兴趣的领域发挥优势。在世界级的名人榜上，美国前总统约翰·肯尼迪、篮球明星迈克尔·乔丹、动画大师沃尔特·迪斯尼、摇滚明星约翰·列农、歌坛天后小甜甜布兰妮等很多人都承认或被认为存在注意力缺陷障碍。

In fact，A.D.H.D. also is not all destructive。The usual observation can be found，Easily distracted people usually also smart、energetic、Strong creativity。Have attention disorders people tend to have these advantages，But their problems are，Only in their own areas of interest and advantage。In the world of celebrity list，Former US President John f. Kennedy、Basketball star Michael Jordan、Animation master Walt Disney、Rock star John lennon、Music scene days after britney spears and many people recognize or be think there is attention deficit disorder。

　　美国耶鲁大学精神病学家托马斯·布朗在《注意力缺陷障碍——儿童和成人注意力涣散》一书中说，ADHD不像怀孕，只存在“有”或者“没有”两种情况，ADHD严重程度是一个“连续区间”。要将注意力不集中诊断为一种疾病，则它们不仅必须长期存在，造成损害，而且必须成组出现，组成一个综合征。

Yale university psychiatrist Thomas brown in《Attention deficit disorder in children and adults--attention and lax》A book，ADHD is not like pregnancy，Exist only“have”or“no”Two kinds of circumstances，ADHD severity is a“Continuous interval”。Will inattention diagnosis for a kind of disease，They not only have to exist for a long time，damage，And must appear in groups，Form a syndrome。

“醒脑神药”背后 “Brain god medicine”behind

　　ADHD会给患者带来诸多麻烦，这是因为他们大脑中负责在神经网络中传导信号的神经递质(多巴胺、去甲肾上腺素)不平衡，这一问题主要发生在负责掌管计划和控制冲动的大脑“前额叶皮层”部位。大脑中这种不平衡所造成的结果，对于儿童来讲就是注意力不集中、多动(主要是男孩，女孩多表现为话多、精神恍惚)，以至于影响学习。而成年人则主要在专心做事、安排优先顺序、对时间和金钱的管理等方面表现糟糕。

ADHD will give patients to bring a lot of trouble，This is because of the brain responsible for neural network in conduction in signal of the neurotransmitters(dopamine、Norepinephrine)Don't balance，The problems mainly in responsible for planning and control over the impulse of the brain“Prefrontal cortex”parts。The balance in the brain by the results，For children speaking is inattention、Moved more(Mainly is the boy，The girl much performance is more than words、Spirit trance)，That impact study。And the adult basically be doing something、Arrangement priorities、With time and money management performance was poor。

　　人们通常会觉得这些人的问题是“意志力薄弱”造成的，而实际上，注意力缺陷障碍背后的秘密就是：大脑执行功能的神经化学递质系统损害，导致部分人在能引起他们兴趣的活动中可以集中注意力；而对许多其他的任务，则存在长期的注意力损害，尽管他们希望并且试图去做好这些事情。

People usually feel that these people question is“Weak willpower”Caused by，And in fact，Attention deficit disorder in the secret is behind：Executive function of nerve brain chemical neurotransmitter system damage，In some people can arouse their interest in the activities can concentrate your attention；And for many other tasks，There are the attention of the long-term damage，Although they hope and trying to do these things。

　　谁都有精力不集中的时候，谁又偶尔没有过迟到呢？但是如果你长期丢三落四，拖拖拉拉，你就会丢掉工作或者失去朋友。因而，患有多动症的人总是面临难以摆脱的人生危机，他们在事业发展上面临“天花板”，没有时间享受生活，生活杂乱无章，做事永远拖到最后，每天紧张忙碌却没有成就。

Everyone has the energy is not focused，Who occasionally not be late？But if you forgot things for a long time，drag，You will lose your job or lost friends。so，The man is always faced with attention deficit disorder to take life crisis，Their career development in the face“ceiling”，No time to enjoy life，Life desultorily，Work drag last forever，Busy every day without success。

　　卓宇觉得，医生所描述的一切，都那么符合他的情况。当最终被诊断为注意力缺陷障碍的时候，他说，“我突然有一种解脱感。我怀疑过自己的智力，憎恨自己缺乏意志力，多年来做过的种种努力都不奏效。现在，我一下子明白了问题到底出在哪儿，不再觉得自己笨，不再怪自己没有自制力。”

ZhuoYu think，The doctor describe the everything，So in his situation。When was eventually diagnosed as attention deficit disorder，He said，“I suddenly have a relief。I doubt his intelligence，Hate my lack of will power，For many years of efforts to do all don't work。now，I knew exactly where is the problem，No longer feel stupid，No longer blame myself without restraint。”

　　被诊断为注意力缺陷障碍的人，除了对生活方式进行调整外，医生一般都推荐药物治疗。和一般人想象的有所不同，临床上治疗多动症用的不是“镇静剂”，反而是“兴奋剂”。这类药物的作用原理是：增加在大脑的神经传导中起重要作用的神经递质，从而让患者能够集中精力、控制冲动。除了药物治疗外，行为治疗则可以在医生的指导下，帮助病人合理地分配时间、安排做事的优先程度，增强执行能力。

Diagnosis of attention deficit disorder，In addition to adjust the way of life，Doctors generally recommend drugs。And general people think different，Clinical attention deficit disorder treatment USES is not“A sedative”，Instead is“doping”。This kind of drug action principle is：Increase in the brain nerve conduction plays an important role in the neurotransmitters，Thus let patients were able to concentrate、Impulse control。In addition to the drugs，Behavioral therapy can be under a doctor's supervision，To help the patient a reasonable distribution of time、Arrangement of doing things the first degree，Improving the ability。

　　虽然中枢神经兴奋剂对多动症的治疗效果在服药后30??60分钟内就能够观察到，但这类药物的滥用也引起人们的担忧。美国疾病预防控制中心的报告说：“美国ADHD相关治疗保健费用保守估计每年高达33亿美元。而且，常用的兴奋剂已经被证明存在长期性的不良反应，如睡眠障碍、食欲下降等”。社会学家则认为，多动症的泛滥是一种“医学化的简化论”，它掩饰了社会本身的结构性问题以及社会革新的必要性，并使得公众将持续面临“公共问题个体化归因”的陷阱。

Although the central nervous doping on the treatment effect of the attention deficit disorder in 30 after taking the drug??60 minutes can observe，But this kind of drug abuse is aroused people's concerns。The United States centers for disease control and prevention report said：“The United States ADHD related treatment cost of health care conservative estimates $3.3 billion a year。and，Commonly used doping has been to prove there long-term adverse reactions，Such as sleep disorders、Decreased appetite, etc”。Sociologists argue that，The spread of attention deficit disorder is one of a kind“The simplified theory of medicine”，It covers the society itself structural problems and the necessity of social innovation，And that the public will continue to face“Public problem individual attribution”trap。

　　而作为被确诊的多动症患者，卓宇则惊喜于药物给自己带来的全新改变。“所有的事情我都能集中精力去做，能够积极面对生活，处理好每天的事，”他说，“如果我在小时候就知道自己患的是多动症，并且接受适当的治疗，我早就应该像现在一样，每天有健康、充实的生活。”

And as diagnosed with attention deficit disorder，ZhuoYu is surprise for drug bring you new change。“All the things I can concentrate on to do，Can positively facing life，Deal with every day，”He said，“If I was little, I know I had is attention deficit disorder，And receive proper treatment，I should have been like now，Every day there are health、Full life。”