Pediatr. pro Praxi, 2002; 1: 14-17 [Psychiatr. pro Praxi, 2001; 3: 121-124]
Hyperkinetické poruchy
- doc. MUDr. Eva Malá CSc
- Psychiatrická ambulance, Neurologická klinika 1. LF UK a VFN, Praha
Keywords: hyperkinetic disorders, diagnostic criteria, comorbidity disorders, imaging techniques, therapy.
Published: December 31, 2002 Show citation
Malá E. Hyperkinetické poruchy. Pediatr. praxi. 2002;3(1):14-17.
ADHD (attention deficit hyperactivity disorder) je diagnostická jednotka, objevující se ve všech věkových kategoriích - od dětství do dospělosti, kde je spojena se sociální maladaptací a kriminalitou.
Neurovývojové opoždění vytváří zátěžové životní události vedoucí k vulnerabilitě jedince - čili minimální organické poškození a kumulace zevních stresů vede k maladaptivnímu chování s vysokou psychiatrickou komorbiditou. U hyperkinetických poruch jde z behaviorálního hlediska o poruchu exekutivních (sebe-regulujících) funkcí. Zobrazovací techniky vykazují poruchu regulace kortiko-striato-thalamo-kortikálního okruhu za přítomnosti téměř nulové pravolevé asymetrie. Úspěšná (ve školním věku) je terapie stimulancii, zvláště je-li kombinována s kognitivně behaviorální terapií.
Hyperkinetic disorders
ADHD (attention deficit hyperactivity disorder) is a diagnostic unit appearing in all age categories - from childhood to adult age where it typically combines with social maladaptation and crime.
Late neural development, due to stressful life situations resulting in a vulnerability of the individual, i.e. minimal organic harm and accumulation of external stressors leads to maladaptive behaviour with a high psychiatric comorbidity. In hyperkinetic patients it is from the behavioral point of view classified as a disorder of executive (self-regulatory) functions. The imaging techniques reveal a defected regulation of cortico-striato-thalamo-cortical circuit with almost zero right-left asymmetry. In school age a successful therapy combines psychostimulants and a cognitive-behavioural therapy.
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