多动症三级（"转诊"）地区小组实例：里昂注意力缺陷和多动症协调小组 (ECLAH)

IF 0.5 4区医学 Q4 PSYCHIATRY

Annales medico-psychologiques Pub Date : 2025-03-01 DOI:10.1016/j.amp.2024.06.009

Hugo Prunier , Lucie Jurek , Caroline Demily , Benjamin Rolland

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引用次数: 0

摘要

注意缺陷多动障碍（ADHD）影响了6%的儿童和3%的成年人，代表了Auvergne-Rhône-Alpes地区约481,600名青少年和240,800名成年人。尽管ADHD很普遍，但法国国家神经发育障碍战略（2023-2027）强调了ADHD缺乏专门的医疗保健途径，以及在获得诊断、治疗和社会心理康复方面面临的挑战。在Auvergne-Rhône-Alpes中，ADHD引起的重大公共卫生问题与当地医疗资源之间的不一致经常导致专业医院团队的误导和拥挤。尽管未经治疗的ADHD有充分的医学和社会并发症，但这种情况仍然存在。在里昂的Vinatier医院，有几个专门的团队为儿童和成人提供多动症的专业知识，但直到最近才有专门的团队专门研究多动症。里昂ADHD协调小组（ECLAH）由Vinatier医院的专业人员于2023年11月倡议成立，ECLAH是一个由心理学家、神经心理学家、精神科医生、儿童精神科医生、成瘾专家、药剂师、项目经理和临床研究助理组成的多学科团队。ECLAH的目标是通过协调护理网络、提供信息、培训、护理和开展ADHD领域的研究，满足Auvergne-Rhône-Alpes区域对ADHD的国家战略要求。经委会作为一个资源小组发挥作用，补充而不是取代现有结构，并侧重于多动症的专业化和专门知识，以加强正在进行的努力。培训使命该团队为“跨年龄ADHD大学文凭”（DIU）做出了贡献。“多动症：从筛查到支持”培训为医疗保健专业人员提供了诊断和治疗多动症所需的知识和工具。“DIVA成人5.0：诊断目标！”培训侧重于ADHD评估的诊断推理和访谈技巧。这些项目坚持当前的科学数据和公认的科学协会的ADHD指南，并获得qualopi®认证，等待继续医学教育的验证。培训后，专业人员通过多学科指导会议获得实施支持。协调和信息任务儿童儿童基金会正在Auvergne-Rhône-Alpes组织一个ADHD护理网络，与全科医生、卫生和教育机构、医疗社会机构、监狱护理、专家中心和患者协会合作。该团队为寻求adhd相关资源的机构和专业人士提供信息和指导，无论是直接还是通过其开发网站。该小组在该区域坚持遵守科学数据和最佳实践建议（RBPP），通过提高认识、培训、远程专业知识和多学科协调会议培养专业知识。经委会还与国家注意缺陷多动症组织协调，促进统一做法和制定注意缺陷多动症指导方针。护理使命eclah为需要诊断或治疗支持的复杂病例的儿童和成人提供三线或“追索性”咨询。这些咨询通常涉及鉴别诊断和共病评估，是与专门单位合作进行的，如儿童精神病学语言、学习和注意力障碍评估中心（CETESLA）和成人里昂大学成瘾服务中心（SUAL）。ECLAH还为患有复杂ADHD或药物禁忌症的个人提供心理教育和治疗教育小组。利用“BREF”心理教育项目，计划为护理人员建立一个支持小组。研究使命eclah从事医学研究，重点关注激素状态下女性ADHD特征，青少年停止哌醋甲酯治疗，哮喘和ADHD之间的联系，以及高水平年轻运动员的ADHD筛查。结论在Auvergne-Rhône-Alpes， eclah是一个支持专业人员及其ADHD患者的三级区域性团队。通过协调区域护理网络，ECLAH加强了现有的护理结构，确保获得可靠的ADHD信息和治疗途径。该团队计划为家庭引入一个心理教育小组，并优先考虑在监狱环境中对成人和青少年进行ADHD检测。

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Exemple d’une équipe territoriale de niveau 3 (« recours ») dans le TDAH : l’Équipe de Coordination Lyonnaise des troubles de l’Attention et de l’Hyperactivité (ECLAH)

Background

Attention Deficit Hyperactivity Disorder (ADHD) affects 6% of children and 3% of adults, representing approximately 481,600 youths and 240,800 adults in the Auvergne-Rhône-Alpes region. Despite its prevalence, the French national strategy for neurodevelopmental disorders (2023–2027) highlights the lack of dedicated healthcare pathways for ADHD and the challenges in accessing diagnosis, treatment, and psychosocial rehabilitation. In Auvergne-Rhône-Alpes, the discordance between the significant public health issue posed by ADHD and the local healthcare resources has often led to misdirection and congestion of specialized hospital teams. This situation persists despite the well-documented medical and societal complications of untreated ADHD. At the Vinatier Hospital in Lyon, several specialized teams offer expertise in ADHD for children and adults, but there was no specific team dedicated to ADHD until recently.

The Lyon ADHD Coordination Team (ECLAH)

Formed in November 2023 at the initiative of professionals from the Vinatier Hospital, ECLAH is a multidisciplinary team comprising psychologists, neuropsychologists, psychiatrists, child psychiatrists, addiction specialists, pharmacists, project managers, and clinical research associates. ECLAH aims to meet the national strategy's requirements for ADHD in the Auvergne-Rhône-Alpes region by coordinating care networks, providing information, training, care, and conducting research in the field of ADHD. ECLAH functions as a resource team, complementing existing structures without replacing them, and focuses on specialization and expertise in ADHD to enhance ongoing efforts.

Training Mission

The team contributes to the “Inter-University Diploma in ADHD across all ages” (DIU). The training “ADHD: From Screening to Support” equips healthcare professionals with the knowledge and tools necessary for ADHD diagnosis and treatment. The “DIVA Adult 5.0: Diagnostic Goal!” training focuses on diagnostic reasoning and interviewing techniques for ADHD evaluation. These programs adhere to current scientific data and ADHD guidelines from recognized scientific societies, with a Qualiopi® certification pending for continuous medical education validation. Following training, professionals receive implementation support through multidisciplinary guidance meetings.

Coordination and Information Mission

ECLAH is organizing a care network for ADHD in Auvergne-Rhône-Alpes, collaborating with general practitioners, health and educational institutions, medico-social establishments, penitentiary care, expert centers, and patient associations. The team provides information and guidance to institutions and professionals seeking ADHD-related resources either directly or through its developing website. The team maintains adherence to scientific data and best practice recommendations (RBPP) in the region, fostering expertise through awareness, training, tele-expertise, and multidisciplinary concertation meetings. ECLAH also coordinates with national ADHD organizations, contributing to the harmonization of practices and the development of ADHD guidelines.

Care Mission

ECLAH offers third-line or “recourse” consultations for children and adults with complex cases requiring diagnostic or therapeutic support. These consultations, often involving differential diagnoses and comorbidity assessments, are conducted in partnership with specialized units such as the Center for the Evaluation of Language, Learning, and Attention Disorders (CETESLA) for child psychiatry and the University Addiction Service of Lyon (SUAL) for adults. ECLAH also provides psychoeducation and therapeutic education groups for individuals with complex ADHD or contraindications to medication. A support group for caregivers is planned, leveraging the “BREF” psychoeducation program.

Research Mission

ECLAH engages in medical research, focusing on ADHD characteristics in women by hormonal status, the cessation of methylphenidate treatment in adolescents, links between asthma and ADHD, and screening for ADHD in high-level young athletes.

Conclusion

ECLAH is a third-level territorial team supporting professionals and their ADHD patients in Auvergne-Rhône-Alpes. By coordinating the regional care network, ECLAH enhances the existing care structures, ensuring access to reliable ADHD information and treatment pathways. The team plans to introduce a psychoeducation group for families and prioritize ADHD detection in penitentiary settings for both adults and youths.

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来源期刊

Annales medico-psychologiques 医学-精神病学

CiteScore

1.30

自引率

33.30%

发文量

196

审稿时长

4-8 weeks

期刊介绍： The Annales Médico-Psychologiques is a peer-reviewed medical journal covering the field of psychiatry. Articles are published in French or in English. The journal was established in 1843 and is published by Elsevier on behalf of the Société Médico-Psychologique. The journal publishes 10 times a year original articles covering biological, genetic, psychological, forensic and cultural issues relevant to the diagnosis and treatment of mental illness, as well as peer reviewed articles that have been presented and discussed during meetings of the Société Médico-Psychologique.To report on the major currents of thought of contemporary psychiatry, and to publish clinical and biological research of international standard, these are the aims of the Annales Médico-Psychologiques.