{"title":"为儿科医生解读多动症。","authors":"Erasmo Barbante Casella, Beatriz Borba Casella","doi":"10.1016/j.jped.2025.101464","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To review current evidence on the pathophysiology, clinical features, differential diagnosis, and therapeutic management of Attention-Deficit/Hyperactivity Disorder (ADHD), emphasizing the pediatrician's role in diagnostic recognition and coordination of multidisciplinary care.</p><p><strong>Data sources: </strong>Narrative synthesis of the contemporary literature addressing genetic and neurobiological underpinnings, diagnostic criteria, comorbidities, and treatment strategies relevant to pediatric practice.</p><p><strong>Summary of findings: </strong>ADHD is a multifactorial neurodevelopmental disorder involving genetic predisposition and neurobiological alterations, particularly in cortico-subcortical circuits related to dopaminergic and noradrenergic modulation. Clinical presentation varies with age and context and may be accompanied by comorbidities such as learning disorders, anxiety, and depression. Diagnosis is clinical, based on standardized criteria and assessment across multiple settings, and requires exclusion of conditions that mimic ADHD. Management is multimodal, encompassing psychosocial interventions, school-based support, and, when indicated, pharmacological therapy. Pediatricians serve as the first point of contact and play a central role in early identification, family guidance, and integration of healthcare and educational teams.</p><p><strong>Conclusion: </strong>Proactive pediatrician involvement is essential for early diagnosis and effective management of ADHD, supporting better prognosis and the child's overall development.</p>","PeriodicalId":14867,"journal":{"name":"Jornal de pediatria","volume":" ","pages":"101464"},"PeriodicalIF":2.5000,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Unraveling ADHD for the pediatrician.\",\"authors\":\"Erasmo Barbante Casella, Beatriz Borba Casella\",\"doi\":\"10.1016/j.jped.2025.101464\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To review current evidence on the pathophysiology, clinical features, differential diagnosis, and therapeutic management of Attention-Deficit/Hyperactivity Disorder (ADHD), emphasizing the pediatrician's role in diagnostic recognition and coordination of multidisciplinary care.</p><p><strong>Data sources: </strong>Narrative synthesis of the contemporary literature addressing genetic and neurobiological underpinnings, diagnostic criteria, comorbidities, and treatment strategies relevant to pediatric practice.</p><p><strong>Summary of findings: </strong>ADHD is a multifactorial neurodevelopmental disorder involving genetic predisposition and neurobiological alterations, particularly in cortico-subcortical circuits related to dopaminergic and noradrenergic modulation. Clinical presentation varies with age and context and may be accompanied by comorbidities such as learning disorders, anxiety, and depression. Diagnosis is clinical, based on standardized criteria and assessment across multiple settings, and requires exclusion of conditions that mimic ADHD. Management is multimodal, encompassing psychosocial interventions, school-based support, and, when indicated, pharmacological therapy. Pediatricians serve as the first point of contact and play a central role in early identification, family guidance, and integration of healthcare and educational teams.</p><p><strong>Conclusion: </strong>Proactive pediatrician involvement is essential for early diagnosis and effective management of ADHD, supporting better prognosis and the child's overall development.</p>\",\"PeriodicalId\":14867,\"journal\":{\"name\":\"Jornal de pediatria\",\"volume\":\" \",\"pages\":\"101464\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-10-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Jornal de pediatria\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jped.2025.101464\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Jornal de pediatria","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jped.2025.101464","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
Objective: To review current evidence on the pathophysiology, clinical features, differential diagnosis, and therapeutic management of Attention-Deficit/Hyperactivity Disorder (ADHD), emphasizing the pediatrician's role in diagnostic recognition and coordination of multidisciplinary care.
Data sources: Narrative synthesis of the contemporary literature addressing genetic and neurobiological underpinnings, diagnostic criteria, comorbidities, and treatment strategies relevant to pediatric practice.
Summary of findings: ADHD is a multifactorial neurodevelopmental disorder involving genetic predisposition and neurobiological alterations, particularly in cortico-subcortical circuits related to dopaminergic and noradrenergic modulation. Clinical presentation varies with age and context and may be accompanied by comorbidities such as learning disorders, anxiety, and depression. Diagnosis is clinical, based on standardized criteria and assessment across multiple settings, and requires exclusion of conditions that mimic ADHD. Management is multimodal, encompassing psychosocial interventions, school-based support, and, when indicated, pharmacological therapy. Pediatricians serve as the first point of contact and play a central role in early identification, family guidance, and integration of healthcare and educational teams.
Conclusion: Proactive pediatrician involvement is essential for early diagnosis and effective management of ADHD, supporting better prognosis and the child's overall development.
期刊介绍:
Jornal de Pediatria is a bimonthly publication of the Brazilian Society of Pediatrics (Sociedade Brasileira de Pediatria, SBP). It has been published without interruption since 1934. Jornal de Pediatria publishes original articles and review articles covering various areas in the field of pediatrics. By publishing relevant scientific contributions, Jornal de Pediatria aims at improving the standards of pediatrics and of the healthcare provided for children and adolescents in general, as well to foster debate about health.