Diagnosis and Treatment of Attention-Deficit Hyperactivity Disorder in Patients with Chronic Pain  

作　　者：Satoshi Kasahara Yumiko Okamura Ko Matsudaira Hiroyuki Oka Yoshie Suzuki Yasuko Murakami Toshiharu Tazawa Hayato Shimazaki Shin-ichi Niwa Yoshitsugu Yamada 

机构地区：[1]Anesthesiology and Pain Relief Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan [2]Department of Neuropsychiatry, Faculty of Medicine, University of Tokyo, Tokyo, Japan [3]Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan [4]Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Juntendo University, Tokyo, Japan [5]Department of Anesthesiology and Pain Medicine, Yokohama City University Medical Center, Yokohama, Japan [6]Department of Psychiatry, Jikei University School of Medicine, Tokyo, Japan [7]Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan

出　　处：《Open Journal of Psychiatry》2017年第4期261-275,共15页精神病学期刊（英文）

摘　　要：Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.Aims: To investigate rates of attention-deficit hyperactivity disorder (ADHD) in patients with chronic pain attending a pain clinic, the effects of a screening measure for ADHD in patients with chronic pain, and the effects of ADHD drugs on both pain and ADHD symptoms. Methods: We retrospectively surveyed 110 patients with chronic pain visiting the Anesthesiology and Pain Relief Center at the University of Tokyo in Japan, who had also consulted a psychiatrist, between April 2012 and July 2015. Results: Of the total of 110 patients with chronic pain, 35 (31.8%) were also diagnosed with ADHD, and the average Wender Utah Rating Scale (WURS) score among the ADHD patients was 39.0 ± 22.1 (n = 25). Only 36.0% of these patients exceeded the cutoff value, suggesting that 64.0% of the patients with ADHD were not identified by screening with the WURS. Twenty-six patients initiated treatment with ADHD medication, with dosage adjustment completed in 21. Of these 21 patients 20 (95.0%) had improved ADHD symptoms. Improved pain symptoms were observed in 14 patients (66.6%), with a reduction in the pain numerical rating scale of 64.7% ± 30.1%. Conclusions: This is the first study investigating the comorbidity of ADHD and chronic pain at pain clinics showing a high level of comorbidity and amelioration of pain and ADHD symptoms with treatment. Careful interpretation is required when the WURS is used to screen patients with chronic pain.

关 键 词：ATOMOXETINE Attention DEFICIT HYPERACTIVITY DISORDER Chronic Pain METHYLPHENIDATE Wender UTAH Rating Scale 

分 类 号：R73[医药卫生—肿瘤]