Trastorno por déficit de atención con hiperactividad. Factores psicosociales y comorbilidad afectiva
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Trastorno por Déficit ele Atención con Hiperactividad, Comorbilidad, Factores sociofamiliaresResumen
El trastorno por déficit de atención con hiperactividad (TDAH) es una entidad heterogénea. Su definición, límites diagnósticos y etiología siguen siendo motivo ele controversia. Por su impo1tancia nosológica, clínica y terapéutica, nos centramos en dos aspectos del TDAH: los factores sociofamiliares asociados a su aparición y curso, y la comorbilidad con trastornos afectivos. En el presente trabajo, los autores revisan la literatura científica (Mecl-Line), centrándose en los últimos cinco años.
Los factores etiológicos que confluyen en el origen del TDAH no tienen la misma importancia en cada paciente: en algunos casos los factores genéticos son determinantes, en otros niños lo serán los psicoafectivos. Es necesario aproximarse de manera individualizada a cada enfermo, sin menospreciar la importancia etiológica e implicaciones terapéuticas de los factores sociofamiliares, especialmente la psicopatología ele los padres. La comorbilidacl asociada al TDAH es tan frecuente que puede considerarse la norma; no sólo dificulta el diagnóstico, sino que tiene consecuencias terapéuticas. A partir ele la heterogeneidad etiológica y la comorbilidad del TDAH, parece necesario distinguir subtipos que permitan una mayor comprensión del trastorno, un refinamiento diagnóstico y un abordaje terapéutico más eficaz.
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