英格兰的一项官方评估指出，存在人们被过度诊断为患有注意力缺陷多动障碍（ADHD）或自闭症的风险。
There is a risk of people being over-diagnosed with ADHD and autism, an official review in England has found.
专家指出，过去25年间诊断案例数量持续上升，目前在某些年轻年龄段中，实际诊断人数似乎已超出预期水平。
Experts said a rise in diagnoses over the past 25 years meant cases now appear to be outstripping the expected number in the population for some younger age groups.
该评估呼吁加强对为国民医疗服务体系提供诊断服务的私营机构的监管，指出这些机构提供的服务质量与一致性令人担忧，并建议禁止相关广告宣传。
The review called for tougher regulation of private firms offering assessments for the NHS, saying they had concerns about quality and consistency, and a ban on advertising.
评估认为，经济环境的不确定性与社交媒体的影响共同导致青少年心理健康问题日益增多，因此需要针对各类病症提供更完善的支援措施。
It concluded economic uncertainty combined with social media was driving an increase in mental health problems among young people and said there needed to be better support in place for all conditions.
这项评估由该领域的权威医学专家牵头开展。10个月前，时任卫生大臣韦斯·斯特里廷在一次采访中称青少年存在被过度诊断及“被贴上标签、失去发展机会”的现象，随后便下令开展此项评估。评估对象涵盖所有年龄段人群，但重点研究诊断率最高的青少年与儿童群体。
The review - led by leading doctors in the field - was ordered 10 months ago by Wes Streeting after the then-health secretary claimed in an interview that young people were over-diagnosed and "written off". It looked at people of all ages, but particularly focused on young people and children who have the highest rates of diagnoses. It is likely to feed into government policies on everything from NHS services and benefits to support for young people who are not in education, employment or training.
该评估结果很可能影响政府后续多项政策的制定，涉及国民医疗服务体系服务、福利发放，以及针对失学、失业、未接受职业培训的青少年的帮扶措施等。
The experts said too often diagnoses of mental health problems and ADHD and autism were ending up as labels that defined people by their "difficulties rather than their strengths and potential", harming their prospects at school, in work and in relationships.
专家指出，对心理健康问题、ADHD及自闭症的诊断结果往往沦为一种标签，让人们仅以“缺陷”而非“优势与潜力”来定义自身，进而损害他们在学业、就业及人际交往中的发展前景。
Children diagnosed with autism and ADHD before the age of 17 are around four times more likely to end up not in education, employment or training between 16 and 24.
17岁前被确诊患有自闭症或ADHD的青少年，在16至24岁期间处于失学、失业或未接受职业培训状态的概率约为其他同龄人的4倍。
With better support after diagnosis, they could be helped to live more fulfilling lives, the review said.
评估指出，若能获得更完善的诊断后支援，这些青少年便有望过上更充实的生活。除了各类治疗服务外，还应提供心理健康方面的帮助——因为相当比例的此类患者还饱受抑郁症等疾病的困扰。
Alongside access to therapies, this should also include support for mental health – significant numbers also struggle with conditions such as depression. But the review found people were also being harmed by long waits for diagnosis for mental health and ADHD and autism.
不过评估也发现，等待心理健康问题、ADHD及自闭症诊断的漫长周期同样会对患者造成负面影响。
The Watsons are just one family who have experience of this.
沃森一家只是有过类似经历的家庭之一。瑞安和妻子发现，他们的儿子阿特拉斯在12到18个月大时便出现了发育异常，未能达到正常的发育里程碑。
Ryan and his wife knew there was something different with their son Atlas when he was around 12 to 18 months old and missing development milestones. But it took three years to get an autism assessment.
然而，他们花了三年时间才为阿特拉斯完成自闭症评估。随着时间推移，阿特拉斯的特殊需求也愈发明显。如今快七岁的阿特拉斯不会说话，仍需使用纸尿裤，日常生活的方方面面都依赖他人照料。
As time passed, his needs became increasingly clear. Now nearly seven, Atlas is non-verbal, still wears nappies and relies on others for all aspects of daily care. Despite this, Ryan said there was no fast-track route for children with the most complex needs.
尽管如此，瑞安表示，对于那些需求最为复杂的孩子来说，并没有任何快速获得评估的途径。“你只能排队等候，直到轮到自己为止。”漫长的等待让这家人争分夺秒，力求在阿特拉斯入学前为他争取到必要的支持。瑞安和妻子一直担心他会被安排进普通学校。
"You basically go on the list and wait however long until you get to the top." The wait left the family racing against time to secure support before Atlas started school. Ryan and his wife feared he would be placed in a mainstream school. "We were terrified," Ryan says.
“我们当时吓坏了，”瑞安说，“凡是有像阿特拉斯这样孩子的家长，都会担心孩子被送进普通学校后得不到妥善照顾。”
"Anyone who has a child like Atlas will have the same panic that they'll start in a mainstream school where it's not safe."
这种压力实在巨大。“我就像同时打两份工，”瑞安说，“白天上班，回家后还要处理这些事情。”最终，阿特拉斯在即将入学前才被确诊。
The strain was immense. "It was like I had two jobs," Ryan says. "I was going to work and then coming home and dealing with these things."
为确保像沃森一家这样的家庭能更快获得评估，此次评估建议对等候名单上的人员重新评估，确保需求最迫切的人优先得到帮助；同时研究哪些人可以不再需要医学诊断，转而获得其他类型的非医疗支持。
Atlas was eventually diagnosed only months before starting school.
这些支持可能包括对学校或工作场所的相应调整，以及改善睡眠、缓解焦虑等方面的生活指导。
To ensure families like the Watsons get quicker assessment, the review calls for reassessment of those on waiting lists to ensure people with the highest needs are prioritised first and to look at whether some could be removed and offered other kinds of non-medical support.
目前，获得相关帮助往往必须以确诊为前提。专家指出，2014年出台的新规定要求家长必须为孩子确诊自闭症或注意力缺陷多动障碍，孩子才能获得学校的额外支持。
This could include adjustments being made at school or in workplaces and lifestyle support, such as help to improve sleep or address anxiety, it said. Too often, access to help requires a diagnosis, with experts highlighting changes in 2014 that required parents to get a diagnosis of autism and ADHD to qualify their children for extra support in schools.
评估委员会主席彼得·福纳吉教授指出，现行体系显然“承受着巨大压力”，如今是时候打破“确诊才是获得支持的唯一途径”这一僵化模式了。
Review chair Prof Peter Fonagy said it was clear the system was "under immense strain" and it was time to get away from diagnosis being a "very narrow pathway" to finding support.
“诊断依然至关重要且必须得到保障——但需要改变的是，它不再是获取帮助的唯一条径。”该评估报告指出，并非所有困难都需要通过医疗手段来解决；同时还存在一种风险，即难以清晰区分真正符合诊断标准的多动症与自闭症，以及那些属于人类大脑功能、认知与行为方面的正常差异。
"Diagnosis remains essential and must be protected - what has to change is that it is no longer the only door through which help can be reached." The review said not every difficulty required a medical response and there was a risk of blurring the lines between diagnosable ADHD and autism and what should be considered the normal human variation in brain function, cognition and behaviour.
报告称，目前社会有可能正从诊断不足的时代转向过度诊断或误诊的时代。数据显示，如今6至17岁的儿童中，确诊患有自闭症的比例已超过4%，这一数值远高于研究认为的1%至2%的真实比例。
it said there was a risk society was now moving from an era of under-diagnosis to over-diagnosis or mis-diagnosis, pointing to data showing more than 4% of children aged six to 17 were now diagnosed with autism, well above the 1-2% that studies suggest is the true level. But it said because some of these figures date back nearly a decade it was not possible to be absolutely certain or conclude over-diagnosis was currently occurring at scale.
不过报告也指出，由于部分数据可追溯至近十年前，因此尚无法完全确定当前是否存在大规模的过度诊断现象。
Mel Merritt, of the National Autistic Society, said the report shows that successive governments "have failed autistic people".
英国国家自闭症协会的梅尔·梅里特表示，这份报告表明历届政府“都未能为自闭症患者提供应有的支持”。她强调：“自闭症患者所遭受的伤害与痛苦是切实存在且普遍发生的，我们迫切需要建立起一个能切实满足他们需求的援助体系。”
"The harm and distress autistic people are facing is real and widespread and there is a desperate need to build a system that supports the needs of autistic people." Abigail Ampofo, of charity YoungMinds, said: "For years, young people have told us they feel blamed for their mental health or accused of making it up.
慈善机构YoungMinds的代表阿比盖尔·安波福则表示：“多年来，许多年轻人向我们倾诉，他们觉得自己因心理健康问题而遭到指责，甚至被视作在夸大其词。我们希望这份评估报告能向他们表明：他们的痛苦并非自身过错，而是现有的社会支持体系存在缺陷。”不过她也指出，要实现这一点还需进行大规模改革。
We hope this review goes some way to show them their distress is not their fault and the systems around them are failing." But she said that would require major reform.
英国政府对该报告的发布表示欢迎，称即将于今年年底发布的心理健康战略中将提出全新的援助模式，同时承诺加强对多动症与自闭症诊断流程的监管。卫生大臣伊薇特·库珀补充道：“丰纳吉教授的评估报告充分凸显了早期干预对于改善心理健康及神经发育障碍的重要性，也凸显了这些疾病可能给患者带来的巨大痛苦。”
The government welcomed the publication of the report and said it would be setting out a new model of providing support in its forthcoming mental health strategy, which is expected before the end of the year, and also promised to introduce tougher regulation of ADHD and autism assessments. Health Secretary Yvette Cooper added: "Professor Fonagy's review has shown the importance of early intervention to address mental health and neurodevelopmental conditions and the huge distress these can cause."