澳大利亚各州和领地正在改变注意力缺陷多动障碍（ADHD）的诊断方式和药物处方方式，让全科医生更多地参与其中。历史上，寻求ADHD诊断和处方的人需要全科医生转诊，才能看专科医生，儿童通常看儿科医生，成年人则看精神科医生。
Australian states and territories are changing how ADHD can be diagnosed and how medication can be prescribed, making general practitioners more involved. Historically, people seeking a diagnosis and prescription for ADHD needed a referral from their GP to see a specialist, often a paediatrician for children, or a psychiatrist for adults.
ADHD患者可能出现一系列症状，例如难以集中注意力、难以专注、难以组织事务，以及记忆力问题、过度活跃和多动。这些症状可能影响学业、友谊以及工作和家庭生活。哪些地方对诊断和治疗进行了改变？
People with ADHD can have a range of symptoms such as difficulty focusing, concentrating, organising, and difficulties with memory, overactivity and hyperactivity. This may affect schooling, friendships, and work and family life. Where have changes to diagnosis and treatment been made?
12月，昆士兰成为第一个允许全科医生诊断并为ADHD开处方的州。全科医生此前已能为四岁以上儿童开处方，前提是专科医生先对该年轻人进行了诊断。
In December, Queensland became the first state to allow GPs to diagnose and prescribe for ADHD. GPs were already able to prescribe to children over the age of four, as long as a specialist had seen and diagnosed the young person first.
10月，新南威尔士州政府宣布，新州近300名全科医生已完成澳大利亚全科医生学院培训，现在可以诊断ADHD并开处方。另有300名院士将于11月接受培训。从2027年初开始，符合条件的患者可能可以免费由全科医生进行评估。
In October, the New South Wales government announced almost 300 GPs in NSW have completed Royal Australian College of General Practitioners training and can now diagnose ADHD and prescribe medication. Another 300 fellows will undertake the training in November. From early 2027, eligible patients may be able to be assessed by GPs for free.
在维多利亚州，150名全科医生将从10月26日起，能够为成人和六岁及以上儿童诊断、治疗ADHD并开处方。
In Victoria, 150 GPs will be able to diagnose, treat and prescribe medication for ADHD to adults and children six years and over from 26 October.
大约65名接受过澳大利亚全科医生学院培训的西澳大利亚州全科医生，自6月起已能够诊断和治疗ADHD。
About 65 Western Australian GPs who undertook RACGP training have been able to diagnosis and treat ADHD since June.
经过专门培训的塔斯马尼亚州全科医生，自9月起已能够诊断和治疗六岁及以上患者。
Specially trained Tasmanian GPs have been able to diagnose and treat patients aged six years and older since September.
自2月起，澳大利亚首都领地的患者可以看经过专门培训的全科医生获取药物，前提是患者年满六岁，并拥有来自相关专科医生（如精神科医生）的现有ADHD诊断。
Since February, patients in the ACT have been able to see specially trained GPs for their medication, as long as they are six or older and have an existing ADHD diagnosis from a relevant specialist such as a psychiatrist.
澳大利亚首都领地还在7月宣布，接受进一步培训的全科医生将被授权为6岁以上、非复杂、不依赖药物的患者诊断多动症并开始用药，但需要获得首席卫生官的批准。预计2026年底会有更多信息。北领地尚未进行任何改革。在全科医生处诊断的流程是什么？
The ACT also announced in July that GPs who undergo further training will be authorised to diagnose ADHD and initiate medication in non-complex patients over six who are not drug-dependent, but they will need approval from the chief health officer. More information is expected in late 2026. No reforms have been made in the Northern Territory. What is the process of diagnosis with a GP?
澳大利亚皇家全科医师学院西澳州主席兼副主席拉米亚·拉曼医生表示，确认你的全科医生受过培训并提供多动症评估非常重要。
The Western Australian chair and vice-president of the RACGP, Dr Ramya Raman, said it is important to check that your GP is trained and provides assessments for ADHD.
拉曼说，最佳做法是与全科医生进行几次预约，在获得诊断之前，综合考虑年龄、健康状况、血液检查和进一步的转诊。
Raman said best practice would be to have a few appointments with your GP, with age, health conditions, blood tests and further referrals taken into account before receiving a diagnosis.
墨尔本大学的儿童和青少年精神病学家兼研究员戴夫·科吉尔教授说：“诊断多动症唯一真正的方法是与人会面，做我们所说的临床访谈。”
Prof Dave Coghill, a child and adolescent psychiatrist and researcher with the University of Melbourne, said: “The only real way to diagnose ADHD is to meet with someone and do what we call a clinical interview.
“你需要询问那些多动症症状，但你也需要确定人们不仅仅是拥有这些症状，而且这些症状在他们的日常生活中造成了现实世界的困难。”这些变化有什么担忧吗？
“You need to ask about those symptoms of ADHD, but also you need to establish that people don’t just have the symptoms but that those symptoms cause real-world difficulties in their day-to-day lives.”
科吉尔说，有人担心各州全科医生接受的培训存在差异，西澳州和新南威尔士州的全科医生接受数月的培训，而其他司法管辖区的全科医生接受的培训较少。
Are there any concerns about the changes? Coghill said there are concerns over the variation of training GPs receive across the states, with WA and NSW GPs receiving months of training while those in other jurisdictions receive less.
科吉尔说，一些全科医生“在仅仅两天的培训课程后就被授予诊断和开药的执照，我认为这不够充分”。
Coghill said some GPs have “been given the licence to diagnose and prescribe after just a two-day training course, which I think is not adequate”.
澳大利亚和新西兰皇家精神科医师学院（RANZCP）主席阿斯塔·托马尔医生希望为更复杂的病例提供更高标准的培训和支持。
The president of the Royal Australia New Zealand College of Psychiatrists (RANZCP), Dr Astha Tomar, wants greater standardisation of training and support offered for more complex cases.
“没有简单的多动症评估，这是一项全面的精神病学评估，”托马尔说。她还担心误诊的可能性，称这些药物可能有“显著的副作用”。
“There is no simple ADHD assessment, it is a comprehensive psychiatric evaluation,” Tomar said. She also worried about the chance of a wrong diagnosis, saying the medications can have “significant side effects”.
“如果你去问我们急诊科的同事，你会发现因焦虑加剧、睡眠困难前来就诊的人数有所增加，但最重要的是精神病性症状。人们出现了与药物相关的精神病性症状，而这种药物有时可能并不是那个人所需要的。”
“If you ask our emergency department colleagues, you will find that there is an increased number of people presenting with heightened anxieties, difficulties with sleep, but most importantly, psychosis. People are presenting with psychotic symptoms related to the medication, which possibly at times was not a medication which that person needed.”