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NICE guideline: attention deficit hyperactivity disorder
  1. M Atkinson1,
  2. C Hollis2
  1. 1Division of Child Health, University of Nottingham, University Hospital Queen’s Medical Centre, Nottingham, UK
  2. 2Department of Child and Adolescent Psychiatry University of Nottingham, Queen’s Medical Centre, Nottingham, UK
  1. Dr Maria Atkinson, Division of Child Health, Nottingham University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH, UK; maria{at}doctors.org.uk

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Introduction

ADHD (attention deficit hyperactivity disorder) is a heterogeneous behavioural syndrome characterised by maladaptive levels of hyperactivity, impulsivity and inattention. ADHD (as defined by DSM-IV-TR) is a common disorder affecting 3.6% of boys and 0.85% of girls between the ages of 5 and 15 years in the UK.1 DSM-IV describes three subtypes of ADHD according to the mixture of symptoms: predominantly inattentive (ADHD-I), predominantly hyperactive-impulsive (ADHD-HI) and combined type (ADHD-C). The ICD-10 definition of hyperkinetic disorder (HKD) describes a severe subgroup of the DSM-IV combined type ADHD and affects about 1.5% of primary school-age boys. In recent years there has been an increase in the clinical recognition of ADHD/HKD with a corresponding rise in the numbers diagnosed and treated, from an estimate of 0.5 per 1000 children diagnosed in the UK 30 years ago2 to more than 3 per 1000 receiving medication for ADHD in the late 1990s.3 This article summarises the main recommendations from the ADHD guideline produced by the National Institute for Health and Clinical Excellence. Readers should refer to the full guideline for the complete set of recommendations and supporting evidence4 (www.nice.org.uk/CG072).

What the Guideline Covers

  • The diagnosis of ADHD in children, young people and adults

  • The treatment of children aged 3 years and older, young people (12–18 years) and adults with a diagnosis of ADHD and HKD

  • Specific treatments such as pharmacological and psychological interventions including family interventions, cognitive–behavioural treatments and parent training; other physical treatments are also considered such as dietary elimination and supplementation

  • The management of ADHD in the presence of co-morbid conditions in children, young people and adults including conduct problems, anxiety, autism spectrum disorder (ASD), learning disability, neurological disorders and substance misuse

  • The organisation of care and services for children, young people and adults with ADHD.

Methodology

The guideline was developed by the …

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