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NICE guideline review: Attention deficit hyperactivity disorder: diagnosis and management (NG87)
  1. Rebecca Amy Dalrymple,
  2. Lindsey McKenna Maxwell,
  3. Shiuli Russell,
  4. Jane Duthie
  1. Acorn Community Child Health Centre, Vale of Leven District General Hospital, Alexandria, West Dunbartonshire, UK
  1. Correspondence to Dr Rebecca Amy Dalrymple, Department of General Paediatrics, Royal Hospital for Children, Glasgow, G51 4TF, UK; rebecca.dalrymple1{at}nhs.net

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Introduction

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobiological disorders of childhood. ADHD is defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (Text Revision) (DSM-V-TR) and is termed ‘hyperkinetic disorder’ in the International Classification of Diseases, 10th revision (ICD-10).1

There are three principle features of ADHD:

  • Impulsivity: causing premature and thoughtless actions with a potential for harm and desire for immediate rewards.

  • Hyperactivity: a restless and shifting excess of movement. The patient may excessively fidget, tap or talk.

  • Inattention: a difficulty sustaining focus as well as disorganisation.

The diagnosis is based on a combination of these symptoms, in excess of what is normal for age or developmental stage. There is likely to be considerable impact on a child’s social, emotional and cognitive development, resulting in significant difficulties within the home, social and educational settings.

A meta-analysis of 154 studies estimated a worldwide prevalence of around 5% using the ICD/DSM criteria.2 A further 5% of children are thought to have substantial difficulties with these symptoms but do not meet the diagnostic threshold for diagnosis.3

Previous guideline

This guideline updates and replaces the previous NICE guideline CG72 (2008). This was used in conjunction with NICE technology appraisal guideline TA98 (2006), which covered some of the treatments for ADHD, such as methylphenidate, atomoxetine and dexamfetamine.

Information about the current guideline

This guideline was commissioned by NICE and developed by the National Collaborating Centre for Mental Health (NCCMH), a collaboration of organisations within the mental health field. There was input from service users, carers and professionals from psychiatry, paediatrics, clinical psychology, education, general practice, nursing and child and adolescent mental health services. The guideline is intended for use in children over the age of 3 years up to adulthood. See box 1 for a link to the full …

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Footnotes

  • Twitter @becksDrD

  • Contributors RAD conceived the article concept and wrote the article. JD, LMM and SR contributed to and edited the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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