Attention Deficit Hyperactivity Disorder: The NICE Guideline on Diagnosis and Management of ADHD in Children, Young People and Adults(NICE Guidelines)

This guideline is endorsed by the National Institute for Health and Clinical Excellence (NICE) and sets out clear, evidence-based recommendations for healthcare and educational staff on how to diagnose and manage ADHD in children, young people and adults to significantly improve their treatment and care. ADHD is a common disorder. It is associated with serious impairments in childhood and those with a sustained diagnosis often develop significant difficulties in adulthood, including personality disorder and substance misuse. The NICE guideline is an important tool in helping professionals to make appropriate decisions about treating and caring for people with ADHD and improving their long-term outcomes. The guideline includes the evidence for the validity of the diagnosis, psychological interventions and parent training, pharmacological treatment, interventions for children in educational settings, dietary interventions, and combining and comparing psychological and pharmacological treatment. It also contains a useful overview of ADHD, and chapters on the organisation of care and on service user experience of treatment and care for ADHD, including a study of children's and young people's views of stimulant medication, which was commissioned especially for this guideline.

Table of Contents:
Full Contents Guideline development group members 1. Preface *National guidelines *The national ADHD guideline 2. Attention deficit hyperactivity disorder *The disorder *Diagnosis and assessment *Epidemiology *Aetiology *Current care and treatment of ADHD for children in the NHS *ADHD from an educational perspective *Adults with ADHD *The economic cost of ADHD 3. Methods used to develop this guideline *Overview *The scope *The Guideline Development Group *Clinical questions *Systematic clinical literature review *Health economics methods *Focus group methodology *Stakeholder contributions *Validation of this guideline 4. The experience of treatment and care for ADHD *Introduction *The experience of ADHD *Living with ADHD *The experiences of children and young people of stimulant medication for ADHD *Issues for adults diagnosed with ADHD and their partners *Recommendations 5. Diagnosis *Introduction *Definitions of terms *The validity of ADHD as a diagnostic category *Methodology *Reviewing the validity of the diagnosis: summary of the evidence *Is the cluster of symptoms that defines ADHD associated with significant clinical and psychosocial impairments? *Is there evidence for a characteristic pattern of developmental changes, or outcomes associated with the symptoms, that define ADHD? *Is there consistent evidence of genetic, environmental or neurobiological risk factors associated with ADHD? *Limitations *Summary of validation of the diagnosis of ADHD *Defining significant impairment *Position statement on the validity of ADHD *Consensus conference *Summary from review of the diagnosis *Implications for practice *Differentiating ADHD in adults from other co-occurring disorders *Recommendations *Research recommendation 6. The organisation of care for ADHD *Introduction *Stepped care model for ADHD - school-aged children and young people *Stepped care model for ADHD - pre-school children *Services for adults with ADHD *Models of care for adults in established services *Competencies for evaluation of ADHD in children and young people *Assessment framework and competencies for evaluation of ADHD in adults *Recommendations 7. Psychological interventions and parent training *Introduction *Psychological interventions for children with ADHD *Psychological interventions for adults with ADHD *Other non-pharmacological approaches *Recommendations *Research recommendations 8. Interventions for children with ADHD in educational settings *Introduction *Databases searched and inclusion criteria *Studies considered *Clinical evidence for screening for ADHD in educational settings *Clinical evidence for advice to teachers about ADHD, effective classroom interventions, and teacher training *From evidence to recommendations *Recommendations *Research recommendations 9. Dietary interventions *Introduction *Elimination diets *Supplementation diets *Recommendations 10. Pharmacological treatment *Introduction *Prescribing for children, young people and adults *The regulatory framework *Databases searched and inclusion/exclusion criteria for clinical evidence *Studies considered in the systematic review of clinical evidence *Methylphenidate (stimulant) *Dexamfetamine (stimulant) *Atomoxetine *Clonidine *Bupropion *Modafinil *Antidepressants *Atypical antipsychotics *Efficacy/ harms in special circumstances *Conclusion from clinical evidence *Health economics evidence *From evidence to recommendations *Recommendations 11. Combining and comparing psychological and pharmacological interventions *Introduction *Combined interventions for children with ADHD *Comparing psychological and pharmacological interventions for children with ADHD *The MTA study: implications for treatment decisions *Health economics evidence *From evidence to recommendations: Treatment decisions and combined treatment for children with ADHD *Recommendations

About the Author :
The National Collaborating Centre for Mental Health (NCCMH) was established in 2001 by the UK-based National Institute for Health and Clinical Excellence (NICE) to develop guidance on the appropriate treatment and care of people with mental health problems and then write the clinical guidelines. The NCCMH is a partnership between the Royal College of Psychiatrists and the British Psychological Society.