attention deficit and hyperkinetic disorders in children and young people dr. derek godfrey (gpr)
TRANSCRIPT
Attention Deficit and Attention Deficit and Hyperkinetic Disorders Hyperkinetic Disorders in Children and Young in Children and Young
PeoplePeople
Dr. Derek Godfrey (GPR)Dr. Derek Godfrey (GPR)
Heterogeneous behavioural syndrome
Symptoms of inattention, hyperactivity and impulsivity
HKD (ICD-10) – more severe disturbance with significant hyperactivity component
Commonly diagnosed disorder with M:F ratio (ADHD prevalence) of 4:1
ADHD/HKD – What are they?ADHD/HKD – What are they?
Common!
Affected children/young people often unpopular with adults and peers
Often fail to achieve potential
Comorbid difficulties often present
Why is it important?Why is it important?
Core symptoms: Inattention Hyperactivity Impulsive behaviour
DSM-IV and ICD-10 criteria are similar but DSM identifies 3 subtypes:
Predominately inattentive, predominately hyperactive/impulse AND combined
Diagnostic Criteria (1)Diagnostic Criteria (1)
To meet diagnostic criteria: Onset before age 7 (ADHD) or 6 (HKD) At least 6 months Pervasive Caused significant functional
impairment Not better accounted for by other
mental disorders
Beware failure to meet above → sig.difficulties
Diagnostic Criteria (2)Diagnostic Criteria (2)
No good quality data for ADHD in Scotland
Rate diminishes in adolescence/can persist
Predictors include: maternal depression, marital discord, -ve parent-child interaction, family disadvantage and FHx.
Current service provision for adults is limited (See NICE guidance)
OutcomesOutcomes
Dietary modification
Psychological: Behavioural parent training School-based interventions
Pharmacological therapy: Only initiated by specialists Shared care once started (Annex 2)
No evidence of benefit from alternative therapies
Treatment/TherapyTreatment/Therapy