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Attention Deficit and Hyperkinetic Disorders in Children and Young People

Attention Deficit and Hyperkinetic Disorders in Children and Young People. Heterogeneous behavioural syndrome Symptoms of inattention, hyperactivity and impulsivity HKD (ICD-10) – more severe disturbance with significant hyperactivity component

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Attention Deficit and Hyperkinetic Disorders in Children and Young People

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  1. Attention Deficit and Hyperkinetic Disorders in Children and Young People

  2. 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?

  3. Common! Affected children/young people often unpopular with adults and peers Often fail to achieve potential Comorbid difficulties often present Why is it important?

  4. 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)

  5. 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)

  6. 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) Outcomes

  7. 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/Therapy

  8. Mephylphenidate

  9. Atomoxetine

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