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Review of clinical guidelines for children and adolescents with attention deficit hyperactivity disorder and their application to an Irish context

Published online by Cambridge University Press:  27 November 2014

G. Kavanagh ,
S. O’Hanrahan ,
G. Hughes  and
F. McNicholas
G. Kavanagh*
Affiliation:
Consultant Child and Adolescent Psychiatrist, Lucena Clinic, Wicklow, Ireland
S. O’Hanrahan
Affiliation:
Research Psychologist, Department of Child and Adolescent Psychiatry, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland
G. Hughes
Affiliation:
Senior Registrar, Linn Dara Inpatient Unit, Palmarston, Dublin, Ireland
F. McNicholas
Affiliation:
Consultant Child and Adolescent Psychiatrist, Department of Child and Adolescent Psychiatry, Our Lady’s Children’s Hospital, Crumlin, Dublin, Ireland St. John of Gods Lucena Clinic, Rathgar and University College Dublin, Dublin, Ireland
*
*Address for correspondence: G. Kavanagh, Consultant Child and Adolescent Psychiatrist, St. John of Gods Lucena Clinic, Wicklow Town, Co. Wicklow, Ireland. (Email: glenda.kavanagh@sjog.ie)
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Abstract

Background:

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with international prevalence rates estimated to be 5%. It is currently the most common disorder treated in Child and Adolescent Mental Health Services in Ireland. There have been a number of guidelines worldwide produced to aid clinicians in the diagnosis and treatment of ADHD; however, there are no guidelines available specifically for the Irish population and healthcare system.

Objectives:

The aim of this paper is to review the available clinical guidelines for the diagnosis and management of ADHD in children adolescents across North America, Canada, Europe and the United Kingdom and to apply these to an Irish context.

Methods:

A number of international guidelines were reviewed. A proposed pathway for the assessment and treatment of children and adolescents with ADHD has been devised with the recommendation that a formalised consensus guideline should be implemented.

Conclusion:

This review paper has highlighted that there is consensus between the guidelines for the diagnosis of ADHD with a thorough clinical history remaining the gold standard. They further agree on the importance of identifying co-morbid disorders. When it comes to the treatment, the guidelines are less unified. This current paper has devised a proposed care pathway for ADHD in Ireland to ensure high quality cost effective care within its healthcare system.

Keywords

Attention deficit hyperactivity disorderdiagnosisguidelinesmanagementtreatment
Type
Review Article
Information
Irish Journal of Psychological Medicine , Volume 32 , Issue 3 , September 2015 , pp. 283 - 293
Copyright
© College of Psychiatrists of Ireland 2014 

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn (text revision). American Psychiatric Association: Washington, DC.Google Scholar
American Academy of Child and Adolescent Psychiatry (AACAP) (2007). Practice parameters for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry 46, 894–921.CrossRefGoogle Scholar
Antshel, M, Barkley, R (2008). Psychosocial interventions in attention deficit hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America 17, 421–437.CrossRefGoogle ScholarPubMed
Barkley, A (2002). Psychosocial treatments for attention deficit/hyperactivity disorder in children. Journal of Clinical Psychiatry 63, 36–43.Google ScholarPubMed
Biederman, J, Faraone, S, Milberger, S, Guite, J, Mick, E, Chen, L, Mennin, D, Marrs, A, Ouellette, C, Moore, P, Spencer, T, Norman, D, Wilens, T, Kraus, I, Perrin, J (1996). A prospective 4 year follow up study of attention deficit hyperactivity and related disorders. Archives of General Psychiatry 53, 437–446.CrossRefGoogle ScholarPubMed
Biederman, J, Melmed, D, Patel, A, McBurnett, K, Konow, J, Lyne, A, Scherer, N (2008). SPD503 study group. A randomized, doubleblind, placebo-controlled study of guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder. Paediatrics 121, e73–e84.CrossRefGoogle Scholar
Bunting, BP, Murphy, SD, O’Neill, SM, Ferry, FR (2012). Lifetime prevalence of mental health disorders and delay in treatment following initial onset: evidence from the Northern Ireland Study of health and stress. Psychological Medicine 48, 1727–1739.CrossRefGoogle Scholar
Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA) (2011). Canadian ADHD Practice Guidelines, 3rd edn. http://www.caddra.ca/cms4/index.php?option=com_content&view=article&id=26&Itemid=70&lang=en Accessed 10 April 2012.Google Scholar
Carpenter, RE, Loo, K, Yang, M, Dang, J, Smalley, L (2009). Social functioning difficulties in ADHD: association with PDD risk. Clinical Child Psychology Psychiatry 14, 329–344.CrossRefGoogle Scholar
Chronis, M, Jones, A, Raggi, V (2006). Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Clinical Psychology Review 26, 486–502.CrossRefGoogle ScholarPubMed
Coughlin, M, Sharry, J, Fitzpatrick, C, Guerin, S, Drumm, M (2009). A controlled evaluation of the parents plus children’s programme: a video-based programme for parents of children aged 6–11 years with behavioural and developmental problems. Clinical Child Psychology & Psychiatry 14, 541–558.CrossRefGoogle Scholar
Department of Health & Children (2006). A Vision of Change: Report of the Expert Group on Mental Health Policy. Stationary Office: Dublin.Google Scholar
Farzin, F, Perry, H, Hessl, D, Loesch, D, Cohen, J, Bacalman, S, Gane, L, Tassone, F, Hagerman, P, Hagerman, R (2001). Should the diagnosis of attention-deficit/hyperactivity disorder be considered in children with pervasive developmental disorder? Journal of Attention Disorders 4, 203–211.Google Scholar
Fitzgerald, M, Bellgrove, M, Gill, M (2007). Handbook of Attention Deficit Hyperactivity Disorder. John Wiley & Sons: The Atrium, West Sussex, England.Google Scholar
Geller, D, Donnelly, C, Lopez, F, Rubin, R, Newcorn, J, Sutton, V, Bakken, R, Paczkowski, M, Kelsey, D, Sumner, C (2007). Atomoxetine treatment for pediatric patients with attention-deficit/hyperactivity disorder with comorbid anxiety disorder. Journal of the American Academy of Child and Adolescent Psychiatry 46, 1119–1127.CrossRefGoogle ScholarPubMed
Gillberg, C, Melander, H, von Knorring, A-L, Janols, L-O, Thernlund, G, Hägglöf, B, Eidevall-Wallin, L, Gustafsson, P, Kopp, S (1997). Long-term stimulant treatment of children with attention-deficit hyperactivity disorder symptoms. A randomized, double-blind, placebo controlled trial. Archives General Psychiatry 54, 857–864.CrossRefGoogle ScholarPubMed
Graham, J, Banaschewski, T, Buitelaar, J, Coghill, D, Danckaerts, M, Dittmann, RW, Do¨pfner, M, Hamilton, R, Hollis, C, Holtmann, M, Hulpke-Wette, M, Lecendreux, M, Rosenthal, E, Rothenberger, A, Santosh, P, Sergeant, J, Simonoff, E, Sonuga-Barke, E, Wong, ICK, Zuddas, A, Steinhausen, HC, Taylor, E (2011). European guidelines on managing adverse effects of medication for ADHD. European Child and Adolescent Psychiatry 20, 17–37.CrossRefGoogle ScholarPubMed
Griffin, C, Guerin, S, Sharry, J, Drumm, M (2010). A multicentre controlled study of an early intervention parenting programme for young children with behavioural and developmental difficulties. International Journal of Clinical and Health Psychology 10, 279–294.Google Scholar
Hyperactivity Attention Deficit Disorder (HADD) (2006). A Survey of ADHD in Irish Children. www.hadd.ie/adhd-survey-ireland-parents.pdf Accessed 10 April 2012.Google Scholar
Jain, R, Segal, S, Kollins, H, Khayrallah, M (2011). Clonidine extended-release tablets for pediatric patients with attention-deficit/hyperactivity disorder. Journal of American Academy Child Adolesc Psychiatry 50, 171–179.CrossRefGoogle ScholarPubMed
Jensen, S, Martin, D, Cantwell, P (1997). Comorbidity in ADHD: implications for research, practice, and DSM-V. Journal of American Academy Child Adolescent Psychiatry 36, 1065–1079.CrossRefGoogle ScholarPubMed
Jones, K, Daley, D, Hutchings, J, Bywater, T, Eames, C (2008). Efficacy of the Incredible Years Programme as an early intervention for children with conduct problems and ADHD: long-term follow-up. Child: Care, Health and Development 34, 380–390.CrossRefGoogle ScholarPubMed
Kirley, A, Fitgerald, M (2002). Adult ADHD: a controversial diagnosis? Irish Journal of Psychological Medicine 19, 86–91.CrossRefGoogle ScholarPubMed
Lynch, F, Mills, C, Fitzpatrick, C (2004). Challenging times: a study to detect Irish adolescents at risk of psychiatric disorders and suicidal ideation. Journal of Adolescence 27, 441–451.CrossRefGoogle ScholarPubMed
McGilloway, S, Ni Mhaille, G, Bywater, T, Furlong, M, Leckey, Y, Kelly, P, Comiskey, C, Donnelly, M (2011). A parenting intervention for childhood behavioral problems: a randomised controlled trial in disadvantaged community-based settings. Journal of Consulting and Clinical Psychology 80, 116–127.CrossRefGoogle ScholarPubMed
Michelson, D, Allen, AJ, Busner, J (2002). Once-daily atomoxetine treatment for children and adolescents with attention deficit hyperactivity disorder: a randomized, placebo-controlled study. The American Journal of Psychiatry 159, 1896–1901.CrossRefGoogle ScholarPubMed
Michelson, D, Buitelaar, K, Danckaerts, M, Gillberg, C, Spencer, TJ, Zuddas, A, Faries, DE, Zang, S, Biederman, J (2004). Relapse prevention in pediatric patients with ADHD treated with atomoxetine: a randomized, double-blind, placebo-controlled study. Journal of American Academy Child Adolescent Psychiatry 43, 896–904.CrossRefGoogle ScholarPubMed
Montoyaa, F, Colomb, M, Ferrinc, D (2011). Is psychoeducation for parents and teachers of children and adolescents with ADHD efficacious? A systematic literature review. European Psychiatry 26, 166–175.CrossRefGoogle Scholar
Mulligan, A, Anney, R, Butler, L, O’Regan, M, Richardson, T, Tulewicz, EM, Fitzgerald, M, Gill, M (2013). Home environment: association with hyperactivity/impulsivity in children with ADHD and their non-ADHD siblings. Child: Care, Health and Development 39, 202–212.CrossRefGoogle ScholarPubMed
National Institute for Health and Clinical Excellence (2008). Attention deficit hyperactivity disorder. Diagnosis and management of ADHD in children, young people and adults. (CG072): London. http://www.nice.org.uk/cg72. Accessed 10 January 2013.Google Scholar
O’Keeffe, N, McNicholas, F (2011). Paediatricians’ views on their role in the assessment and management of ADHD and Autism. Irish Medical Journal 104, 282–284.Google ScholarPubMed
Polanczyk, G, De Lima, S, Horta, L, Biederman, J, Rohde, LA (2007). The worldwide prevalence of ADHD: a systematic review and metaregression analysis. American Journal of Psychiatry 164, 942–948.CrossRefGoogle ScholarPubMed
Reeve, E, Garfinkel, B (1991). Neuroendocrine and growth regulation: the role of sympathicomimetic medication. In Ritalin: Theory and Management (ed. L Greenhill and BB Osman), pp 289–300. Liebert: New York.Google Scholar
Sallee, R, Lyne, A, Wigal, T, McGough, J (2009). Longterm safety and efficacy of guanfacine extended release in children and adolescents with attention-deficit/hyperactivity disorder. Journal of Child Adolescent Psychopharmacology 19, 215–226.CrossRefGoogle ScholarPubMed
Simonoff, E, Pickles, A, Charman, T, Chandler, S, Loucas, T, Baird, G (2008). Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. Journal of American Academy Child Adolescent Psychiatry 47, 921–929.CrossRefGoogle Scholar
SIGN (Scottish Intercollegiate Guidelines Network) (2009). Management of attention deficit and hyperkinetic disorders in children and young people. (Guideline Number 112). Edinburgh. http://www.sign.ac.uk/pdf/sign112.pdf. Accessed 12 January 2013.Google Scholar
Spencer, J, Abikoff, B, Connor, F, Biederman, J, Pliszka, SR, Boellner, S, Read, SC, Pratt, R (2006). Efficacy and safety of mixed amphetamine salts extended release Adderall XR in the management of oppositional defiant disorder with or without comorbid attention-deficit/hyperactivity disorder in school-aged children and adolescents: a 4-week, multicenter, randomized, double-blind, parallel group, placebo-controlled, forced-dose-escalation study. Clinical Therapy 28, 402–418.CrossRefGoogle ScholarPubMed
Spencer, T (2006). ADHD and comorbidity in childhood. Journal of Clinical Psychiatry 8, 27–31.Google Scholar
Subcommittee on Attention-Deficit/Hyperactivity Disorder. Steering committee on Quality Improvement and Management (2011). ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Paediatrics 128, 1–16.Google Scholar
Taylor, E, Chadwick, O, Heptinstall, E, Danckaerts, M (1996). Hyperactivity and conduct problems as risk factors for adolescent development. Journal of American Academy Child Adolescent Psychiatry 35, 1213–1226.CrossRefGoogle ScholarPubMed
Taylor, E, Döpfner, M, Sergeant, J, Asherson, P, Banaschewski, T, Buitelaar, J, Coghill, D, Danckaerts, M, Rothenberger, A, Sonuga-Barke, E, Steinhausen, HC, Zuddas, A (2004). European clinical guidelines for hyperkinetic disorder – first upgrade. European Child & Adolescent Psychiatry l3 (Suppl. 1): 17–30.Google Scholar
The MTA Co-operative Group (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA cooperative group. Multimodal treatment study of children with ADHD. Archives of General Psychiatry 56, 1073–1086.CrossRefGoogle Scholar
Wilens, E, McBurnett, K, Bukstein, O, McGough, J, Greenhill, L, Lerner, M, Stein, MA, Connor, CK, Duby, J, Newcorn, J, Bailey, CE, Kratochvil, CJ, Coury, D, Casat, C, Denisco, MJ, Halstead, P, Bloom, L, Zimmerman, BA, Gu, J, Cooper, KM, Lynch, JM (2006). Multisite controlled study of OROS methylphenidate in the treatment of adolescents with attention-deficit/hyperactivity disorder. Archive Paediatric Adolescent Medicine 160, 82–90.CrossRefGoogle ScholarPubMed
World Federation of Mental Health (2005). Without boundaries, Challenges and Hopes for living with ADHD: An International Survey.Google Scholar
World Health Organisation (1992). ICD-10 Classifications of Mental and Behavioural Disorder: Clinical Descriptions and Diagnostic Guidelines. World Health Organisation: Geneva.Google Scholar
Yoshida, Y, Uchiyama, T (2004). The clinical necessity for assessing attention deficit/hyperactivity disorder (AD/HD) symptoms in children with high-functioning pervasive developmental disorder (PDD). European Child Adolescent Psychiatry 13, 307–314.CrossRefGoogle ScholarPubMed
Zwi, M, Jones, H, Thorrgard, C, York, A, Dennis, JA (2011). Parent training interventions for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years. The Cochrane Database of Systematic Review 7, CD003018, doi:10.1002/14651858.CD003018.pub3.Google Scholar