1. Attention Deficit and Hyperkinetic Disorders in Children and Young People
Dr. Derek Godfrey (GPR)

3. ADHD/HKD – What are they?
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

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

6. Diagnostic Criteria (1)
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

7. Diagnostic Criteria (2)
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

8. Outcomes 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)

11. No evidence of benefit from alternative therapies
Treatment/Therapy
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

13. Mephylphenidate

14. Atomoxetine