NICE guideline review: Attention deficit hyperactivity disorder: diagnosis and management (NG87)

Attention deficit hyperactivity disorder (ADHD) is one of the most common neurobiological disorders of childhood. ADHD is defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (Text Revision) (DSM-V-TR) and is termed ‘hyperkinetic disorder’ in the International Classification of Diseases, 10th revision (ICD-10).1 There are three principle features of ADHD: The diagnosis is based on a combination of these symptoms, in excess of what is normal for age or developmental stage. There is likely to be considerable impact on a child’s social, emotional and cognitive development, resulting in significant difficulties within the home, social and educational settings. A meta-analysis of 154 studies estimated a worldwide prevalence of around 5% using the ICD/DSM criteria.2 A further 5% of children are thought to have substantial difficulties with these symptoms but do not meet the diagnostic threshold for diagnosis.3 This guideline updates and replaces the previous NICE guideline CG72 (2008). This was used in conjunction with NICE technology appraisal guideline TA98 (2006), which covered some of the treatments for ADHD, such as methylphenidate, atomoxetine and dexamfetamine. This guideline was commissioned by NICE and developed by the National Collaborating Centre for Mental Health (NCCMH), a collaboration of organisations within the mental health field. There was input from service users, carers and professionals from psychiatry, paediatrics, clinical psychology, education, general practice, nursing and child and adolescent mental health services. The guideline is intended for use in children over the age of 3 years up to adulthood. See box 1 for a link to the full …