Editorials

Treating hyperkinetic disorders in childhood

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6995.1617 (Published 24 June 1995) Cite this as: BMJ 1995;310:1617
  1. Eric Taylor,
  2. Rosemary Hemsley
  1. Professor of developmental neuropsychiatry MRC Child Psychiatry Unit, London SE5 8AF
  2. Lecturer in clinical psychology Institute of Psychiatry, London SE5 8AF

    Treatment needs care but is worth while

    British doctors are nowadays more likely to diagnose and treat hyperactivity in children. There are three reasons for the change. Firstly, the International Classification of Diseases, 10th revision (ICD-10) includes a definition of “hyperkinetic disorder” that is more explicit than previous versions.1 The disorder is much more than naughtiness or high energy that overtaxes weary or depressed parents. Its essential characteristics are persistent traits of severe and pervasive inattentiveness, overactivity, and impulsiveness, beginning in the first five years of life. Centres that have changed from using ICD-9 to using ICD-10 have already noted that the diagnosis is being made more often.2

    Secondly, pressure from parents' support groups has forced increased professional recognition. Private clinics, often promoted direct to the public, have been set up to diagnose “attention deficit-hyperactivity disorder.” Some prescribe methylphenidate and other stimulant drugs in the North American way; others concentrate on advice about diet and allergies. Thirdly, methylphenidate has recently been made generally available in Britain after some years on a named patient basis.

    In the light of these trends should the NHS be providing more specialist services? American and Australian practice is based on the fact that doctors there diagnose attention deficit-hyperactivity disorder very much more commonly than British doctors diagnose hyperkinetic disorder, even when they are all …

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