Practice Guidelines

Diagnosis and management of attention-deficit/hyperactivity disorder in children, young people, and adults: summary of NICE guidance

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a1239 (Published 24 September 2008) Cite this as: BMJ 2008;337:a1239
  1. Tim Kendall, joint director1, deputy director2, consultant psychiatrist and medical director3,
  2. Eric Taylor, head4,
  3. Alejandra Perez, systematic reviewer5,
  4. Clare Taylor, editor1
  5. on behalf of the Guideline Development Group
  1. 1National Collaborating Centre for Mental Health, Research and Training Unit, London E1 8AA
  2. 2Royal College of Psychiatrists’ Research and Training Unit, London E1 8AA
  3. 3Sheffield Care Trust, Sheffield
  4. 4Department of Child and Adolescent Psychiatry, King’s College London, Institute of Psychiatry, London SE5 8AF
  5. 5British Psychological Society—CORE, Sub-Department of Clinical Health Psychology, University College London, London WC1E 7HB
  1. Correspondence to: A Perez a.perez{at}ucl.ac.uk

    Why read this summary?

    Attention-deficit/hyperactivity disorder (ADHD) is a common childhood condition that may affect different areas of the child’s life, seriously impairing academic achievement, peer relationships, and self care. Many affected children become socially isolated and develop conduct problems. Some 15% of children with ADHD will still have the condition in adulthood, and even more will develop a personality disorder and/or a substance misuse disorder in adulthood.1 2 3

    Diagnosis rates for ADHD and prescriptions of stimulant medication have risen substantially in England during the past decade, with 220 000 prescriptions for stimulants (costing about £5m (€6.3m; $9.4m)) in 1998 and 418 300 (almost £13m) in 2004.4 The prescription of stimulants, which are potential drugs of misuse, to children remains controversial, with concerns about their safety and the potential for misuse and diversion (where the drug is passed on to others for non-prescription use).This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the diagnosis and management of ADHD in children, young people and adults.5

    Recommendations

    NICE recommendations are based on systematic reviews of best available evidence. When minimal evidence is available, recommendations are based on the guideline development group’s opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets.

    Service organisation and training of professionals

    Specialist ADHD teams for children and young people and equivalent teams for adults should jointly develop training programmes on the diagnosis and management of ADHD for all mental health, paediatric, social care, educational, forensic, and primary care providers who have contact with people with ADHD. [Based on opinion of the Guideline Development Group]

    Diagnosis and assessment

    • Diagnose ADHD when all of the following three conditions apply [Recommendation based on high quality systematic reviews, diagnostic and observational studies, opinion of the Guideline Development Group, and a consensus conference …

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