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  1. Morris Zwi, consultant child and adolescent psychiatrist1,
  2. Philip Clamp, general practitioner2
  1. 1Richmond CAMHS, South West London and St George’s NHS Mental Health Trust, Richmond Royal Hospital, Richmond TW9 2TE
  2. 2St John’s Surgery, Bromsgrove B61 7JJ
  1. morris.zwi{at}swlstg-tr.nhs.uk

    Monitoring children with early injuries could reduce later risk

    The cause of attention deficit hyperactivity disorder (ADHD) is uncertain and has provoked considerable debate. The Department of Health in the United Kingdom is currently commissioning a systematic review of its causation.1 In the linked retrospective cohort study (doi: 10.1136/bmj.a1984), Keenan and colleagues examine the hypothesis that head injury in young children might be a causative factor in the development of ADHD.2

    Concern has been expressed internationally about the increased prescribing of stimulants to treat ADHD in children.3 Prescriptions in England rose from 220 000 in 1994 to 418 300 in 2004.4 International estimates of prevalence vary considerably. The American Psychiatric Association estimates that 3-5% of school age children have ADHD,5 but studies vary considerably from as low as 0.85% of girls in the UK to 19.8% of boys in Colombia.6 A UK survey of 10 438 children aged 5-15 found that 3.62% of boys and 0.85% of girls had ADHD.7

    Recently published guidelines from the National Institute for Health …

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