Attention Deficit Hyperactivity Disorder: The NICE Guideline on Diagnosis and Management of ADHD in Children, Young People and Adults
National Collaborating Centre for Mental Health (NCCMH)
This guideline is endorsed by the National
Institute for Health and Clinical Excellence (NICE) and sets out
clear, evidence-based recommendations for healthcare and
educational staff on how to diagnose and manage ADHD in children,
young people and adults to significantly improve their treatment
and care.
ADHD is a common disorder. It is associated with serious
impairments in childhood and those with a sustained diagnosis often
develop significant difficulties in adulthood, including
personality disorder and substance misuse. The NICE guideline is an
important tool in helping professionals to make appropriate
decisions about treating and caring for people with ADHD and
improving their long-term outcomes.
The guideline includes the evidence for the validity of the
diagnosis, psychological interventions and parent training,
pharmacological treatment, interventions for children in
educational settings, dietary interventions, and combining and
comparing psychological and pharmacological treatment.
It also contains a useful overview of ADHD,
and chapters on the organisation of care and on service user
experience of treatment and care for ADHD, including a study of
children's and young people’s views of stimulant medication, which
was commissioned especially for this guideline.
List of the other NICE
mental health guidelines
NICE Mental Health Guidelines
These guidelines from NICE set out clear
recommendations, based on the best available evidence, for health
care professionals on how to work with and implement physical,
psychological and service-level interventions for people with
various mental health conditions.
The book contains the full guidelines that cannot be obtained
in print anywhere else. It brings together all of the evidence that
led to the recommendations made, detailed explanations of the
methodology behind their preparation, plus an overview of the
condition covering detection, diagnosis and assessment, and the
full range of treatment and care approaches.
The accompanying free CD-ROM contains all the data used as
evidence, including:
- Included and excluded studies.
- Profile tables that summarise both the quality of the evidence
and the results of the evidence synthesis.
- All meta-analytical data, presented as forest plots.
- Detailed information about how to use and interpret forest
plots.
Full Contents
Guideline development group members
1. Preface
- National guidelines
- The national ADHD guideline
2. Attention deficit hyperactivity
disorder
- The disorder
- Diagnosis and assessment
- Epidemiology
- Aetiology
- Current care and treatment of ADHD for
children in the NHS
- ADHD from an educational perspective
- Adults with ADHD
- The economic cost of ADHD
3. Methods used to develop this
guideline
- Overview
- The scope
- The Guideline Development Group
- Clinical questions
- Systematic clinical literature review
- Health economics methods
- Focus group methodology
- Stakeholder contributions
- Validation of this guideline
4. The experience of treatment and
care for ADHD
- Introduction
- The experience of ADHD
- Living with ADHD
- The experiences of children and young people
of stimulant medication for ADHD
- Issues for adults diagnosed with ADHD and
their partners
- Recommendations
5. Diagnosis
- Introduction
- Definitions of terms
- The validity of ADHD as a diagnostic
category
- Methodology
- Reviewing the validity of the
diagnosis: summary of the evidence
- Is the cluster of symptoms that defines ADHD
associated with significant clinical and psychosocial
impairments?
- Is there evidence for a characteristic
pattern of developmental changes, or outcomes associated with the
symptoms, that define ADHD?
- Is there consistent evidence of genetic,
environmental or neurobiological risk factors associated with
ADHD?
- Limitations
- Summary of validation of the diagnosis of
ADHD
- Defining significant impairment
- Position statement on the validity of
ADHD
- Consensus conference
- Summary from review of the diagnosis
- Implications for practice
- Differentiating ADHD in adults from other
co-occurring disorders
- Recommendations
- Research recommendation
6. The organisation of care for
ADHD
- Introduction
- Stepped care model for ADHD – school-aged
children and young people
- Stepped care model for ADHD - pre-school
children
- Services for adults with ADHD
- Models of care for adults in established
services
- Competencies for evaluation of ADHD in
children and young people
- Assessment framework and competencies for
evaluation of ADHD in adults
- Recommendations
7. Psychological interventions and
parent training
- Introduction
- Psychological interventions for children with
ADHD
- Psychological interventions for adults with
ADHD
- Other non-pharmacological approaches
- Recommendations
- Research recommendations
8. Interventions for children with
ADHD in educational settings
- Introduction
- Databases searched and inclusion
criteria
- Studies considered
- Clinical evidence for screening for ADHD in
educational settings
- Clinical evidence for advice to teachers
about ADHD, effective classroom interventions, and teacher
training
- From evidence to recommendations
- Recommendations
- Research recommendations
9. Dietary interventions
- Introduction
- Elimination diets
- Supplementation diets
- Recommendations
10. Pharmacological
treatment
- Introduction
- Prescribing for children, young people and
adults
- The regulatory framework
- Databases searched and inclusion/exclusion
criteria for clinical evidence
- Studies considered in the systematic review
of clinical evidence
- Methylphenidate (stimulant)
- Dexamfetamine (stimulant)
- Atomoxetine
- Clonidine
- Bupropion
- Modafinil
- Antidepressants
- Atypical antipsychotics
- Efficacy/ harms in special circumstances
- Conclusion from clinical evidence
- Health economics evidence
- From evidence to recommendations
- Recommendations
11. Combining and comparing
psychological and pharmacological interventions
- Introduction
- Combined interventions for children with
ADHD
- Comparing psychological and pharmacological
interventions for children with ADHD
- The MTA study: implications for treatment
decisions
- Health economics evidence
- From evidence to recommendations: Treatment
decisions and combined treatment for children with ADHD
- Recommendations