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Attention Deficit and Hyperkinetic Disorders in Children and Young People

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Core symptoms: Inattention Hyperactivity Impulsive behaviour DSM-IV and ICD-10 criteria are similar but DSM identifies 3 subtypes: Predominately inattentive, ... – PowerPoint PPT presentation

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Title: Attention Deficit and Hyperkinetic Disorders in Children and Young People


1
  • Attention Deficit and Hyperkinetic Disorders in
    Children and Young People

Dr. Derek Godfrey (GPR)
2
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3
ADHD/HKD What are they?
  • Heterogeneous behavioural syndrome
  • Symptoms of inattention, hyperactivity and
    impulsivity
  • HKD (ICD-10) more severe disturbance with
    significant hyperactivity component
  • Commonly diagnosed disorder with MF ratio (ADHD
    prevalence) of 41

4
Why is it important?
  • Common!
  • Affected children/young people often unpopular
    with adults and peers
  • Often fail to achieve potential
  • Comorbid difficulties often present

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Diagnostic Criteria (1)
  • Core symptoms
  • Inattention
  • Hyperactivity
  • Impulsive behaviour
  • DSM-IV and ICD-10 criteria are similar but DSM
    identifies 3 subtypes
  • Predominately inattentive, predominately
    hyperactive/impulse AND combined

7
Diagnostic Criteria (2)
  • To meet diagnostic criteria
  • Onset before age 7 (ADHD) or 6 (HKD)
  • At least 6 months
  • Pervasive
  • Caused significant functional impairment
  • Not better accounted for by other mental
    disorders
  • Beware failure to meet above ? sig.difficulties

8
Outcomes
  • No good quality data for ADHD in Scotland
  • Rate diminishes in adolescence/can persist
  • Predictors include maternal depression, marital
    discord, -ve parent-child interaction, family
    disadvantage and FHx.
  • Current service provision for adults is limited
    (See NICE guidance)

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Treatment/Therapy
  • Dietary modification
  • Psychological
  • Behavioural parent training
  • School-based interventions
  • Pharmacological therapy
  • Only initiated by specialists
  • Shared care once started (Annex 2)
  • No evidence of benefit from alternative therapies

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Mephylphenidate
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Atomoxetine
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(No Transcript)
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