CPG on ADHD

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This <strong>CPG</strong> is a healthcare decision aid. It is not mandatory and it is not a substitute for the clinical judgement of healthcarepersonnel.Version: 2010Published by: Ministry of Science and InnovationLayout: ArpirelieveINOP: 477-09-053-3Copyright deposit: B-35151-2009
This <strong>CPG</strong> has been funded through the agreement signed by the Institutode Salud Carlos II, an independent body of the Ministry of Science andInnovation, and the Agencia d’Informació, Avaluació I Qualitat (AIAQS) ofCatalonia, within the framework of collaboration provided for in the QualityPlan for the National Health System of the Ministry of Health, Social Policyand Equality.This guideline must be quoted:Development Group of the Clinical Practice Guideline on Attention Defi cit Hyperactivity Disorder (ADHD) in Childrenand Adolescents. Fundació Sant Joan de Déu, coordinator. Clinical Practice Guideline on Attention Defi cit HyperactivityDisorder (ADHD) in Children and Adolescents.Quality Plan for the National Health System of the Ministry of Health, SocialPolicies and Equality. Agència dinformació, Avaluació i Qualitat (AIAQS) of Catalonia; 2010. Clinical Practice Guidelinesin the Spanish NHS (SNS): AATRM No 2007/18.MINISTERIODE SANIDAD, POLÍTICA SOCIALE IGUALDAD
Page 3: Clinical Practice Guidelineon Atten
Page 8 and 9: AppendicesAppendix 1 Levels of evid
Page 10 and 11: We trust that this work will undoub
Page 12 and 13: Jesús Eirís Puñal, neuropaediatr
Page 15 and 16: Questions to be answeredADHD1. How
Page 17 and 18: 39. In which ADHD subtypes is pharm
Page 19 and 20: Recommendations of the CPG<
Page 21 and 22: 6. Assessment instruments6.1. Which
Page 23 and 24: 7.2.3. Pyschopedagogical re-educati
Page 25 and 26: 7.3.7. In ADHD: How long should the
Page 27 and 28: 7.3.13. What scientific evidence ex
Page 29 and 30: B 7.5.3.2.In children and adolescen
Page 31 and 32: 9.4. How involved must the minor be
Page 33 and 34: 1. IntroductionBackgroundThe “Evi
Page 35 and 36: Table 1. ADHD prevalence studies in
Page 37: Health RepercussionsThe repercussio
Page 40 and 41: Secondary objectivesa) To generate
Page 42 and 43: • Formulation of clinical questio
Page 44 and 45: evidence have been solved by consen
Page 46 and 47: ment.At school age, the hyperactive
Page 48 and 49: Volumetric brain studies have shown
Page 50 and 51: 4.4. What is the natural course of
Page 52 and 53: Parents’ psychopathologyIn the st
Page 55 and 56:
5. DiagnosisQuestions to be answere
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A SR conducted by the NICE guidelin
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Family backgroundSummary of scienti
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5.4. In the diagnosis of ADHD in ch
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5.7. In the diagnosis of ADHD in ch
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6.1. Which screening instruments an
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Title Authors Year Description Age
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Title Authors Year Description Age
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RecommendationsC 6.1.1. 6.1.2. 6.2.
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6.5. In ADHD in children and adoles
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7. Treatment7.1. Psychological trea
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Variable: ADHD symptomsScientific e
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Variable: Internalized symptomsScie
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The scientific evidence about the e
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Variable: Social skillsScientific e
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7.1.4. How effective is the psychol
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7.2. Psychopedagogical TreatmentQue
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• Working on habits that foster a
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Teacher’s adaptationsScientific e
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Scientific evidenceThere is not suf
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7.3. Pharmacological treatmentQuest
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to proteins is 15% and there are no
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AtomoxetineThis is a non-stimulant
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7.3.2. In ADHD: What pharmacologica
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There is strong scientific evidence
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Variable: Behavioural problemsScien
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There is not sufficient scientific
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BupropionThe NICE CPG</stro
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Summary of the scientific evidence
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7.3.4. In ADHD: When and with what
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MethylphenidateSummary of the scien
Page 121 and 122:
AtomoxetineSummary of the scientifi
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The consensus of the American Heart
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In a RCT that studied the efficacy
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7.3.13. What scientific evidence ex
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7.3.15. Does the efficacy of pharma
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Recommendations 7.3.17.1. 7.3.17.2.
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Scientific evidenceThe scientific e
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Page 137 and 138:
Page 139 and 140:
There is limited scientific evidenc
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The combined intervention of MTA is
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There is limited scientific evidenc
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The scientific evidence of Zupancic
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RecommendationsC 7.5.1.1.The use of
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Summary of the scientific evidenceT
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Summary of the scientific evidenceT
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Elimination interventions include t
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Auditory stimulationThis is based o
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8. PreventionGiven the mainly genet
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Recommendations 9.1.1.In the specif
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Recommendations 9.4.1.Applicableleg
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10. Diagnostic and therapeutic stra
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Algorithm 3. Pharmacological treatm
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11. Dissemination and implementatio
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12. Future research recommendations
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home, at school or in the recreatio
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Appendix 1: Evidence levels and rec
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Impulsivitya) Often blurts out answ
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Appendix 3. Information for patient
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3. How does ADHD evolve with age?In
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5.1. Psychological treatment for AD
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What drugs are available in Spain?A
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Is pharmacological treatment for AD
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10. What can be done from school to
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Appendix 4. GlossaryAGREE: Instrume
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and mental operations, self-regulat
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tions that are to be compared.The r
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Appendix 5. AbbreviationsAACAPAAPAD
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MAMFF_20mgMHSMSCAMTA StudyNICENIMHN
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Appendix 6. Declaration of interest
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Alicia Koplowitz Foundation, Jansse
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Health Care Guideline: Diagnosis an
Page 210 and 211:
Attention deficit hyperactivity dis
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tionario de Conners en nuestro medi
Page 214 and 215:
50. Quinn P, Wigal S. Perceptions o
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twin study: preliminary report. 199
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Number 3, August 1999. Agency for H
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controlled trial of integrated home
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Improvement. Clinical Practice Guid
Page 224 and 225:
Adolesc Psychiatry. 2006 Nov;45(11)
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Acad Child Adolesc Psychiatry. 1995
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omized, double-blind, placebo-contr
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300. Wilens TE, Newcorn JH, Kratoch
Page 232 and 233:
functioning pervasive developmental
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P.V.P.: 10 €MINISTERIODE SANIDAD,
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