CPG on ADHD

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Title Authors Year Description Age rangeSDQSkills andDifficultiesQuestionnaireRobertGoodman1997 133– General psychopathology screening questionnaire– 25 3-point Likert type items– 5scales: Emotional symptoms, Behaviouralproblems, hyperactivity/Inattention, relationshipproblems with peers and prosocial behaviourParents andteachers:– 3 to 16 yearsSelfrport:– 11 to 16 years– Versions: Parents, teachers and adolescentsStructured and semistructured interviewsDiagnosticInter view forChildren andAdolescentsDICA-IVHerjanic& Reich1982 135– Most recent semistructured version– Assesses an extensive group of psychopathologicaldisorders in the child and adolescents populationaccording to DMS-II and DSM-IV criteria– Versions: Children, adolescents and parents– 6-17 years(parents)– 6-12 years(parents)– 13-17 years(adolescents)Schedule forAffectiveDisordersand SchizophreniainSchool AgeChildrenK SADSChamberset al.1985 138– Semistructured diagnostic interview– Assesses past and present episodes of psychopathologyin children and adolescents, according toDSM-IV and DSM-II-R criteria– Several sections: Sociodemographic, screeningquestions for 46 diagnostic categories, diagnosticsupplements and functioning– 6-17 yearsPsychometricproperties– Area under the ROCcurve to discriminatepsychiatric patients:0.87 (CI 95%: 0.83-0.91) for Parents and0.85 (95% CI: 0.78-0.93) for teachers(Goodman, 1997) 133– Useful in discriminationof psychiatricpatients (Johnston etal., 2000) 134 .Comments– Versions translated to Spanish,Catalan, Gallego and Basque(www.sdqinfo.com)– Preliminary validation InGallego (García-Cortizar, et aL,2000) 134– There are no normative data forthe Spanish population.– Reliability betweeninterviewers (K between0.65 and 1.00)(de la Osa, et al.,1996) 136 .– Version translated and validatedinto Spanish (Ezpeleta, et al.,1997) 137– Requires previous training– Reliability test-retest:0.78 to 0.86 in parents;0.24 to 0.43 in selfreport– Reliability between– Version translated to Spanishinterviewers (K between0.76 and 1.00) Cesar Soutullo, Universidad de(de la Peña, et al., 2002 140 ;(Ulloa, etaL, 2006) 139 Navarra) (www.cun.es/la clinica/servicios-medicos/psiquiatria/mas-sobre-el departamento/unidades/ psiquiatria-infantil-yadolescente)– Requires clinical training andexperience of the interviewer68 CLINICAL PRACTICE GUIDELINE ON ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) IN CHILDREN AND ADOLESCENTS
Title Authors Year Description Age rangeDiagnosticInter viewSchedule forChildrenDISCShaffer,et al.1999 141– Structured interview– Assesses psychopathological disorders in children and adolescentsaccording to DSM-IV criteria– Administered to parents (DISC-P) and to patients (DISC-C)– 4-17 years(DISC-P)– 11-7 years(DISC-C)Psychometricproperties– Reliability betweenInterviewers (Kbetween 0.42 and0.70 for parents; Kbetween 0.10 and0.80 for child/adolescent)(Bravo, etal, 2001) 142Comments– Version translatedto Spanish andvalidated in PuertoRico (Bravo, et aL,2001) 142– Non-clinical personnelcan administeritCLINICAL PRACTICE GUIDELINES IN THE SPANISH NHS 69
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Clinical Practice Guidelineon Atten
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This CPG has been
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AppendicesAppendix 1 Levels of evid
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We trust that this work will undoub
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Jesús Eirís Puñal, neuropaediatr
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Questions to be answeredADHD1. How
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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
Page 57 and 58: A SR conducted by the NICE guidelin
Page 59 and 60: Family backgroundSummary of scienti
Page 61 and 62: 5.4. In the diagnosis of ADHD in ch
Page 63: 5.7. In the diagnosis of ADHD in ch
Page 66 and 67: 6.1. Which screening instruments an
Page 68 and 69: Title Authors Year Description Age
Page 72 and 73: RecommendationsC 6.1.1. 6.1.2. 6.2.
Page 74 and 75: 6.5. In ADHD in children and adoles
Page 77 and 78: 7. Treatment7.1. Psychological trea
Page 79 and 80: Variable: ADHD symptomsScientific e
Page 81 and 82: Variable: Internalized symptomsScie
Page 83 and 84: The scientific evidence about the e
Page 85 and 86: Variable: Social skillsScientific e
Page 87 and 88: 7.1.4. How effective is the psychol
Page 89 and 90: 7.2. Psychopedagogical TreatmentQue
Page 91 and 92: • Working on habits that foster a
Page 93 and 94: Teacher’s adaptationsScientific e
Page 95 and 96: Scientific evidenceThere is not suf
Page 97 and 98: 7.3. Pharmacological treatmentQuest
Page 99 and 100: to proteins is 15% and there are no
Page 101 and 102: AtomoxetineThis is a non-stimulant
Page 103 and 104: 7.3.2. In ADHD: What pharmacologica
Page 105 and 106: There is strong scientific evidence
Page 107 and 108: Variable: Behavioural problemsScien
Page 109 and 110: There is not sufficient scientific
Page 111 and 112: BupropionThe NICE CPG</stro
Page 113 and 114: There is not sufficient scientific
Page 115 and 116: Summary of the scientific evidence
Page 117 and 118: 7.3.4. In ADHD: When and with what
Page 119 and 120: MethylphenidateSummary of the scien
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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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There is not sufficient scientific
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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
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Attention deficit hyperactivity dis
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tionario de Conners en nuestro medi
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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
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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
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functioning pervasive developmental
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P.V.P.: 10 €MINISTERIODE SANIDAD,
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CPG on ADHD

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