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Coghill D, Banaschewski T, Cortese S, et al. The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG). Eur Child Adolesc Psychiatry. 2021;doi: 10.1007/s00787-021-01871-x.
Coghill, D., Banaschewski, T., Cortese, S., Asherson, P., Brandeis, D., Buitelaar, J., Daley, D., Danckaerts, M., Dittmann, R. W., Doepfner, M., Ferrin, M., Hollis, C., Holtmann, M., Paramala, S., Sonuga-Barke, E., Soutullo, C., Steinhausen, H. C., Van der Oord, S., Wong, I. C. K., Zuddas, A., & Simonoff, E. (2021). The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG). European child & adolescent psychiatry, . https://doi.org/10.1007/s00787-021-01871-x
Coghill, David, et al. "The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG)." European child & adolescent psychiatry vol. (2021). doi: https://doi.org/10.1007/s00787-021-01871-x
Coghill D, Banaschewski T, Cortese S, Asherson P, Brandeis D, Buitelaar J, Daley D, Danckaerts M, Dittmann RW, Doepfner M, Ferrin M, Hollis C, Holtmann M, Paramala S, Sonuga-Barke E, Soutullo C, Steinhausen HC, Van der Oord S, Wong ICK, Zuddas A, Simonoff E. The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG). Eur Child Adolesc Psychiatry. 2021 Oct 22; doi: 10.1007/s00787-021-01871-x. Epub 2021 Oct 22. PMID: 34677682; PMCID: PMC8532460.
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Eur Child Adolesc Psychiatry. 2021 Oct 22; doi: 10.1007/s00787-021-01871-x. Epub 2021 Oct 22.

The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG).

European child & adolescent psychiatry

David Coghill, Tobias Banaschewski, Samuele Cortese, Philip Asherson, Daniel Brandeis, Jan Buitelaar, David Daley, Marina Danckaerts, Ralf W Dittmann, Manfred Doepfner, Maite Ferrin, Chris Hollis, Martin Holtmann, Santosh Paramala, Edmund Sonuga-Barke, César Soutullo, Hans-Christoph Steinhausen, Saskia Van der Oord, Ian C K Wong, Alessandro Zuddas, Emily Simonoff

Affiliations

  1. Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
  2. Murdoch Children's Research Institute, Melbourne, Australia.
  3. Royal Children's Hospital, Melbourne, Australia.
  4. Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
  5. Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
  6. Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK.
  7. Solent NHS Trust, Southampton, UK.
  8. Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA.
  9. Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.
  10. NIHR MindTech Mental Health MedTech Cooperative & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan CANDAL, Institute of Mental Health, University of Nottingham, Nottingham, UK.
  11. Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  12. Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
  13. Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.
  14. Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.
  15. Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
  16. Research Group of Developmental Psychiatry, Center for Developmental Psychiatry, KU Leuven, Kapucijnenvoer 7, Blok H, 3000, Leuven, Belgium.
  17. Department of Child and Adolescent Psychiatry, UPC KU Leuven, Leuven, Belgium.
  18. Paediatric Psychopharmacology, Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.
  19. Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
  20. Haringey CAMHS, NHS, and ReCognition Health, London, UK.
  21. LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany.
  22. Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  23. Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.
  24. Louis A Fallace Department of Psychiatry and Behavioral Science, University of Texas, Houston, TX, USA.
  25. Department of Child and Adolescent Psychiatry, Aarhus University, Aarhus, Denmark.
  26. Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital of Psychiatry, Zurich, Switzerland.
  27. Clinical Psychology and Epidemiology, Institute of Psychology, University of Basel, Basel, Switzerland.
  28. Department of Child and Adolescent Mental Health, University of Southern Denmark, Odense, Denmark.
  29. Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark.
  30. Clinical Psychology, KU Leuven, Leuven, Belgium.
  31. Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands.
  32. School of Pharmacy, University College London, London, UK.
  33. Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, University of Cagliari and Antonio Cao Paediatric Hospital, G. Brotzu Hospital Trust, Cagliari, Italy.
  34. LWL-University Hospital for Child and Adolescent Psychiatry, Ruhr-University Bochum, Hamm, Germany. [email protected].
  35. Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. [email protected].

PMID: 34677682 PMCID: PMC8532460 DOI: 10.1007/s00787-021-01871-x

Abstract

ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adverse effects of different interventions for ADHD, these individual research reports and the reviews, meta-analyses and guidelines summarizing their findings are sometimes inconsistent and difficult to interpret. We have summarized the current evidence and identified several methodological issues and gaps in the current evidence that we believe are important for clinicians to consider when evaluating the evidence and making treatment decisions. These include understanding potential impact of bias such as inadequate blinding and selection bias on study outcomes; the relative lack of high-quality data comparing different treatments and assessing long-term effectiveness, adverse effects and safety for both pharmacological and non-pharmacological treatments; and the problems associated with observational studies, including those based on large national registries and comparing treatments with each other. We highlight key similarities across current international clinical guidelines and discuss the reasons for divergence where these occur. We discuss the integration of these different perspective into a framework for person/family-centered evidence-based practice approach to care that aims to achieve optimal outcomes that prioritize individual strengths and impairments, as well as the personal treatment targets of children and their families. Finally, we consider how access to care for this common and impairing disorder can be improved in different healthcare systems.

© 2021. Crown.

Keywords: Attention deficit hyperactivity disorder; Evidence-based medicine; Guideline; Intervention

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