Comment: Why ADHD is a complex disorder
Nikos Myttas
pp 3-3
Diagnostic and treatment guidelines and local care pathways are useful for as long as they are meaningful, and can be easily translated and applied in day-to-day clinical practice. It is often the case that children with complex neurodevelopmental disorders are just that: complex, with more than one psychiatric condition and, sometimes, additional cognitive and psychosocial deficits.
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Autism spectrum disorders and ADHD: diagnosis issues
Peter Hill
pp 4-7
Jake,* aged 10, is referred to an attention deficit hyperactivity disorder (ADHD) service because of marked inattentiveness and aggressive outbursts at school and at home. Completed screening
questionnaires indicate inattention and impulsivity
with rather less hyperactivity. His teacher
points out that he can focus very well on tasks of his own choosing, but it is very difficult to get him to concentrate on class work. He is often out of his seat in class and is generally restless. At home, he has terrible tempers, and is angrily impatient when he has to transition from one activity or situation to another and furious when
the day has not turned out as originally planned. He will go on for days on end to his parents about some idea or demand and generally seems
to have a rigid style of thinking: ‘as far as he’s
concerned everything is black and white’.
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Gender disparities: adolescent girls with ADHD
Nikos Myttas
pp 8-11
Nature has not always been a woman’s best friend and during the secondary school years
the hurdles that have to be negotiated and overcome by young women are invariably challenging, overwhelming, frightening, demoralising
and seemingly unsurpassable, even for the most adept and well-functioning adolescent. When attention deficit hyperactivity disorder (ADHD)
is added to the mix, the result can be a downward
spiral and a self-destructive experience.
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Service for adults with ADHD: from inception to delivery
Marios Adamou
pp 12-13
Despite a swell of evidence and firm clinical experience from child psychiatrists and paediatricians that attention deficit hyperactivity disorder
(ADHD) does not miraculously abruptly disappear when adolescents enter adulthood,
adults with ADHD in the UK still struggle to access even very basic care that is specific for their condition. Although guidelines were published by the National Institute for Health and
Clinical Excellence (NICE) in 2008, in which provision for the diagnosis and management of
adults with ADHD was recommended, NHS trusts have not followed this advice and there are only a handful of UK adult ADHD services.
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The importance of teaching care workers about ADHD
Fran Harland
pp 14-16
As someone whose work involves training foster carers and residential workers in various aspects of healthcare and social care, I am all too aware
of the need to work towards improving outcomes for children and young people in the looked-after system. Research highlights the disadvantages these young people experience in
many facets of their lives.
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The role of multidisciplinary teams in referring ADHD
Andy Bloor
pp 17-18
Currently, one of the most common referral routes for patients with attention deficit
hyperactivity disorder (ADHD) is from a GP in a community practice through to specialist child and adolescent mental health services (CAMHS). Other, less common, routes would be from other organisations in the children and young people's workforce or self-referral from the parent, child or the young person themselves. A comprehensive assessment would
then take place in a specialist setting, usually
with a specialist child psychiatrist.
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ADHD and criminality – a biosocial perspective
Barry Bourne
pp 19-22
It could be argued that the increasing contributions
of genetics and neuropsychology in the last
decades of the 20th century to the aetiology of personal characteristics has led to a more balanced consideration of causality in criminal
behaviour, correcting the predominantly social
deterministic model that has always sat uncomfortably
with the incidence of ‘white collar crime’, which demonstrates the power of risk
over cold intellect, as displayed by certain errant
high-profile politicians in the recent past. Nowhere is the evidence for a strong constitutional basis to behaviour more compelling than
in the research on attention deficit hyperactivity
disorder (ADHD), albeit with potential exacerbation
by malign environmental influences.
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