The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG)
Open accessAbstract
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.
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- Authors
- 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.
- Affiliations
- Royal Children's Hospital (AU)
- Heidelberg University (DE)
- University of Nottingham (GB)
- King's College London (GB)
- University of Zurich (CH)
- Radboud University Medical Center (NL)
- KU Leuven (BE)
- LWL-Universitätsklinik Hamm (DE)
- University of Southern Denmark (DK)
- UCL School of Pharmacy (GB)
- University of Cagliari (IT)
- Corresponding author
- Simonoff, Emily
- ORCID
- Venue
- European Child & Adolescent Psychiatry
- Published
- 2021-10-22
- Volume
- 32
- Issue
- 8
- Pages
- 1337-1361
- ISSN
- 1018-8827 (ISSN-L)
- 1435-165X
- PMC
- PMC8532460
- OpenAlex
- W3207759740
- Cited by
- 180
- References
- 139
- Citations by year
- 2026: 32 · 2025: 44 · 2024: 42 · 2023: 40 · 2022: 17 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1
- FWCI
- 4.50
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Child & Adolescent Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by)
- UvA-DARE (University of Amsterdam) (submittedVersion, cc-by)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion, cc-by-nc-nd)
- Lirias (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion, cc-by)
- Repository for Publications and Research Data (ETH Zurich) (submittedVersion, cc-by)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by)
- ETH Zürich Research Collection
- Zurich Open Repository and Archive (University of Zurich)
- Funders
- Eli Lilly and Company
- Sunovion
- National Institute for Health and Care Excellence
- National Institute for Health and Care Research (NIHR200263)
- University of Cambridge
- University of Oxford
- Deutsche Forschungsgemeinschaft
- Volkswagen Foundation
- Bundesministerium für Bildung und Forschung
- Bundesministerium für Gesundheit
- Servier
- H. Lundbeck A/S
- National Institute of Mental Health
- Cilag
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, children and adolescents, evidence-based practice, methodological bias, treatment effectiveness, adverse effects, pharmacotherapy, non-pharmacological treatment, long-term outcomes, family-centered care, health care access
- MeSH terms
- Adolescent, Ambulatory Care Facilities, Attention Deficit Disorder with Hyperactivity, Child, Humans, Mental Health
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