Attention deficit hyperactivity disorder

Question 1

Diagnostic criteria (DSM-5)

Answer 1

A). Either 1 or 2 or both combined

1. inattention
2. hyperactivity and impulsiveness

B). 6 or more of the symptoms listed under 1 and 2 in children and 5 in people aged 17 and older (see DSM-5)

C). Symptoms must be present in 2 or more situations (e.g. at school and at home or work)

D). Disturbance causes clinically significant distress or impairment in social, academic or occupational functioning

Question 2

Management of children (based on initial accurate diagnosis)

Answer 2

• Refer to appropriate consultant (e.g. child psychiatrist)
• Protect child’s self-esteem
• Counsel and support family
• Involve teachers
• Refer to parent support group

Exclusion diet probably ineffective but encourage good diet (consider dietitian’s help).

Pharmacological: Based on psychostimulants for ≥4yrs:

• methylphenidate (start with immediate release agent) or dexamphetamine
• antidepressants (e.g. SSRIs) second-line but may become first-line