International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): clinical implications and treatment practice suggestions. |
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Authors: | Stan Kutcher Michael Aman Sarah J Brooks Jan Buitelaar Emma van Daalen J?rg Fegert Robert L Findling Sandra Fisman Laurence L Greenhill Michael Huss Vivek Kusumakar Daniel Pine Eric Taylor Sam Tyano |
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Affiliation: | Dalhousie University Department of Psychiatry, QE II Health Sciences Centre, Abbie J. Lane Building-Suite 9212, 5909 Veterans' Memorial Lane, Halifax, Nova Scotia, B3H 2E2, Canada. stan.kutcher@dal.ca |
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Abstract: | Researchers and clinicians worldwide share concerns that many youngsters with attention-deficit/hyperactivity disorder (ADHD) and/or disruptive behaviour disorders (DBDs) do not receive appropriate treatment despite availability of effective therapies. At the request of Johnson and Johnson (sponsor), 11 international experts in child and adolescent psychiatry were selected by Professor Stan Kutcher (chair) to address these concerns. This paper describes the experts' consensus conclusions, including treatment practice suggestions for physicians involved in the early treatment of youngsters with ADHD (or hyperkinetic disorder, in countries preferring this classification) and/or DBDs internationally: suggested first-line treatment for ADHD without comorbidity is psychostimulant medication aided by psychosocial intervention. For ADHD with comorbid conduct disorder (CD), psychosocial intervention combined with pharmacotherapy is suggested. For primary CD, suggested first-line treatment is psychosocial intervention, with pharmacotherapy considered as an 'add-on' when aggression/impulsivity is marked and persistent. Pharmacotherapy requires careful titration; full-day coverage is the suggested goal. Regular long-term follow-up is recommended. |
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