ADHD: Clinical management

Abstract

Attention Deficit Hyperactivity Disorder (AD/HD) is among the most common behavioral-developmental disorders, affecting 5-15% of children in developed countries. This rate has risen rapidly in the past 20 years as a result of better recognition, more treatment options, and perhaps an actual increase in prevalence. AD/HD is likely to be common in developing countries as well, although less frequently recognized as a medical condition. As awareness of developmental problems grows and life-threatening infectious diseases decline, physicians in developing countries will be called upon to identify and manage AD/HD. Regardless of setting, diagnosis and management of ADHD must occur at the level of primary care because there are simply not enough sub-specialists available. The hallmarks of AD/HD are readily apparent, and effective and safe medications exist. However, there are many diverse conditions that may mimic the condition or co-exist with it, and it can be difficult to find the right medication and titrate it to the optimal dose, which may change over time. Non-medication treatments can be effective for many of the behaviors that accompany AD/HD, but these require education of parents, children, and teachers. With these complexities in mind, this chapter seeks to present strategies and tools that facilitate efficient and thorough management of AD/HD in the outpatient setting.