ADHD and hyperkinetic disorder

Abstract

Editor's note Attention deficit and hyperactivity disorder (ADHD) and hyperkinetic disorder (HKD) are not exactly synonymous. ADHD comes from DSM, and there can be some symptoms of inattention and/or impulsivity and hyperactivity, while HKD comes from ICD, and inattention, impulsivity and hyperactivity must all be present for the diagnosis of HKD to be made. Thus ADHD is a broader diagnostic term, and there is clearer evidence for the effectiveness of medications, especially the stimulants, in HKD than in ADHD. Nonetheless, medications, especially first-line treatment with the psychostimulants, has a great deal of data to support its effectiveness. There are less data supporting the use of other non-stimulant drugs such as atomoxetine and bupropion, and the data are less convincing and have smaller effect sizes than the psychostimulants. While psychosocial treatments, particularly behaviour therapy, have evidence for effectiveness, the evidence is not as strong as for the pharmacologic interventions, and the treatments seem more behaviour specific, less generalizable and quite often lose their effectiveness when the treatments end. While combined psychosocial and psychopharmacologic treatments are effective, it appears that most of the effectiveness comes from the pharmacologic intervention, although patients in combined treatment appear to need lower doses of pharmacologic agents. Introduction Attention deficit hyperactivity disorder (ADHD) or hyperkinetic disorder (HKD) is a common childhood condition affecting children and youth around the world across various cultures (Biederman et al ., 1991; Rohde et al ., 2001)).