The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder

Faraone, Stephen V.; Banaschewski, Tobias; Coghill, David; Zheng, Yi; Biederman, Joseph; Bellgrove, Mark A.; Newcorn, Jeffrey H.; Gignac, Martin; Saud, Nouf M. Al; Manor, Iris; Rohde, Luís Augusto; Yang, Li; Cortese, Samuele; Almagor, Doron; Stein, Mark A.; Albatti, Turki H.; Al-Joudi, Haya F.; Alqahtani, Mohammed M. J.; Asherson, Philip; Atwoli, Lukoye; Bölte, Sven; Buitelaar, Jan K.; Crunelle, Cleo L.; Daley, David; Dalsgaard, Søren; Döpfner, Manfred; Espinet, Stacey D.; Fitzgerald, Michael; Franke, Barbara; Gerlach, Manfred; Haavik, Jan; Hartman, Catharina A.; Hartung, Cynthia M.; Hinshaw, Stephen P.; Hoekstra, Pieter J.; Hollis, Chris; Kollins, Scott H.; Kooij, J. J. Sandra; Kuntsi, Jonna; Larsson, Henrik; Li, Tingyu; Liu, Jing; Merzon, Eugene; Mattingly, Greg; Mattos, Paulo; McCarthy, Suzanne; Mikami, Amori Yee; Molina, Brooke S. G.; Nigg, Joel T.; Purper-Ouakil, Diane; Omigbodun, Olayinka; Polanczyk, Guilherme Vanoni; Pollak, Yehuda; Poulton, Alison; Rajkumar, Ravi Philip; Reding, Andrew; Reif, Andreas; Rubia, Katya; Rucklidge, Julia J.; Romanos, Marcel; Ramos‐Quiroga, Josep Antoni; Schellekens, Arnt; Scheres, Anouk; Schoeman, Renata; Schweitzer, Julie B.; Shah, Henal; Solanto, Mary V.; Sonuga‐Barke, Edmund; Soutullo, César; Steinhausen, Hans Christoph; Swanson, James M.; Thapar, Anita; Tripp, Gail; Glind, Geurt van de; Brink, Wim van den; Oord, Saskia Van der; Venter, André; Vitiello, Benedetto; Walitza, Susanne; Wang, Yufeng

doi:10.1016/j.neubiorev.2021.01.022

Cited by 750 publications

(646 citation statements)

References 326 publications

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“…Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition estimated to affect 3-5% of the population [1,2] across high, middle and low-income countries [2,3]. Characterised by symptoms of inattention, hyperactivity and impulsivity [4], ADHD can negatively impact life expectancy and quality of life [5]. ADHD often co-occurs with a variety of genetic [6], psychiatric [7][8][9] and neurodevelopmental conditions [10][11][12], particularly Autism Spectrum Disorder (ASD).…”

Section: Introductionmentioning

confidence: 99%

Behavioural Measures of Infant Activity but Not Attention Associate with Later Preschool ADHD Traits

et al. 2021

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Mapping infant neurocognitive differences that precede later ADHD-related behaviours is critical for designing early interventions. In this study, we investigated (1) group differences in a battery of measures assessing aspects of attention and activity level in infants with and without a family history of ADHD or related conditions (ASD), and (2) longitudinal associations between the infant measures and preschool ADHD traits at 3 years. Participants (N = 151) were infants with or without an elevated likelihood for ADHD (due to a family history of ADHD and/or ASD). A multi-method assessment protocol was used to assess infant attention and activity level at 10 months of age that included behavioural, cognitive, physiological and neural measures. Preschool ADHD traits were measured at 3 years of age using the Child Behaviour Checklist (CBCL) and the Child Behaviour Questionnaire (CBQ). Across a broad range of measures, we found no significant group differences in attention or activity level at 10 months between infants with and without a family history of ADHD or ASD. However, parent and observer ratings of infant activity level at 10 months were positively associated with later preschool ADHD traits at 3 years. Observable behavioural differences in activity level (but not attention) may be apparent from infancy in children who later develop elevated preschool ADHD traits.

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Section: Introductionmentioning

confidence: 99%

Behavioural Measures of Infant Activity but Not Attention Associate with Later Preschool ADHD Traits

et al. 2021

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“…With a worldwide community prevalence between 2 and 7%, attention-deficit hyperactivity disorder (ADHD) is one of the most common mental disorders among children and adolescents (1,2). The global burden of ADHD is significant (3,4) and it is estimated that more than 40% of individuals with childhood ADHD continue to experience symptoms and impairment in adulthood (5). National and international guidelines on ADHD recommend a multimodal treatment approach for children and adolescents with a combination of medication and psychosocial interventions (6).…”

Section: Introductionmentioning

confidence: 99%

“…The evidence for long-term effects of drugs to treat ADHD on reducing impairments such as educational outcomes is limited and inconsistent (8). There is a strong evidence base that treatment with ADHD medications reduces negative outcomes such as injuries, cigarette smoking, suicide, and criminal activity (4).…”

Section: Introductionmentioning

confidence: 99%

First-Time Users of ADHD Medication Among Children and Adolescents in Germany: An Evaluation of Adherence to Prescribing Guidelines Based on Claims Data

et al. 2021

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Background: Drug utilization studies based on real-world data are vital for the identification of potentially needed improvements to rational prescribing. This is particularly important for the pharmacological treatment of children and adolescents with attention-deficit hyperactivity disorder (ADHD) due to the associated potential side effects and the frequent use. Whereas prevalent use is well-characterized, studies on first-time use of ADHD medication are scarce. This study aimed to evaluate off-label prescribing in first-time users of ADHD medication among children and adolescents in Germany based on three criteria: (i) lack of a documented ADHD diagnosis; (ii) first-time pharmacological treatment with a second-line drug; and (iii) patient age below 6 years.Methods: Based on German claims data, we included children and adolescents aged 0–17 years with a first-time dispensation of any ADHD medication in the period 2015–2017. These first-time users were characterized with regard to sex, age, specialty of the prescribing physician, documentation of an ADHD diagnosis, psychiatric hospitalization, psychiatric comorbidities, and history of other psychopharmacological drugs at first-time use.Results: The study population comprised 18,703 pediatric first-time users of ADHD medication. Of these, 9.8% had no documented ADHD diagnosis. Most of the ADHD drug users received first-line ADHD pharmacotherapy (methylphenidate, atomoxetine), whereas 2.6% were prescribed second-line ADHD medication (lisdexamfetamine, guanfacine, dexamfetamine, multiple ADHD drugs) as first drug. Overall, 1.2% of first-time users were aged below 6 years. A total of 12.7% of the study population met any off-label criterion.Conclusions: About 13% of pediatric first-time users of ADHD medication in Germany received an off-label pharmacotherapy at first-time use. Prescribing ADHD medication without a confirmed ADHD diagnosis was the most common of the three assessed off-label criteria. Off-label prescribing regarding drug choice and age of patients only occurred in a small percentage of initial pharmacological ADHD treatment. Our results suggest the need for improvement in rational prescribing, especially with regard to diagnostic requirements.

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“…These findings underline the importance of considering active elements in control conditions, and the need to grade these active elements consistently across Neurofeedback and other neurotherapies studies. The recent consensus statement on evidence-based ADHD treatments excluded studies and meta-analyses with non-active or heterogeneous controls such as waiting control or treatment as usual (Faraone et al, 2021). However, this approach may underestimate some genuine NF-effects in real life settings that are also detectable by blinded raters or are slower to develop.…”

Section: Eeg-nfmentioning

confidence: 99%

Neurotherapeutics for Attention Deficit Hyperactivity Disorder (ADHD): a Review

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et al. 2021

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This review focuses on the evidence for neurotherapeutics for Attention Deficit Hyperactivity Disorder (ADHD). EEG-Neurofeedback has been tested for about 45 years with latest meta-analyses of randomised controlled trials (RCT) showing small/medium effects compared to non-active controls only. Three small studies piloted neurofeedback of frontal activations in ADHD using functional magnetic resonance imaging or near-infrared spectroscopy, finding no superior effects over control conditions. Brain stimulation has been applied to ADHD using mostly repetitive transcranial magnetic and direct current stimulation (rTMS/tDCS). rTMS has shown mostly negative findings on improving cognition or symptoms. Meta-analyses of tDCS studies targeting mostly dorsolateral prefrontal cortex show small effects on cognitive improvements with only two out of three studies showing clinical improvements. Trigeminal nerve stimulation has shown to improve ADHD symptoms with medium effect in one RCT. Modern neurotherapeutics are attractive due to their relative safety and potential neuroplastic effects. However, they need to be thoroughly tested for clinical and cognitive efficacy across settings and beyond core symptoms and for their potential for individualised treatment.

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The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder

Cited by 750 publications

References 326 publications

Behavioural Measures of Infant Activity but Not Attention Associate with Later Preschool ADHD Traits

Behavioural Measures of Infant Activity but Not Attention Associate with Later Preschool ADHD Traits

First-Time Users of ADHD Medication Among Children and Adolescents in Germany: An Evaluation of Adherence to Prescribing Guidelines Based on Claims Data

Neurotherapeutics for Attention Deficit Hyperactivity Disorder (ADHD): a Review

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