The National Guideline, NG87, makes recommendations for recognising, diagnosing and managing ADHD in children, young people and adults.
National guidelines include comprehensive recommendations for the identification, referral and diagnosis of children, young people, and adults with suspected ADHD. A brief summary is provided here. Healthcare professionals should also refer to the complete guideline, NG 87.5
For children or young people presenting in primary care with behavioural and/ or attention problems suggestive of ADHD, primary care practitioners should determine the severity of the problems, how they affect the child or young person, and the parents or carers, and the extent to which they pervade different domains and settings. If the problems are associated with severe impairment, referral should be made to secondary care for assessment.
Adults presenting with symptoms of ADHD in primary care or general adult psychiatric services, who do not have a childhood diagnosis, should be referred to a mental health specialist trained in the diagnosis and treatment of ADHD for assessment.
There should be evidence of typical manifestations of ADHD that began during childhood and persisted throughout life. The symptoms should not be explained by other psychiatric diagnoses and should have resulted in, or be associated with, moderate or severe psychological, social and/ or educational or occupational impairment.
Adults who have previously been treated for ADHD as children or young people and present with symptoms suggestive of continuing ADHD should be referred to general adult psychiatric services for assessment.
The diagnosis of ADHD is made in the same way as for other common psychiatric disorders; by careful evaluation of the mental state and a full psychiatric evaluation, including developmental history, functional impairments, and current and past psychiatric history.1
For a diagnosis of ADHD, symptoms of hyperactivity/ impulsivity and/or inattention should:
- Meet the diagnostic criteria in DSM‑5 or ICD‑10 (hyperkinetic disorder) and
- Cause at least moderate psychological, social and/or educational or occupational impairment based on interview and/or direct observation in multiple settings and
- Be pervasive, occurring in 2 or more important settings including social, familial, educational and/or occupational settings.
References
1. UK Adult ADHD Network. Handbook for Attention Deficit Hyperactivity Disorder in Adults. 2013. Springer Healthcare Communications.
5. National Institute for Health and Care Excellence. Attention deficit hyperactivity disorder: diagnosis and management. NICE Guideline 87. NICE, 2018. Available at: www.nice.org.uk/guidance/ng87 (Accessed May 2021)