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This chapter begins by summarizing the research and clinic-based evidence regarding the nature of attention deficit hyperactivity disorder (ADHD). The manner in which the disorder affects individuals as they mature from childhood to adulthood is then discussed, and various intervention strategies are presented. The two main current classification schemes, namely the fourth edition of the Diagnostic and Statistical Manual (DSM-IV), published by the American Psychiatric Association (APA), and the tenth edition of the International Classification of Diseases (ICD-10), published by the World Health Organization (WHO) contain a disorder characterized by a cluster of three core behavioural symptoms: inattention; hyperactivity; and impulsivity. The development of ADHD in individual is likely to be multi-factorial. Genetic contributions, neurobiological factors, illness, psychological variables and environmental factors may all play a role. The three main treatment approaches to ADHD are: pharmacological; psychological; and nutritional. The actual treatment options vary depending on the targets of intervention.
As sustained methylphenidate becomes available in the United Kingdom,
there is likely to be considerable demand related to the difficulties that
frequently arise with standard methylphenidate due to the need for midday
doses at school, as well as the pronounced ‘on/off’ therapeutic effects
sometimes seen with multiple doses. This article briefly discusses longer
acting stimulants, reviews the available literature, anticipates possible
problems in the use of slow release methylphenidate, and presents clinical
guidelines for its use.
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