Attention deficit hyperactivity disorder: clinical update.

British Journal of General Practice, April 2014 e243 Attention deficit hyperactivity disorder (ADHD) is characterised by inappropriate levels of inattention, hyperactivity, and impulsivity: the core symptoms. It is the most common neurobehavioural childhood disorder affecting 5% of children and 2–4% of adults worldwide.1 The National Institute of Health and Care Excellence (NICE)1 acknowledges ADHD as a lifespan developmental disorder: up to 60% of children have difficulties in adulthood.2 Each GP has approximately 20 children and 20 adults with ADHD at one time. Many remain undiagnosed and often suffer unnecessarily with adverse long-term outcomes. ADHD is highly heritable, occurring more frequently in boys.1 Those without hyperactivity, particularly girls, tend to be overlooked. A positive family history is the biggest risk factor for ADHD.1 ADHD can affect mental health, behaviour, selfesteem, and emotional development in children and adolescents and causes significant dysfunction along with parental distress. Children with ADHD often underperform academically, with increased school truancy and expulsion.3 Untreated ADHD places heavy demands on health, social, and educational resources. This group of patients should be considered when planning child mental health, educational services,1 and adult psychiatry services with seamless transition services for adolescents.