ABSTRACT
El Grupo de Especial Interés en el Trastorno por Déficit de Atención/Hiperactividad (GEITDAH) presenta en este artículo un consenso de expertos de toda España sobre los trastornos de conducta en niños y adolescentes. A partir del trabajo inicial del equipo de la Unidad de Paidopsiquiatría del Hospital Quirón-Teknon de Barcelona, se han consensuado aspectos básicos que podrían ser el punto de partida para futuros consensos. Ha sido también objetivo prioritario del trabajo actualizar en los trastornos de conducta en niños y adolescentes los criterios del Manual diagnóstico y estadístico de los trastornos mentales, quinta edición, y su comorbilidad con el trastorno por déficit de atención/hiperactividad (AU)
In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quirón-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder (AU)
Subject(s)
Child , Female , Humans , Male , Child Behavior Disorders , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/epidemiology , Attention Deficit and Disruptive Behavior Disorders/etiology , Attention Deficit and Disruptive Behavior Disorders/therapy , Social Behavior Disorders/diagnosis , Social Behavior Disorders/epidemiology , Social Behavior Disorders/etiology , Social Behavior Disorders/therapy , Epidemiological Monitoring/trends , Attention Deficit Disorder with Hyperactivity , Antisocial Personality Disorder , Parent-Child Relations , Violence , Self Concept , Attitude , Education , Risk Factors , Comorbidity , Spain/epidemiologyABSTRACT
In this paper, the Special Interest Group on Attention Deficit Hyperactivity Disorder (GEITDAH, from its name in Spanish) presents a consensus reached by experts from all over Spain on conduct disorders in children and adolescents. Following the initial work by the team at the Pedopsychiatry Unit at the Quiron-Teknon Hospital in Barcelona, agreements have been reached on a number of basic aspects that could be the starting point for future consensuses. A top priority aim of the work was also to update the criteria in the Diagnostic and statistical manual of mental disorders, fifth edition, for conduct disorders in children and adolescents, together with their comorbidity with attention deficit hyperactivity disorder.
TITLE: Consenso del GEITDAH sobre los trastornos de conducta en niños y adolescentes.El Grupo de Especial Interes en el Trastorno por Deficit de Atencion/Hiperactividad (GEITDAH) presenta en este articulo un consenso de expertos de toda España sobre los trastornos de conducta en niños y adolescentes. A partir del trabajo inicial del equipo de la Unidad de Paidopsiquiatria del Hospital Quiron-Teknon de Barcelona, se han consensuado aspectos basicos que podrian ser el punto de partida para futuros consensos. Ha sido tambien objetivo prioritario del trabajo actualizar en los trastornos de conducta en niños y adolescentes los criterios del Manual diagnostico y estadistico de los trastornos mentales, quinta edicion, y su comorbilidad con el trastorno por deficit de atencion/hiperactividad.
Subject(s)
Conduct Disorder , Adolescent , Adolescent Behavior , Aggression , Antisocial Personality Disorder/diagnosis , Antisocial Personality Disorder/epidemiology , Attention Deficit Disorder with Hyperactivity/epidemiology , Attention Deficit and Disruptive Behavior Disorders/diagnosis , Attention Deficit and Disruptive Behavior Disorders/epidemiology , Authoritarianism , Child , Child Behavior , Child Behavior Disorders/diagnosis , Child, Preschool , Combined Modality Therapy , Comorbidity , Conduct Disorder/diagnosis , Conduct Disorder/epidemiology , Conduct Disorder/etiology , Conduct Disorder/psychology , Conduct Disorder/therapy , Crime , Diagnosis, Differential , Diagnostic and Statistical Manual of Mental Disorders , Executive Function , Humans , Infant , Parent-Child Relations , Parenting , Psychiatric Status Rating Scales , Psychotherapy/methods , Psychotropic Drugs/therapeutic use , Teaching/methods , ViolenceABSTRACT
El grupo GEITDAH (Grupo de Especial Interés en el Trastorno por Déficit de Atención/Hiperactividad) presenta en este artículo un consenso de expertos de toda España sobre el tratamiento nutricional del TDAH. El tratamiento del trastorno por déficit de atención con o sin hiperactividad (TDAH) debe ser multimodal. El tratamiento nutricional es suplementario y comienza a haber pruebas científicas de su eficacia. Las intervenciones dietéticas pueden tener pequeños efectos beneficiosos en los síntomas del TDAH. La controvertida eliminación de aditivos artificiales, conservantes, colorantes y azúcares ha sido bien estudiada, y no tiene suficiente soporte científico por el momento para su recomendación generalizada como tratamiento eficaz del TDAH. Tampoco el empleo adicional de Acetil-L Carnitina con metilfenidato. Los suplementos de hierro o zinc deben suministrarse en los pacientes con TDAH con deficiencias conocidas. En este momento los hallazgos de los ensayos controlados aleatorizados son demasiado limitados y no apoyan de forma definitiva hasta la fecha el uso habitual en la práctica clínica de los ácidos grasos esenciales (omega-3 y 6) como tratamiento primario o suplementario en los niños con TDAH. Aunque, parecen aliviar síntomas relacionados con el TDAH, al menos en algunos niños, y los beneficios son mayores en el colegio que en casa
In this article, the GEITDAH -the Spanish abbreviation of the Special Interest Group on Attention Deficit Hyper-activity Disorder (ADHD)- presents a consensus about nutritional treatment for ADHD reached by experts in the management of ADHD from all over Spain. The ADHD treatment should be multimodal.Nutritional treatment is supplementary and there is some begining evidence of modest efficacy. Dietary interventions can have little beneficial effects in ADHD symptomatology. The controversial restricted elimination of food additives, preservatives, artificial food colours and refined sugar from diet is good studied. Present findings do not support to date the positive recommendation of its use as an appropriate treatment in ADHD. Neither do they support Acetyl-L Carnitine supplementation to augment methylphenidate. Iron and zinc should be supplemented in selected patients with know deficiencies. Current findings from randomized trials are limited and have not consistently supported the generalized clinical use of PUFA supplements (omega-3 fatty acids) as a primary or supplementary treatment for children with ADHD
Subject(s)
Humans , Child , Attention Deficit Disorder with Hyperactivity/diet therapy , Nutritional Support/methods , Nutrition Therapy/methods , Fatty Acids, Omega-3/administration & dosage , Food, Fortified , Expert Testimony , ConsensusABSTRACT
INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is one of the most frequent reasons for visits in daily clinical practice, with a prevalence rate of 1-7% in Spain. The effectiveness of stimulants for the treatment of ADHD has been widely demonstrated and methylphenidate (MPD) is the most commonly used. There are currently several different immediate-release or extended-release formulations of MPD on the market. AIMS: To review the characteristics of the different formulations of MPD, with special attention paid to the studies on Equasym®, an extended-release preparation soon to be made available in Spain. The article also includes recommendations for clinical practice and the choice of drugs. DEVELOPMENT: Several studies have assessed the effectiveness of Equasym® versus placebo or in comparison to other MPD formulations. The extended-release preparations have a therapeutic action that is similar to that of the immediate-release versions, the difference between them being the plasma concentration profiles over time during the day, which are reflected in the pharmacodynamic effects. Equasym® is more effective in the morning, whereas other formulations, such as Concerta®, allow greater control of the symptoms in the afternoon. These differences are important when it comes to prescribing the treatment. CONCLUSIONS: One of the main advantages of having different formulations of MPD available is that it allows the professional to choose the drug that best suits the clinical features and needs of each patient. The individual response is the essential criterion in deciding on the most appropriate treatment.
Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Dopamine Uptake Inhibitors/administration & dosage , Methylphenidate/administration & dosage , Drug Administration Schedule , HumansABSTRACT
Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) constituye uno de los motivos más frecuentes de consulta en la práctica clínica diaria, con una tasa de prevalencia del 1-7% en España. La eficacia de los estimulantes para el tratamiento del TDAH está ampliamente demostrada, y el metilfenidato (MTF) es el más comúnmente utilizado. En la actualidad se comercializan varias formulaciones de MTF de acción inmediata o prolongada. Objetivo. Revisar las características de las distintas formulaciones de MTF, con un enfoque especial en los estudios sobre Equasym ®, un preparado de acción prolongada próximamente disponible en España. También se incluyen recomendaciones para la práctica clínica y la elección de los fármacos. Desarrollo. Varios estudios han evaluado la eficacia de Equasym ® frente a placebo o en comparación con otras formulaciones de MTF. Los preparados de liberación prolongada tienen una acción terapéutica parecida a los de liberación inmediata, y se diferencian entre sí por los perfiles temporales de concentración plasmática durante el día, que se reflejan en los efectos farmacodinámicos. La eficacia de Equasym ® es mayor por la mañana, mientras que otras formulaciones, como Concerta ®, permiten un mejor control de los síntomas por la tarde. Estas diferencias son importantes a la hora de prescribir el tratamiento. Conclusiones. Disponer de diferentes formulaciones de MTF es beneficioso, porque permite elegir en cada caso el fármaco que mejor se ajuste a las características clínicas y necesidades de cada paciente. La respuesta individual es el criterio fundamental para decidir el tratamiento más adecuado (AU)
Introduction. Attention deficit hyperactivity disorder (ADHD) is one of the most frequent reasons for visits in daily clinical practice, with a prevalence rate of 1-7% in Spain. The effectiveness of stimulants for the treatment of ADHD has been widely demonstrated and methylphenidate (MPD) is the most commonly used. There are currently several different immediate-release or extended-release formulations of MPD on the market. Aims. To review the characteristics of the different formulations of MPD, with special attention paid to the studies on Equasym ®, an extended-release preparation soon to be made available in Spain. The article also includes recommendations for clinical practice and the choice of drugs. Development. Several studies have assessed the effectiveness of Equasym ® versus placebo or in comparison to other MPD formulations. The extended-release preparations have a therapeutic action that is similar to that of the immediaterelease versions, the difference between them being the plasma concentration profiles over time during the day, which are reflected in the pharmacodynamic effects. Equasym ® is more effective in the morning, whereas other formulations, such as Concerta ®, allow greater control of the symptoms in the afternoon. These differences are important when it comes to prescribing the treatment. Conclusions. One of the main advantages of having different formulations of MPD available is that it allows the professional to choose the drug that best suits the clinical features and needs of each patient. The individual response is the essential criterion in deciding on the most appropriate treatment (AU)
Subject(s)
Humans , Male , Female , Child , Methylphenidate/administration & dosage , Attention Deficit Disorder with Hyperactivity/drug therapy , Dosage Forms , Patient Selection , Central Nervous System Stimulants/administration & dosageABSTRACT
El grupo de especial interés en TDAH (GEITADH) expone en este artículo su consenso sobre algoritmos de derivación en la asistencia para el paciente afecto de TDAH. Es un diseño sencillo realizado por un amplio número de profesionales de toda España con el objetivo de poder ser adaptado a necesidades asistenciales locales. Se revisan también otros algoritmos con influencia nacional
The Spanish Especial Interest Group on ADHD (GEITDAH) presents in this article its consensus on pathways for attending ADHD patients. This is a clear and simple consensus in order to facilitate the development of local algoritms inspired on it. Some ADHD algorithms used in the Spanish Health Services are reviewed
Subject(s)
Humans , Attention Deficit Disorder with Hyperactivity/diagnosis , Symptom Assessment/methods , Algorithms , Mass Screening/methods , Referral and Consultation , Diagnostic Errors/prevention & control , Professional Training , Practice Patterns, Physicians'ABSTRACT
El GEITDAH, Grupo de Especial Interés en el Trastorno por Déficit de Atención/Hiperactividad (TDAH), presenta en este artículo un consenso de expertos de toda España sobre el manejo del TDAH. Se han consensuado aspectos básicos que deberían ser el punto de partida para futuros consensos locales o regionales. Es también un objetivo de este consenso disminuir la variabilidad en la asistencia que se da en nuestro país al TDAH y servir de estímulo para fines docentes. Su reducida extensión permitirá una mayor difusión a fin de lograr todos estos fines de forma más efectiva. Las conclusiones del consenso se han articulado en torno a una introducción sobre aspectos básicos y recomendaciones para: diagnóstico, tratamiento (farmacológico y psicoterapéutico), flujo de pacientes y aspectos organizativos (AU)
In this article, the GEITDAH the Spanish abbreviation of the Special Interest Group on Attention Deficit Hyperactivity Disorder (ADHD) presents a consensus reached by experts in the management of ADHD from all over Spain. The consensus concerns fundamental aspects that should be the starting point for future local or regional consensus guides. Another aim of this consensus is also to reduce the amount of variability that occurs in the health care offered to patients with ADHD in our country, as well as to act as a stimulus in educational matters. That fact that it is not very long will make it more popular among greater numbers of people and this will allow these goals to be reached more effectively. The conclusions in the consensus guide have been constructed around an introduction dealing with basic aspects and recommendations for diagnosis, treatment (both pharmacological and psychotherapeutic), patient flow and organisational aspects (AU)
