A simple tool to help you differentiate between ADHD and the most common overlapping comorbidities in children
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Attention-deficit/hyperactivity disorder (ADHD) has evolved from that of a discrete behavioral condition to a complex neurobiologic disorder with various associated comorbidities.2-4 It is now recognized that ADHD is usually accompanied by coexisting disorders and other complicating factors that may or may not be identified and adequately treated.5
In light of this, the American Academy of Pediatrics (AAP) practice update of 2019 concluded that the majority of pediatric patients with ADHD also meet the criteria for another mental health disorder.6
In January 2020, the Society for Developmental and Behavioral Pediatrics (SDBP), a panel of developmental-behavioral pediatricians, psychologists, and nurse practitioners, introduced the first-ever clinical practice guideline for patients with complex ADHD.5
The guideline was developed specifically to help guide diagnosis and treatment decisions in complex ADHD.5
– Dr. Frank Lopez, MD
Development of a multimodal treatment plan for children and adolescents with suspected complex ADHD initiated by clinicians with specialized expertise/training
Grade B—Strong Recommendation
Use of an evidence-based approach to assess for comorbid conditions, including their severity and associated functional impairment
Grade B—Strong Recommendation
Psychoeducation to address all functional domains (behavioral, social, and academic)
Grade B—Strong Recommendation
Treatment of complex ADHD focused not only on symptom management, but on prevention of adverse outcomes (eg, depression and anxiety)
Grade C to B—Recommendation to Strong Recommendation
Monitoring of patients throughout their lives, with emphasis on key developmental periods (eg, school transitions), given chronic nature of ADHD
Grade B—Strong Recommendation
– William J Barbaresi, MD
How will this new SDBP guideline inform your practice?
The SDBP guideline underscores that assessment and treatment of children with complex ADHD require a multimodal approach from multiple systems (eg, healthcare, education, etc) to ensure the best possible outcomes.5 Learn more about psychiatric comorbidities here.
References:1. Barbaresi WJ. The SDBP Complex ADHD Clinical Practice Guideline: it’s about time. J Dev Behav Pediatr. 2020;41 Suppl 2S:S33–S34. 2. Koolwijk I, Stein DS, Chan E, Powell C, Driscoll K, Barbaresi WJ. “Complex” attention-deficit hyperactivity disorder, more norm than exception? Diagnoses and comorbidities in a developmental clinic. J Dev Behav Pediatr. 2014;35:591–597. 3. Brown TE. Developmental complexities of attentional disorders. In: Brown TE, Ed. ADHD Comorbidities: Handbook for ADHD Complications in Children and Adults; Arlington, VA: American Psychiatric Publishing Inc; 2009:3-23. 4. Shaw P, Polanczyk GV. Combining epidemiological and neurobiological perspectives to characterize the lifetime trajectories of ADHD. Eur Child Adolesc Psychiatry. 2017;26(2):139-141. 5. Barbaresi WJ, Campbell L, Diekroger EA, et al. The Society for Developmental and Behavioral Pediatrics Clinical Practice Guidelines for the Assessment and Treatment of Children and Adolescents With Complex Attention-Deficit Disorder: process of care algorithms. J Dev Behav Pediatr. 2020;41(suppl 2S):S58–S74. 6. Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement Management, Wolraich M, et al. Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2019;144(4):e20192528. 7. Data on file. Supernus Pharmaceuticals.