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Understanding how best to treat ADHD: a dual approach

Published: 1 December 2023

Southampton Professor Samuele Cortese led a team from the European ADHD Guidelines Group (EAGG) that investigated which medications are most effective for children and adults. In a different but related, line of research, Professor Margaret Thompson and colleagues produced training to help parents and families of children with ADHD to support their children’s understanding of the world around them as they develop. 

This Southampton-led research has informed international clinical guidelines, including European guidance for ADHD management during the pandemic, and increased evidence-based practices among clinicians, including 2,000 members of the World Federation of ADHD.

Managing a global condition

Worldwide it is estimated that around 5 to 7% of children have ADHD and the most frequently used treatment is medicine that targets the cognitive centres of the brain. The annual cost of untreated ADHD in the UK is estimated to be £670m.

Samuele says that 20 to 30 years ago, ADHD was considered to be a childhood disorder that disappeared over time; but this is not the case. 

Some people appear to get better because they develop coping strategies, but 60 to 65% continue to have impairing symptoms into adulthood and it is vital to find the best way to treat the disorder.

Professor Samuele Cortese

He advocates a comprehensive management strategy that includes both pharmacological and non-pharmacological approaches.

He says, while medications are the most effective way of treating the so-called core symptoms of ADHD such as inattention, hyperactivity and impulsivity, non-pharmacological interventions may be helpful for other problems that are often associated with ADHD.

Creating the evidence

The EAGG research generated the most rigorous body of evidence available worldwide on the treatment of ADHD. 

The team analysed all known pharmacological trials of ADHD medications and compiled the first comprehensive database of the most effective treatments. This has been used to inform ADHD guidelines internationally.

The database allows prescribers to make informed decisions about the most effective medication for their patients.

The second strand of research, led by Southampton, involved developing a non-pharmacological training approach specifically for parents of children with ADHD and their families - the New Forest Parenting Programme (NFPP).

Recommended interventions included focusing on promoting positive not negative behaviours, managing time and planning, and how to communicate with their child.

Parents also got the opportunity to meet and share their experiences, learn from each other, and understand that the same challenges are faced by other parents.

NFPP has been expanded across the UK and versions have been developed for different cultures and languages, including the USA, Denmark, Japan, Hong Kong, South Africa, India and China.

Our work demonstrates the importance and impact of the combination of pharmacological and non-pharmacological treatments for neurodevelopmental disorders such as ADHD.
Professor of Child & Adolesct Psychiatry

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