[Role of psychostimulants in hyperactive children].
The Attention Deficit Hyperactivity Disorder (ADHD) still remains under diagnosed and under recognized in France, although this illness affects at least one pupil in each classroom. Despite its prevalence, untreated ADHD can lead to school failure, relationship break-ups, drug abuse, and a tremendous sense of underachievement. The treatment is centred on a combination of psychotherapy, psycho-educative skills, and psychostimulant medication. There are concerns about the appropriateness of psychostimulant drug prescription to children in France. Anyway, a complete review of the literature reveals the efficacy of this treatment when compared with placebo in children and adolescents suffering from ADHD, and its good tolerability profile. Moreover, pharmacotherapy was associated with a reduction in risk for substance use disorders in ADHD youth. We'll try to demonstrate that the problem shouldn't be focused on the efficacy of psychostimulant drugs but on clinical and diagnostic strategies. Actually, the clinical picture of ADHD is not very specific and there could be a risk of misdiagnosis of ADHD in children with hyperactive and/or attention behaviours from other origins (i.e. social and/or educative problems). As a differential diagnosis, the hypothesis of an early-onset bipolar disorder should be systematically assessed because of the huge symptomatic overlaps between the two illnesses.
Kochman
Frédéric
F
Unité de pédopsychiatrie (D Daniel Bayart) EPSM Agglomération lilloise 59871 Saint-André. fkochman@voila.fr
Karila
Laurent
L
Tiravi
Sandrine
S
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003951:Diagnostic Errors; D006801:Humans; D010347:Patient Care Planning; D010919:Placebos; D011613:Psychotherapy
D000697:Central Nervous System Stimulants; D010919:Placebos