[Better health care for children and adolescents with attention deficit hyperactivity disorder]

Recently Donker et al. reported a massive rise in the prescription of methylphenidate by general practitioners in the northeast of The Netherlands. On comparing their results with national and international guidelines on the management of attention deficit hyperactivity disorder (ADHD) it would appear that medication is not always being prescribed to the correct group of children i.e. those with the core problems of ADHD. Girls are under-diagnosed, while boys frequently receive medication for oppositional or conduct problems, which are usually better treated by parent management training. Many children are never given the full multidisciplinary assessment recommended by the guidelines and it is unclear whether other evidence-based treatments such as school liaison or parent management training were offered. Overall it seems children with ADHD do not always receive the treatment they require. Improvement might be achieved if the European and Dutch recommendations are followed.