Mental health

Topics for discussion

Note: This statement of principles does not represent an official position of the World Health Organization. It is meant to serve as a stimulus for discussion by professional groups, parents and other interested parties. It is planned that other "Topics for Discussion" will be posted over time."

Principles of Care for Children and Adolescents with Hyperkinetic Disorders

  • Hyperkinetic Disorders (ICD-10 F90)* are complex disorders where the diagnosis may too often be made with insufficient evidence. A focus only on the symptoms associated with Hyperkinetic Disorders without an appropriate diagnostic evaluation may lead to misdiagnosis and inappropriate treatment. The symptoms associated with Hyperkinetic Disorders are also seen with other disorders and sometimes as a part of normal developmental stages or in response to environmental stress that can be remediated.
  • There are specific diagnostic criteria for these disorders that have been established by professional bodies and these must be adhered to for proper diagnosis and treatment to be rendered. There are dilemmas associated with these disorders including its possible overdiagnosis worldwide, undertreatment when an appropriate diagnosis is made, inappropriate treatment worldwide, and pressures to make the diagnosis from those who may not have a comprehensive understanding of the disorder including parents, school personnel, and healthcare providers.
  • The treatment of Hyperkinetic Disorders, like many other disorders, will depend on the nature of the presentation and support system for the child or adolescent. It is essential to recognize that a variety of treatments are available for the disorder and that medication while effective with an appropriate diagnosis does not substitute for other possibly important interventions to lessen the child's or adolescent's associated problems in the family, social setting and school.
  • The use of medication, as always, should be undertaken with appropriate caution. The too ready or excessive use of medication, and the increasing "off-label" use of medications other than stimulants, such as, methylphenidate, for treatment can result in negative consequences.
  • WHO recognizes the importance of making the diagnosis of Hyperkinetic Disorders but urges increased training for appropriate diagnosis and treatment among all healthcare providers and those with contact with children who may be so diagnosed.

*314. Attention-Deficit/Hyperactivity Disorder in DMS IV.