NIH Consensus Development Conference Will Address Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder

The National Institutes of Health (NIH) will hold a Consensus Development Conference on Diagnosis and Treatment of Attention Deficit Disorder, November 16-18, 1998, in the main auditorium of the William H. Natcher Building on the NIH campus in Bethesda, Maryland. A news conference will conclude the 21/2-day meeting at 1 p.m. EST on Wednesday, November 18, 1998.

Attention deficit hyperactivity disorder, or ADHD, is the most common behavioral disorder of childhood, estimated to affect 3-5% of school-age children. Its core symptoms include an inability to sustain attention and concentration, developmentally inappropriate levels of activity, distractibility, and impulsivity. Although some persons have suggested that ADHD is just normal childhood behavior, children with ADHD usually have pronounced difficulties and impairment due to the disorder across multiple settings-in home, at school, and with peers-as well as resultant long-term adverse effects on later academic, vocational, social-emotional, and psychiatric outcomes. The ADHD symptoms, degree of impairment, and longitudinal course form a coherent pattern such that well-trained clinicians can reliably diagnose ADHD at a level of accuracy that rivals or exceeds many other medical diagnostic and assessment procedures. Moreover, many clinical treatment studies of the condition have also been conducted, resulting in substantial evidence of efficacy for a variety of treatments.

Despite the substantial progress in the assessment, diagnosis, and treatment of children and adults with ADHD, the disorder has remained controversial in many public and private sectors. The confusion resulting from many diverse, frequently expressed opinions (often not based on research evidence) has made many families, health care providers, educators, and policy-makers uncertain about the status of the disorder and its long-term consequences; whether it should be treated, and if so, how; which treatments yield the best outcomes; and what the personal, family, and societal costs and consequences of the disorder are, whether treated or not.

One of the major controversies concerning ADHD concerns the use of psychostimulants to treat the condition. Psychostimulants, including dextroamphetamine, methylphenidate, and pemoline, are by far the most widely researched, clinically effective, and commonly prescribed treatments for ADHD. These medications are regarded by many in the medical community as constituting the psychopharmacologic treatment of choice for ADHD. The use of methylphenidate and amphetamine nationwide has increased significantly in recent years. This increased availability and use of psychostimulants has intensified the concerns about use, overuse, and abuse.

This 21/2-day conference will bring together national and international experts in the fields of psychiatry, psychology, pediatrics, neurology, pharmacology, nursing, family medicine, addiction medicine, and behavioral medicine, as well as representatives from the public. The conference is sponsored by the NIH Office of Medical Applications of Research, the National Institute on Drug Abuse, and the National Institute of Mental Health.

After 11/2 days of presentations and audience discussion, an independent, non-Federal consensus panel chaired by Dr. David J. Kupfer, Thomas Detre Professor and Chair, Department of Psychiatry, University of Pittsburgh, will weigh the scientific evidence and write a draft statement that will be presented to the audience on the third day. The statement will take into account the panel's review of the scientific literature prepared during the preceding year. The consensus statement will address the following key questions: What is the scientific evidence to support ADHD as a disorder? What is the impact of ADHD on individuals, families, and society? What are the effective treatments for ADHD? What are the risks of the use of stimulant medication and other treatments? What are the existing diagnostic and treatment practices, and what are the barriers to appropriate identification, evaluation, and intervention? What are the directions for future research?

The panel will present its draft statement to the public for comment at 9 a.m. on Wednesday, November 18. Following this public comment session, the panel will release its revised consensus statement at a news conference at 1 p.m. and take questions from the media. Dr. Kupfer will moderate the news conference. The consensus statement is the report of an independent panel and is not a policy statement of the NIH or the Federal Government.

The NIH Consensus Development Program was established in 1977 as a form of "science court" to resolve in an unbiased manner controversial topics in medicine. To date, NIH has conducted 108 such conferences addressing a wide range of controversial medical issues important to health care providers, patients, and the general public. An average of six consensus conferences is held each year.

Additional information about this conference, including the meeting agenda, local area hotels, and directions to NIH, is available at the NIH Consensus Development Program Web site at http://consensus.nih.gov. To register for the conference, call 301-592-3320, send e-mail to [email protected], or visit the Web site.

NOTE TO TV EDITORS: The news conference at 1 p.m. on Wednesday, November 18 will be broadcast live via satellite on the following coordinates: Galaxy 6, Transponder 12.

NOTE TO RADIO EDITORS: An audio report of the conference results will be available November 18-25, 1998 from the NIH Radio News Service by calling 1-800-MED-DIAL (1-800-633-3425).