Material and methods: Data was accumulated by retrospectively looking at the records of 102 children of both sexes between 3 and 15 years of age, referred to the ADHD outpatient clinic during the period June 1, 1998 - May 31, 1999. A semi-structured diagnostic parent interview was used to assess childhood psychiatric disorders according to ICD-10. The ADHD Rating Scale- IV, the Home Situations Questionnaire and the Child Behavior Checklist were completed by the parents. Teachers filled out the ADHD Rating Scale and the Teacher Report Form as well as a form evaluating the child's academic progress. To assess intellectual functioning, WISC-III or WPPSI-R were administered. Medical evaluation was performed and drug treatment recorded.
Results: Seventy-two children fulfilled ICD-10 diagnostic criteria of hyperkinetic disorder. High rates of other behavioural disorders, especially oppositional defiant disorder and a significant frequency of emotional disorders were recorded. Nearly two-thirds of the children had been started on medication prior to referral, most often amytryptiline and methylphenidate. Eleven children received combined pharmacotherapy but 35% had not received any drug treatment. Psychopharmacotherapy for most of the children was started between the age of four and eight years. Behaviour management counselling and parent training was recommended in most cases.
Conclusions: Thirty children did not meet full hyperkinetic disorder diagnostic criteria, but these children may nonetheless have manifested high levels of symptoms. Most of the children were started on tricyclic antidepressants rather than stimulants which is unusual compared with international research and practice. The reason is unclear but may reflect the high rate of comorbidity but also doctors' preferences.