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The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder

The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder
The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder

Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. Methods: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. Results: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.

ADHD, Brain, Course, Diagnosis, Genetics, Outcome, Treatment
0149-7634
789-818
Faraone, Stephen.V.
459e29d2-a72a-4cff-b92e-33d5cbeaa8f0
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
et al.
Faraone, Stephen.V.
459e29d2-a72a-4cff-b92e-33d5cbeaa8f0
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb

Faraone, Stephen.V. , et al. (2021) The World Federation of ADHD International Consensus Statement: 208 Evidence-based Conclusions about the Disorder. Neuroscience & Biobehavioral Reviews, 128, 789-818. (doi:10.1016/j.neubiorev.2021.01.022).

Record type: Article

Abstract

Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. Methods: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. Results: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.

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Accepted/In Press date: 25 January 2021
e-pub ahead of print date: 4 February 2021
Published date: September 2021
Additional Information: Funding Information: J.J.S.K. receives research support from Parnassia Groep, the Netherlands . Funding Information: J.M.S reports the following financial disclosures: Advisory Board for Medice; travel support from Medice and Shire/Takeda. Funding Information: G.V.P. reports the following financial disclosures: Advisor/consultant/speaker for Takeda, Medice, Aché, Novo Nordisk, travel expense for attending AACAP2019 Meeting from Takeda, royalties from Editora Manole. He also received grant funding from São Paulo Research Foundation (FAPESP, grant 2016/22455-8) and National Council for Scientific and Technological Development (CNPq, grant 310582/2017-2). Funding Information: M.D. reports the following financial disclosures over the last 3 years: consulting income and research support from Lilly, Medice, Shire, Takeda, and Vifor. He received income as head, supervisor, and lecturer of the School of Child and Adolescent Cognitive Behaviour Therapy at the University Hospital Cologne and as consultant for Child Behaviour Therapy at the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung). He also received royalties from treatment manuals, books and psychological tests published by Beltz, Elsevier, Enke, Guilford, Hogrefe, Huber, Kohlhammer, Schattauer, Springer, Wiley. Funding Information: C.M.H. has received grant support from the Institutional Development Award (IDeA) from NIGMS . Funding Information: J.A.R.Q. was on the speakers’ bureau and/or acted as consultant for Eli-Lilly, Janssen-Cilag, Novartis, Shire, Takeda, Bial, Shionogui, Lundbeck, Almirall, Braingaze, Sincrolab, Medice and Rubió in the last 5 years. He also received travel awards (air tickets + hotel) for taking part in psychiatric meetings from Janssen-Cilag, Rubió, Shire, Takeda, Shionogui, Bial, Medice and Eli- Lilly. The Department of Psychiatry chaired by him received unrestricted educational and research support from the following companies in the last 5 years: Eli-Lilly, Lundbeck, Janssen- Cilag, Actelion, Shire, Ferrer, Oryzon, Roche, Psious, and Rubió. He also received grant funding from the Department of Health of the Government of Catalonia . Funding Information: M.R. has received grant funding from the German Federal Ministry of Education and Research (BMBF) Grant 01EE1408 . Funding Information: S.V.F. In the past year, he received income, potential income, travel expenses continuing education support and/or research support from, Akili Interactive Labs, Arbor, Genomind, Ironshore, Ondosis, Otsuka, Rhodes, Shire/Takeda, Sunovion, Supernus, Tris, and Vallon. With his institution, he has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. In previous years, he received support from: Alcobra, CogCubed, Eli Lilly, Enzymotec, Janssen, KemPharm, Lundbeck/Takeda, McNeil, Neurolifesciences, Neurovance, Novartis, Pfizer, and Vaya. He also receives royalties from books published by Guilford Press: Straight Talk about Your Child's Mental Health; Oxford University Press: Schizophrenia: The Facts; and Elsevier: ADHD: Non-Pharmacologic Interventions. He is also Program Director of www.adhdinadults.com. He is supported by the European Union's Seventh Framework Programme for research, technological development and demonstration under grant agreement no. 602805, the European Union's Horizon 2020 research and innovation programme under grant agreements Nos. 667302 & 728018 and NIMH grants 5R01MH101519 and U01 MH109536-01.J.B. is currently receiving research support from the following sources: AACAP, Feinstein Institute for Medical Research, Food & Drug Administration, Genentech, Headspace Inc., NIDA, Pfizer Pharmaceuticals, Roche TCRC Inc., Sunovion Pharmaceuticals Inc., Takeda/Shire Pharmaceuticals Inc., Tris, and NIH. Dr. Biederman's program has received departmental royalties from a copyrighted rating scale used for ADHD diagnoses, paid by Biomarin, Bracket Global, Cogstate, Ingenix, Medavent Prophase, Shire, Sunovion, and Theravance; these royalties were paid to the Department of Psychiatry at MGH. In 2020: Through MGH corporate licensing, Dr. Biederman has a US Patent (#14/027,676) for a non-stimulant treatment for ADHD, a US Patent (#10,245,271 B2) on a treatment of impaired cognitive flexibility, and a patent pending (#61/233,686) on a method to prevent stimulant abuse. He receives honoraria from the MGH Psychiatry Academy for tuition-funded CME courses. In 2019, Dr. Biederman was a consultant for Akili, Avekshan, Jazz Pharma, and Shire/Takeda. He received research support from Lundbeck AS and Neurocentria Inc. Through MGH CTNI, he participated in a scientific advisory board for Supernus.M.A.B. in the last five years has received travel support and speaker fees from Shire Pharmaceuticals. He was on the Scientific Advisory Board of Tali Health, the developers of a cognitive training game for ADHD and other neurodevelopmental disorders. M.A.B. is supported by a Senior Research Fellowship from the National Health and Medical Research Council (NHMRC) of Australia. He is President of the Australian ADHD Professionals Association (AADPA).J.H.N. reports the following financial disclosures in the past three years: is/has been an advisor and/or consultant for Adlon Therapeutics, Akili Interactive, Arbor, Cingulate Therapeutics, Corium, Eisai, Enzymotec, Lundbeck, Medice, Myriad Neuroscience, NLS, OnDosis, Rhodes, Shire/Takeda, and Supernus. He was a DSMB member for Pfizer and Sunovion, received research funds from Enzymotec, Otsuka, Shire and Supernus, and received speaker fees from Shire/Takeda for disease-state presentations.I.M. reports the following financial disclosures for the last 3 years: Consultant: Novartis Israel, Teva Israel, Medison Ltd. Advisory Board: Teva (2018). Honorariums: Amaoon, Takeda, and MHS virtual summit. She has also received PI funding from Alcobra (S/P), Nuance Ltd.L.A.R. reports the following financial disclosures: he has been a member of the speakers? bureau/advisory board and/or acted as a consultant for Bial, Eli-Lilly, Janssen-Cilag, Medice, Novartis, Pfizer and Shire in the last 3 years. He receives authorship royalties from Oxford Press and ArtMed. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by him received unrestricted educational and research support from the following pharmaceutical companies in the last 3 years: Eli-Lilly, Janssen-Cilag, Novartis, and Shire. He received travel grants from Shire for attending the 2018 APA meetings. He also receives research support from Brazilian government institutions: Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq), Funda??o de Amparo ? Pesquisa do Estado do Rio Grande do Sul (FAPERGS), Hospital de Cl?nicas de Porto Alegre (HCPA), and Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES).L.Y. reports the following financial disclosures: has been a member of the speakers? bureau and/or acted as a consultant for Eli-Lilly and Janssen. Has also received grant funding from National Natural Science Foundation of China (81671358, 81873803).P.A. has received honoraria for consultancy to Shire/Takeda, Eli-Lilly and Novartis; educational/research awards from Shire, Lilly, Novartis, Vifor Pharma, GW Pharma and QbTech; speaker at sponsored events for Shire, Lilly, Flynn Pharma and Novartis. He has also received grant funding support from NIHR Biomedical Research Centre (NIHR/MRC 14/23/17) and NIHR Senior Investigator award (NF-SI-0616-10040).L.A. has received grant funding from the National Institutes of Health; Broad Institute of MIT and Harvard. Also received funding from Tonix Pharmaceuticals for research on PTSD treatment.S.D. received research supported by grants from The Lundbeck Foundation (iPSYCH grant no. R248-2017-2003), National Institute of Health (R01, grant no. ES026993), Novo Nordisk Foundation (grant no. 22018), the European Commission (Horizon 2020, grant no. 667302), Tryg Foundation (109399), Helsefonden (grant no. 19-8-0260) and the European Union's Horizon 2020 research and innovation programme under grant agreement No. 847879.B.F. has received educational speaking fees from Medice. She also received grant funding from the Netherlands Organization for Scientific Research (NWO) Vici Innovation Program (personal grant 016?130-669 to B.F.), European Community Horizon 2020 Programme (H2020/2014 ? 2020) under grant agreement no. 667302 (CoCA).C.M.H. has received grant support from the Institutional Development Award (IDeA) from NIGMS.C.H. reports lecture fees and honorarium in 2019 from the British Association of Psychopharmacology (BAP). He has also received funding from the National Institute for Health Research (NIHR); UK Medical Research Council (MRC).S.H.K. reports the following financial disclosures: Akili Interactive (Research Support, Consulting Stock Options), Behavioral Innovations Group (Equity), Bose Corporation (Research Support), Tris Pharma (Research Support), Neos (Research Support), Sana Health (Research Support), OnDosis (Research Support), KemPharm (Research Support). He has also received funding from the NIH, John Templeton Foundation.J.J.S.K. receives research support from Parnassia Groep, the Netherlands.T.L. receives research support from the Joint medical research project of Chongqing Science and Technology Bureau and Health Committee (Key project, Project No.: 2018zdxm012): Chinese research and promotion of Manual for Primary Care Clinicians about the Diagnosis and Treatment of Children with Attention Deficit Hyperactivity Disorder (4th Edition). J.L. has no conflicts of interest or financial disclosures to report.E.M. reports the following financial disclosures in the last 3 years: Advisory/Lecture for: Teva Israel, Medison Ltd. He also received grant support from the Israel Ministry of Health.G.M has received grant funding from Akili, Alcobra, Alkermes, Allergan, Axsome, Boehringer, Genentech, Jansen, Lundbeck, Medgenics, NLS Pharma, Otsuka, Reckitt Benckiser, Roche, Sage, Shire, Sunovion, Supernus, Takeda, Taisho and Teva.A.Y.M. has received funding from the Institute of Education Sciences; Michael Smith Foundation for Health Research; Social Sciences and Humanities Research Council of Canada.J.T.N. has received grant funding support from the National Institute of Mental Health.G.V.P. reports the following financial disclosures: Advisor/consultant/speaker for Takeda, Medice, Ach?, Novo Nordisk, travel expense for attending AACAP2019 Meeting from Takeda, royalties from Editora Manole. He also received grant funding from S?o Paulo Research Foundation (FAPESP, grant 2016/22455-8) and National Council for Scientific and Technological Development (CNPq, grant 310582/2017-2).M.R. has received grant funding from the German Federal Ministry of Education and Research (BMBF) Grant 01EE1408.J.A.R.Q. was on the speakers? bureau and/or acted as consultant for Eli-Lilly, Janssen-Cilag, Novartis, Shire, Takeda, Bial, Shionogui, Lundbeck, Almirall, Braingaze, Sincrolab, Medice and Rubi? in the last 5 years. He also received travel awards (air tickets + hotel) for taking part in psychiatric meetings from Janssen-Cilag, Rubi?, Shire, Takeda, Shionogui, Bial, Medice and Eli- Lilly. The Department of Psychiatry chaired by him received unrestricted educational and research support from the following companies in the last 5 years: Eli-Lilly, Lundbeck, Janssen- Cilag, Actelion, Shire, Ferrer, Oryzon, Roche, Psious, and Rubi?. He also received grant funding from the Department of Health of the Government of Catalonia.Arnt S. has been supported by a Veni Grant from the Dutch Science Organization (ZonMW).E.S.B. reports the following financial disclosures over the last three years: MRC, ESRC, Wellcome Trust, The Waterloo Foundation, University of Copenhagen, KU Leuven, Shire/Takeda, Neurtech Solutions, QBTech.C.S. in 2019?2020 reports the following financial disclosures: Lundbeck (Clinical Trial, Departmental Funds), NeuroTech Solutions, Medice (Advisory Board), Rubio (Speaker), Editorial Medica Panamericana (Book Royalties).Y.W. receives research support from Sanming Project of Medicine in Shenzhen ?The ADHD research group from Peking University Sixth hospital? (SZSM201612036), the Major State Basic Research Development Program of China (973Program, 2014CB846100). Funding Information: Arnt S. has been supported by a Veni Grant from the Dutch Science Organization (ZonMW) . Funding Information: T.L. receives research support from the Joint medical research project of Chongqing Science and Technology Bureau and Health Committee (Key project, Project No.: 2018zdxm012): Chinese research and promotion of Manual for Primary Care Clinicians about the Diagnosis and Treatment of Children with Attention Deficit Hyperactivity Disorder (4th Edition) . J.L. has no conflicts of interest or financial disclosures to report. Funding Information: M.V.S. has received grant funding from the National Institute of Health. Funding Information: D.P.O. reports financial disclosures from Shire (advisory board/speaker fees 2016-2018), travel/accommodation/honoraria from Medice, speaker fees from Otsuka and Janssen, travel/accommodation support from HAC Pharma, scientific committee of a study by Mensia without personal fees. Funding Information: B.S.G.M. has received grant funding from the National Institutes of Health. Funding Information: S.P.H. has received book royalties from Oxford University Press and St. Martin's Press, as well as grant support from N.I.H. Funding Information: S.H.K. reports the following financial disclosures: Akili Interactive (Research Support, Consulting Stock Options), Behavioral Innovations Group (Equity), Bose Corporation (Research Support), Tris Pharma (Research Support), Neos (Research Support), Sana Health (Research Support), OnDosis (Research Support), KemPharm (Research Support). He has also received funding from the NIH , John Templeton Foundation . Funding Information: G.M has received grant funding from Akili , Alcobra , Alkermes , Allergan , Axsome , Boehringer , Genentech , Jansen , Lundbeck , Medgenics , NLS Pharma , Otsuka , Reckitt Benckiser , Roche , Sage , Shire , Sunovion , Supernus , Takeda , Taisho and Teva . Funding Information: K.R. has received a grant from Takeda Pharmaceuticals. Funding Information: A.R. reports the following financial disclosures in the last 3 years: Advisor/consultant/speaker for Medice, Janssen, SAGE, Servier and Shire/Takeda. He has also received grant support from the EC. Funding Information: B.F. has received educational speaking fees from Medice. She also received grant funding from the Netherlands Organization for Scientific Research (NWO) Vici Innovation Program (personal grant 016–130-669 to B.F.), European Community Horizon 2020 Programme ( H2020/2014 – 2020 ) under grant agreement no. 667302 (CoCA). Funding Information: C.H. reports lecture fees and honorarium in 2019 from the British Association of Psychopharmacology (BAP). He has also received funding from the National Institute for Health Research (NIHR) ; UK Medical Research Council (MRC) . Funding Information: A.T. had research funded by Wellcome Trust, MRC, ESRC and Waterloo Foundation. Funding Information: D.D. reports grants, personal fees and non-financial support from Shire/Takeda. Personal fees and non-financial support from Medice and Eli Lilly. Non-financial support from QbTech. And book royalties from Jessica Kingsley from the self-help version of the New Forest Parenting Programme and fees from the provision of training and supervision for the New Forest Parent Training Programme. Funding Information: J.T.N. has received grant funding support from the National Institute of Mental Health . Funding Information: S.D. received research supported by grants from The Lundbeck Foundation (iPSYCH grant no. R248-2017-2003 ), National Institute of Health (R01, grant no. ES026993 ), Novo Nordisk Foundation (grant no. 22018 ), the European Commission (Horizon 2020, grant no. 667302 ), Tryg Foundation ( 109399 ), Helsefonden (grant no. 19-8-0260 ) and the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 847879 . Funding Information: E.M. reports the following financial disclosures in the last 3 years: Advisory/Lecture for: Teva Israel, Medison Ltd . He also received grant support from the Israel Ministry of Health . Publisher Copyright: © 2021 The Author(s)
Keywords: ADHD, Brain, Course, Diagnosis, Genetics, Outcome, Treatment

Identifiers

Local EPrints ID: 446961
URI: http://eprints.soton.ac.uk/id/eprint/446961
ISSN: 0149-7634
PURE UUID: 26346057-26bd-4509-be11-0748c8487b5d
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

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Date deposited: 01 Mar 2021 17:30
Last modified: 17 Mar 2024 03:37

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Author: Stephen.V. Faraone
Author: Samuele Cortese ORCID iD
Corporate Author: et al.

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