European clinical guidelines for hyperkinetic disorder -- first upgrade.

Background: The validity of clinical guidelines changes over time, because new evidence-based knowledge and experience develop.

Objective: Hence, the European clinical guidelines on hyperkinetic disorder from 1998 had to be evaluated and modified.

Method: Discussions at the European Network for Hyperkinetic Disorders (EUNETHYDIS) and iterative critique of each clinical analysis. Guided by evidence-based information and based on evaluation (rather than metaanalysis) of the scientific evidence a group of child psychiatrists and psychologists from several European countries updated the guidelines of 1998. When reliable information is lacking the group gives a clinical consensus when it could be found among themselves.

Results: The group presents here a set of recommendations for the conceptualization and management of hyperkinetic disorder and attention deficit/hyperactivity disorder (ADHD).

Conclusion: A general scheme for practice in Europe could be provided, on behalf of the European Society for Child and Adolescent Psychiatry (ESCAP).