The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder.

OBJECTIVE: The objective of this article was to provide an overview of the development and recommendations from the Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). The guideline aims to promote accurate and timely identification and diagnosis, and optimal and consistent treatment of ADHD. METHODS: Development integrated the best available evidence with multidisciplinary clinical expertise and the preferences of those with lived experience, underpinned by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The 23 guideline development group members included psychiatrists, paediatricians, general practitioners, psychologists, speech pathologists, occupational therapists, educators, Indigenous psychologists, and people with a lived experience; with two independent chairs and a methodologist. Where appropriate, evidence reviews from the National Institute for Health and Care Excellence (NICE) 2018 'Attention Deficit Hyperactivity Disorder: Diagnosis and Management' guideline were updated. Fifty prioritised clinical questions were addressed in 14 systematic reviews (new and updated from NICE 2018) and 28 narrative reviews. RESULTS: The 113 clinical recommendations apply to young children (5 years and under), children, adolescents and adults. They provide guidance for clinicians on identification, screening, diagnosis, multimodal treatment and support, including pharmacological and non-pharmacological interventions. The guideline and supporting information are available online: https://adhdguideline.aadpa.com.au/. CONCLUSIONS: The guideline was approved by the National Health and Medical Research Council (NHMRC) of Australia and relevant medical and allied health professional associations. It is anticipated that successful implementation and uptake of the guideline by organisations, health care providers and other professionals will increase delivery of evidence-based treatment and improve health outcomes for the more than 800,000 Australians with ADHD.

Psychiatrists' experiences of being stalked: a qualitative analysis.

Stalking is a well-recognized social phenomenon, one that particularly affects health care professionals, especially psychiatrists and other mental health workers; however, the nature and effects of stalking of psychiatrists have not been examined in detail. This study is a qualitative thematic analysis of the free-text responses of 2,585 psychiatrists in the United Kingdom (approximately 25% of all U.K. psychiatrists), almost 11 percent of whom described being stalked according to a strict research definition, and 21 percent of whom perceived themselves as having been stalked. It demonstrates that threat minimization, negative psychological impact, awareness of vulnerability, and difficulty obtaining help were major themes in how psychiatrists viewed their experiences of being stalked. It shows how some psychiatrists coped better than others and makes suggestions for appropriate professional support.

Who stalks? A description of patients at a high security hospital with a history of stalking behaviour.

BACKGROUND: Knowledge about stalking, and in particular the people who do it, is limited in the UK. AIM: This study aims to describe a sample of stalkers drawn from the resident population of Broadmoor high security hospital in the UK. METHODS: Case notes and research database information for 362 consecutive admissions were used to identify stalkers retrospectively. Data were extracted using a stalking behaviour screening checklist. RESULTS: A total of 33 patients (9.1%) were classified as stalkers. They were mostly male (28), young (median age 29), unmarried (30), minimally educated and unemployed. Most had psychosis and personality disorder. They had inflicted a wide range of unwanted intrusions and communications on their victims, and both threats (55%) and assaults (45%) were common. The types of stalkers were more or less equally split between intimacy seeking, rejected suitors, resentful and predatory, with only a tiny group being incompetent suitors. CONCLUSIONS: Although this small group of stalkers had been intrusive and attacking, few had been referred for treatment because of the stalking. The screening questionnaire is easy to use and can be done from records. It may be that such screening should become routine in specialist secure hospitals.

Stalking of mental health professionals: an underrecognised problem.

Doctors and mental healthcare professionals are at greater risk of being stalked than the general population, particularly by their patients. Despite causing significant psychological distress, stalking remains underrecognised and poorly managed. Healthcare organisations should ensure appropriate policies are in place to aid awareness and minimise risk, including the provision of formal educational programmes.