Packages of care for ADHD in low- and middle-income countries

In the final article in a six part series on treating mental health problems in resource-poor settings, Alan Flisher, from the University of Cape Town, and colleagues present "packages of care" for treating Attention-Deficit/Hyperactivity Disorder in low- and middle-income countries.

Attention-deficit/hyperactivity disorder (AD/HD) is a pervasive developmental disorder that, although commonest in childhood and adolescence, can be diagnosed at any age. The chronic condition affects individuals throughout their lives, across all cultural contexts, say the authors, and is associated with considerable social, psychological, and economic adversity. Its worldwide prevalence is about 5%.

Packages of care are combinations of treatments aimed at improving the recognition and management of conditions to achieve optimal outcomes. The authors found that "an appropriate package of treatment for AD/HD in low- and middle-income countries (LMICs) should include screening of high-risk groups, psycho-educational interventions with caregivers, methylphenidate, and behavioral interventions."

The PLoS Medicine series on mental, neurological and substance use disorders in LMICs is accompanied by a related perspective by Vikram Patel and Graham Thornicroft, the guest editors of the series. The series collection page, with links to the five other articles in the series, is compiled on Speaking of Medicine, the PLoS Medicine blog: http://speakingofmedicine.plos.org/2009/10/12/collection-page-for-new-series-on-mental-health-in-low-and-middle-income-countries/