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A brief chronological review

In the 1980s, the European Union (EU) offered a scholarship to visit sister institutions to establish common educational programmes. A visit of Professor Joe Sergeant to Professor Eric Taylor at the Institute of Psychiatry, King`s College London led to the idea that a joint training programme on ADHD and associated disorders for clinical researchers in Europe was overdue. Later, Ciba-Geigy (now ‘Novartis International AG’) offered to support a meeting organized by Professor Hans-Christoph Steinhausen in Zürich in 1987. At a subsequent meeting in Rome, it was decided by all participants that the initiative needed a name, and went for ‘EUNETHYDIS’.

Over the next 10 years, annual meetings took place to share and present crucial ADHD-related research in European centres, and to layout plans for a common research programme. An important grant application by Professor Terje Sagvolden was awarded in this period. This grant, Biopsychology of Hyperkinesia (Biophyris), enabled research teams from clinics, experimental psychology, and the biological sciences to collaborate. The research programme was described by Sagvolden and Sergeant (1998). Links between the different areas of expertise within the programme have been summarized by Taylor et al. (1998). Joint research in various areas, including neuropsychology (Rubia, Oosterlaan, Sergeant, Brandeis & van Leeuwen, 1998; Sonuga-Barke, Saxton & Hall, 1998), animal research (Boix, Qiao, Kolpus & Sagvolden, 1998; Carey et al., 1998; Papa, Sergeant & Sadile, 1998; Russell et al., 1998; Sagvolden, Aase, Zeiner & Berger, 1998) and psychophysiology (Oades, 1998; van Leeuwen et al., 1998; Brandeis et al., 1998), were published.

This research programme demonstrated that EUNETHYDIS can deliver effective collaborative research in which the importance of training young researchers was emphasized and developed. For example, a special section of the EUNETHYDIS annual meeting is solely devoted to presentations by early career researchers (“Junior EUNETHYDIS”), followed by feedback from more senior members. During these sessions, most valuable input came from James Swanson on how to evaluate therapeutic interventions, and which ‘rules of thumb’ might be useful for clinical practice.

Through a plan initiated by Professors Phil Asherson and Steve Faraone, the International Molecular Genetic study of ADHD (IMAGE) enabled various EUNETHYDIS centres to participate in a study of combined subtype ADHD at the neuropsychological and genetic levels (Neale et al., 2010). This laid the seeds for later research projects supported by the EU.

In the 1990s, the need to define the clinical benchmarks for treating ADHD became a primary concern for EUNETHYDIS. Clinical guidelines for the disorder were developed (Taylor et al., 1998), updated (Taylor et al., 2004), and expanded (Banaschewski et al., 2006). Special attention was given to the management of adverse effects (Graham et al., 2011; Cortese et al., 2013), and to the quality of life of ADHD patients (Coghill et al., 2009; Danckaerts et al., 2009). This research was conducted by a EUNETHYDIS workgroup which became known as the European ADHD Guidelines Group (EAGG).

The EAGG persisted in its activities by addressing several critical issues concerning clinical interventions in ADHD, for example the effectiveness of non-pharmacological interventions for ADHD. A systematic review and meta-analyses of dietary and psychological treatments was reported (Sonuga-Barke et al., 2013) and was followedby updated reviews and meta-analyses for behavioural interventions (Daley et al., 2014) as well as dietary interventions (Stevenson et al., 2014), cognitive training (add REF), and neurofeedback (Cortese et al., 2015; Cortese et al., 2016). Critical evaluation of the effectiveness of medication in ADHD has been a crucial task of the EAGG workgroup, and has recently been conducted using a network analysis, thankfully indicating a clear effectiveness of most medications for ADHD (Cortese et al., 2018).

During the recent years of collaborative EUNETHYDIS research, the importance of associated conditions such as autism, oppositional defiant disorder (ODD), conduct disorder (CD), learning disabilities and developmental coordination disorder (DCD) has been recognized. Recent work continues to show both the communalities and specificities of ADHD and associated disorders (Geurts et al., 2004, 2008; Mulligan et al., 2008; Niemeyer et al., 2010; de Jong et al., 2009; Fliers et al., 2009; Rommelse et al., 2009, van Lieshout et al., 2017; 2018) as well as emotional dysregulation, ODD, CD and substance abuse (Schoenmacker et al., 2018). Developmental changes accompanying ADHD in adolescence and adulthood have been given attention by EUNETHYDIS groups (Franke et al., 2018; Hartman, Geurts, Buitelaar & Rommelse, 2016; Helfer et al., 2018; Kooij et al., 2018) not only as clinical phenomena but also in terms of cortical development (Hoogman et al., 2017).

We are confident that the European centres that form the backbone of EUNETHYDIS will continue in meeting the aims of training junior clinical researchers, joining forces in effective research and providing best evidence-based knowledge of the treatment of ADHD and its associated disorders.

References

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