Hyperactivity is the most common neuropsychiatric disorder diagnosed in children. And around 1% of kids in the UK are thought to have the most extreme form - hyperkinesis.

The association between hyperactivity and behavioural problems is well known, say the authors, but the extent to which it appears to be a major risk for family break-down is much less well known.

They base their conclusions on 201 children, all of whom were patients at one child psychiatry clinic. The children's average age was 8, and three quarters of them were boys.

Half the children had either been diagnosed with emotional or behavioural disorders, and a further one in six had been diagnosed with both. Of the remainder, just under one in five (18.4%) had confirmed hyperkinesis.

In all, 18% of the children had been removed from their original families to foster parents, children's homes, or adoptive families. Some had also been admitted to hospital for prolonged periods.

Hyperkinetic children were more than three times as likely to have been removed from their families as all the other children in this sample. Exclusion of children with mixed disorders from the calculations increased the odds to more than four.

These findings held true, even after taking account of other negative social factors likely to influence the results, and are likely to apply to all hyperactive children seen by general paediatricians as well, say the authors.

Family disruption/break-down might be avoided if the hyperactivity were recognised sooner and treated, they suggest.

But an accompanying editorial says that the cut-off between pathology and a child with a difficult temperament is unclear, an
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Contact: Emma Dickinson
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BMJ Specialty Journals
20-Feb-2005