Clinicians across Europe say ADHD care still lacks practical evidence for tailoring treatment to individual patients. They also report that some existing research has not been carried into clinical guidelines or routine practice, while language barriers may make guidance harder to access. Those are the three broad unmet-need areas highlighted by a survey of clinicians involved in caring for children and adolescents with ADHD.
The online survey was completed by 1,441 clinicians of varying seniority from 23 European countries. It asked about medication-based and non-medication ADHD management practices and about clinicians' perceptions of treatment appropriateness. Its stated purpose was to characterize those practices and perceptions across Europe.
Three gaps in care
The first gap concerned treatment personalisation. The findings identify insufficient evidence on personalisation and on practical predictors of treatment response. Both parts of the finding are practical: the survey names predictors of response, not only the broad goal of personalised care.
The second gap was the movement of evidence into care. Some existing evidence had not been adequately translated into clinical guidelines or routine practice, particularly evidence on comparative treatment effects and dose-response relationships, meaning how a treatment response relates to dose, relevant to medication titration, or adjusting a medication dose. The unmet need therefore covers both the comparison of treatments and the practical use of dose information.
The third need involved access to guidance that international guidelines already address. The authors suggest language barriers may limit access and emphasize country-specific recommendations in local languages. The focus is therefore on making guidance reachable and relevant within national settings, not only on creating more guidance.
Why national guidance matters
The abstract places these concerns in an uneven national setting. Some European countries lack national ADHD guidelines, while others have guidance that is outdated or insufficiently detailed. It also points toward country-specific recommendations in local languages as a way to address the access problem identified by the survey.
The ESCAP Research Academy developed and implemented the survey with input from the European ADHD Guidelines Group. The authors describe it as, to their knowledge, the largest survey of its kind conducted in Europe. The survey is presented as an updated picture of European clinical practice, although it remains based on what respondents reported.
What the survey can and cannot answer
That distinction matters. This was an online survey, so the results capture clinicians' reports about management practices and their perceptions of treatment appropriateness. Respondents came from 23 countries and varied in seniority, but the survey alone cannot show how closely their views match practice among all European clinicians.
The authors say the findings can inform future clinical guidelines, research priorities, health policy and training programmes aimed at reducing bias in ADHD treatment perception and delivery. The survey-generated datasets can be made available on demand, and the authors declare no competing interests.
Paper data and sources
Original title: Clinical practices in ADHD management across Europe: findings from the ESCAP research academy survey.
Authors: Héloïse Young, Alexis Revet, Julie Hagstrøm et al.
Journal/Repository: European child & adolescent psychiatry
Status: Peer-reviewed
First online: 2026-08-21
DOI: 10.1007/s00787-026-03161-w
Original paper · Full text