Document Detail


Are stimulants overprescribed? Treatment of ADHD in four U.S. communities.
MedLine Citation:
PMID:  10405496     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To address rising concerns about the possible overdiagnosis of attention-deficit hyperactivity disorder (ADHD) and overtreatment with stimulants. To date, almost no studies have examined ADHD in unbiased community-based studies, ascertaining both the prevalence of the diagnosis within nonreferred populations and the extent to which various treatments (i.e., stimulant medication, mental health treatments, and educational interventions) are used. METHOD: As a part of the Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, the authors examined epidemiological survey data obtained from 1,285 children and their parents across 4 U.S. communities. Analyses examined the frequency of children's ADHD diagnosis, the extent to which medications were prescribed, as well as the provision of other services (e.g., psychosocial treatments, school-based educational interventions). RESULTS: Findings indicated that 5.1% of children met full DSM-III-RADHD criteria across the pooled sample. Only 12.5% of children meeting ADHD criteria had been treated with stimulants during the previous 12 months. Some children who had been prescribed stimulants did not meet full ADHD diagnostic criteria, but these children manifested high levels of ADHD symptoms, suggesting that the medication had been appropriately prescribed. Children with ADHD were generally more likely to receive mental health counseling and/or school-based interventions than medication. CONCLUSIONS: Medication treatments are often not used in treating ADHD children identified in the community, suggesting the need for better education of parents, physicians, and mental health professionals about the effectiveness of these treatments. On the basis of these data it cannot be concluded that substantial "overtreatment" with stimulants is occurring across communities in general.
Authors:
P S Jensen; L Kettle; M T Roper; M T Sloan; M K Dulcan; C Hoven; H R Bird; J J Bauermeister; J D Payne
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Academy of Child and Adolescent Psychiatry     Volume:  38     ISSN:  0890-8567     ISO Abbreviation:  J Am Acad Child Adolesc Psychiatry     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-08-05     Completed Date:  1999-08-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8704565     Medline TA:  J Am Acad Child Adolesc Psychiatry     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  797-804     Citation Subset:  IM    
Affiliation:
NIMH, Bethesda, MD 20892-9669, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Attention Deficit Disorder with Hyperactivity / drug therapy*,  epidemiology*
Central Nervous System Stimulants / therapeutic use*
Child
Community Mental Health Services / statistics & numerical data
Connecticut / epidemiology
Demography
Drug Utilization / statistics & numerical data*
Education, Special / statistics & numerical data
Female
Georgia / epidemiology
Health Services Misuse*
Health Surveys
Humans
Male
Methylphenidate / therapeutic use
New York / epidemiology
Prevalence
Puerto Rico / epidemiology
Sampling Studies
United States / epidemiology
Grant Support
ID/Acronym/Agency:
UO1 MH46717/MH/NIMH NIH HHS; UO1 MH46718/MH/NIMH NIH HHS; UO1 MH46725/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Central Nervous System Stimulants; 113-45-1/Methylphenidate
Comments/Corrections
Comment In:
J Am Acad Child Adolesc Psychiatry. 2000 Mar;39(3):269-70; author reply 270-1   [PMID:  10714041 ]
J Am Acad Child Adolesc Psychiatry. 2000 Mar;39(3):269; author reply 270-1   [PMID:  10714040 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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