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The use of health care services and psychotropic medication in a community sample of 9-year-old schoolchildren with ADHD

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Abstract

Objective

To examine the prevalence of the use of health care services and psychotropic medication within a community sample (N = 283) of 9-year-old school children and, more specifically, to evaluate the use of prescribed stimulants.

Methods

Data from the second follow-up phase of the “Study of Attention Deficit Maastricht” (SAM) were analysed. Assessments at age 9 included a structured psychiatric interview with parents, behaviour and family situation questionnaire, IQ estimate and global assessment scale. Use of health care services and medication was obtained by the DICA-R and from the Youth Health Care records.

Results

About 190 children of the selected sample had at least one child psychiatric diagnosis, 26 (14%) of them were clinically referred and 12 (6%) received stimulants. Of the children with ADHD (N = 45), 10/45 (22%) received stimulants. Conversely, 2 out of 12 children who were treated with stimulants did not meet full DSM-IV diagnostic criteria, but were subthreshold ADHD cases. The treatment status was highly dependent on being clinically referred.

Conclusion

The major finding of our survey is a lack of referral to child mental health services, and associated underdiagnosis and undertreatment, particularly in children with ADHD. There is a critical need to translate and implement the diagnostic and treatment guidelines to clinical practice.

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Acknowledgements

This research was supported by Maastricht University Hospital, Zorg Onderzoek Nederland (Netherlands Organization for Health Research and Development; formally the Prevention Foundation of the Netherlands), the Brain & Behaviour Research Institute of Maastricht University and the Clemens Foundation of the Netherlands.

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Authors and Affiliations

  1. Dept. of Psychiatry, University Hospital, De Pintelaan 185, 9000, Gent, Belgium

    Sabine Tremmery

  2. Dept. of Psychiatry, Radboud University Nijmegen Medical Centre, and Karakter, Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands

    Jan K. Buitelaar

  3. Dept. of Psychiatry, University of Leuven, Leuven, Belgium

    Jean Steyaert

  4. Dept. of Biostatistics, Hasselt University, Hasselt, Belgium

    Geert Molenberghs

  5. Youth Health Care Service, Municipal Health Center, Maastricht, Netherlands

    Frans J.M. Feron

  6. Dept. of Psychiatry & Neuropsychology, Maastricht University, Maastricht, Netherlands

    Ariane C. Kalff, Petra P.M. Hurks & Jelle Jolles

  7. Gedragswetenschappelijke Dienst van Kempenhaeghe, Heezeam, Netherlands

    Jos G.M. Hendriksen

  8. Dept. of Neurology, Maastricht University Hospital, Maastricht, Netherlands

    Johan S.H. Vles

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  1. Sabine Tremmery
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  2. Jan K. Buitelaar
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Correspondence to Sabine Tremmery.

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Tremmery, S., Buitelaar, J.K., Steyaert, J. et al. The use of health care services and psychotropic medication in a community sample of 9-year-old schoolchildren with ADHD. Eur Child Adolesc Psychiatry 16, 327–336 (2007). https://doi.org/10.1007/s00787-007-0604-5

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