title: Diagnosing childhood attention-deficit/hyperactivity disorder. Do family practitioners and pediatricians make the same call?
abstract: BACKGROUND
  The purpose of this study was to determine whether--and if so, how--primary care physicians in Minnesota differ in diagnosing and treating childhood ADHD.
  
  
  METHODS
  A questionnaire was mailed to 200 family physicians (100 urban; 100 rural) and 100 pediatricians (60 urban; 40 rural). The questionnaire asked about assessment, diagnosis, and treatment strategies physicians would use in response to three patient vignettes.
  
  
  RESULTS
  While all physicians in both specialities reported similar differential diagnoses, pediatricians used more special tests and assessment scales than family physicians (p < 0.05). More family physicians referred patients for further evaluation (p < 0.05). Eighty-nine percent of pediatricians used DSM-IV criteria compared with 37% of family physicians (p < 0.001). Parents (98%) and teachers (82%) were usually involved in management planning, and methylphenidate (Ritalin) was the most commonly prescribed drug (87%).
  
  
  CONCLUSIONS
  Regardless of specialty, size of community, or distance from mental health services, physicians in this study did not differ in the diagnosis or treatment of ADHD in response to hypothetical cases. Pediatricians reported using DSM-IV criteria in their practices when making diagnoses more often than family physicians.
authors.affiliation: University of Minnesota, USA.
authors.forename: B
authors.initials: B
authors.lastname: Evink
authors.forename: B J
authors.initials: BJ
authors.lastname: Crouse
authors.forename: B A
authors.initials: BA
authors.lastname: Elliott
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003937:Diagnosis, Differential; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008910:Minnesota; D015588:Observer Variation; D010348:Patient Care Team; D010372:Pediatrics; D011569:Psychiatric Status Rating Scales
chemical_list: D000697:Central Nervous System Stimulants