[Drug treatment of school children with attention deficit and hyperactivity disorder].
BACKGROUND
The use of stimulants in the treatment of AD/HD has increased dramatically over the last twenty years. We wanted to assess the prevalence of students treated with stimulants in the elementary schools in the city of Trondheim, Norway.


METHODS
Fifty of 53 schools (94%), representing 16,141 students, answered two questionnaires. Mentally retarded, autistic and otherwise severely handicapped students attending special groups or schools, were excluded.


RESULTS
In all, 57 students (3.5 per 1,000) were treated with either methylphenidate or racemic amphetamine. Multivariate analysis suggested that the structure of the classroom was an essential risk factor for being treated with stimulants. The risk was higher in so-called "open schools" (no fixed walls between groups of students) than in schools with traditional classrooms (< 30 students in rooms separated by fixed walls). (Odds ratio: 5.5; 95% confidence interval: 1.1-26.4.) More detailed information was obtained from 47 of the 57 students; only one of whom was female. Teaching resources required for optimal pedagogical treatment were available for about one out of two of these 47 students.


CONCLUSIONS
Our results do not suggest that an inappropriately high proportion of students in the region are taking stimulants for AD/HD. On the contrary, AD/HD may be underdiagnosed and inadequately treated in girls. It seems likely that students with AD/HD are less likely to be treated with stimulants in schools with traditional classrooms, and our results also suggest a lack of teaching resources for these students.
Vik
T
T
Trondsletten habiliteringssenter for barn, Institutt for samfunnsmedisinske fag og allmennpraksis Norges teknisk-naturvitenskapelige universitet 7489 Trondheim. torstein.vik@medisin.ntnu.no
Grov
B
B
Garåsen
H
H
D000293:Adolescent; D000661:Amphetamine / Q000008:administration & dosage / Q000009:adverse effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects; D009664:Norway / Q000453:epidemiology; D012572:School Health Services; D011795:Surveys and Questionnaires
D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000661:Amphetamine