Use of medication by young people with attention-deficit/hyperactivity disorder.
OBJECTIVE
To examine the prevalence of psychotropic medication use by children with attention-deficit/hyperactivity disorder (ADHD) and children without ADHD. To identify factors associated with stimulant use by children in the community.


METHODS
A representative, multistage probability sample of Australian households was conducted in 1998. Parents completed questionnaires assessing children's mental health problems and health-related quality of life. They also completed a structured interview to identify children's psychiatric disorders and their use of medications during the previous six months.


METHODS
Parent or main caregiver of 3597 children aged 6-17 years.


METHODS
Rates of use of stimulants (dexamphetamine and methylphenidate), antidepressants and clonidine by children.


RESULTS
Overall, 1.8% of children (95% CI, 1.5%-2.3%) were receiving stimulant medication. Of those with ADHD, 12.6% (95% CI, 9.8%-16.1%) were being treated with stimulants, 2.3% (95% CI, 1.3%-4.3%) with antidepressants, and 1.9% (95% CI, 1.0%-3.7%) with clonidine. Among children without ADHD, 0.5% (95% CI, 0.3%-0.8%) were receiving stimulant medication. This represented 22.9% (95% CI, 14.6%-34.0%) of all the children who were receiving stimulants. Variables significantly associated with stimulant use were being male, having ADHD, attending a paediatrician, and having higher scores on the Aggressive Behaviour and Attention Problems scales on the Child Behaviour Checklist.


CONCLUSIONS
About 13% of Australian children with ADHD, and a substantial number of children without ADHD, are taking stimulants. The question of whether Australian children are being undertreated or overtreated with stimulant medication depends on the criteria used to assess the appropriateness of stimulant use. Additional information is needed to clarify when stimulants should be used to treat ADHD.
Sawyer
Michael G
MG
Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006, Australia. michael.sawyer@adelaide.edu.au
Rey
Joseph M
JM
Graetz
Brian W
BW
Clark
Jennifer J
JJ
Baghurst
Peter A
PA
D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001315:Australia / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003000:Clonidine / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D006801:Humans; D007407:Interviews as Topic; D008774:Methylphenidate / Q000627:therapeutic use; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires
D000928:Antidepressive Agents; D000697:Central Nervous System Stimulants; D011619:Psychotropic Drugs; D008774:Methylphenidate; D003907:Dexamethasone; D003000:Clonidine