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


CONCLUSIONS
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.
Tremmery
Sabine
S
Department of Psychiatry, University Hospital, De Pintelaan 185, 9000, Gent, Belgium.
Buitelaar
Jan K
JK
Steyaert
Jean
J
Molenberghs
Geert
G
Feron
Frans J M
FJ
Kalff
Ariane C
AC
Hurks
Petra P M
PP
Hendriksen
Jos G M
JG
Vles
Johan S H
JS
Jolles
Jelle
J
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D002662:Child Health Services / Q000706:statistics & numerical data*; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003710:Demography; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D009426:Netherlands / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D012017:Referral and Consultation / Q000706:statistics & numerical data
D000697:Central Nervous System Stimulants; D008774:Methylphenidate