title: International variation in treatment procedures for ADHD: social context and recent trends.
abstract: OBJECTIVE
  Scientific and clinical interest in attention-deficit hyperactivity disorder (ADHD) is increasing worldwide. This article presents data from a cross-national workshop and survey related to questions of variability in diagnostic and, particularly, treatment procedures.
  
  
  METHODS
  Representatives of nine nations (Australia, Brazil, Canada, China, Germany, Israel, the Netherlands, Norway, and the United Kingdom), plus the United States, who attended a 2010 workshop on ADHD, responded to a survey that addressed diagnostic procedures for ADHD; treated prevalence of medication approaches, as well as psychosocial interventions; types of medications and psychosocial treatments in use; payment systems; beliefs and values of the education system; trends related to adult ADHD; and cultural and historical attitudes and influences related to treatment.
  
  
  RESULTS
  Use of both medication and psychosocial treatment for ADHD varies widely within and across nations. More expensive long-acting formulations of medications are becoming more widespread. Nations with socialized medical care provide a wide array of evidence-based interventions. Economic, historical, and political forces and cultural values are related to predominant attitudes and practices. Strong antipsychiatry and antimedication voices remain influential in many nations.
  
  
  CONCLUSIONS
  There is considerable variation in implementation of care for ADHD. Recognition of the social context of ADHD is an important step in ensuring access to evidence-based interventions for this prevalent, chronic, and impairing condition.
authors.affiliation: Department of Psychology, the University of California, Berkeley, CA, USA. hinshaw@berkeley.edu
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Hinshaw
authors.forename: Richard M
authors.initials: RM
authors.lastname: Scheffler
authors.forename: Brent D
authors.initials: BD
authors.lastname: Fulton
authors.forename: Heidi
authors.initials: H
authors.lastname: Aase
authors.forename: Tobias
authors.initials: T
authors.lastname: Banaschewski
authors.forename: Wenhong
authors.initials: W
authors.lastname: Cheng
authors.forename: Paulo
authors.initials: P
authors.lastname: Mattos
authors.forename: Arne
authors.initials: A
authors.lastname: Holte
authors.forename: Florence
authors.initials: F
authors.lastname: Levy
authors.forename: Avi
authors.initials: A
authors.lastname: Sadeh
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Sergeant
authors.forename: Eric
authors.initials: E
authors.lastname: Taylor
authors.forename: Margaret D
authors.initials: MD
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D003625:Data Collection; D004493:Education; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D010818:Practice Patterns, Physicians'; D012922:Social Change