title: Attention deficit hyperactivity disorder and medication use by children during parental military deployments.
abstract: OBJECTIVE
  Parental deployment is associated with children's increased mental health needs. Attention Deficit Hyperactivity Disorder (ADHD) is the most common pediatric mental health diagnosis. We hypothesize children with ADHD will have increased mental health and medication needs during parental deployment.
  
  
  METHODS
  Retrospective cohort study of children with ADHD aged 4-8 years in the Military Health System.
  
  
  RESULTS
  Of 413,665 children aged 4-8 years, 34,205 (8.3%) had ADHD and 19,123 (55.9%) of these were prescribed ADHD medications. During parental deployments, children with ADHD had a 13% increased rate of mental and behavioral health care visits (IRR 1.13 [95% CI 1.12-1.14; p < 0.00001]) and a decreased rate of medication changes (IRR 0.94 [95% CI 0.91-0.96; p < 0.00001]) compared to when parents were at home. Medication changes related to deployment varied by age; school-aged children had decreased medication events (IRR 0.88 [95% CI 0.86-0.91; p < 0.00001]) and preschool-aged children had increased medication events (IRR 1.05 [95% CI 1.02-1.10; p = .006]) during parental deployment.
  
  
  CONCLUSIONS
  During parental deployment, children with ADHD aged 4-8 years have increased mental health visits and decreased ADHD medication changes. Younger children have increased medication changes, whereas older children have decreased changes during a parent's deployment.
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hisle-Gorman
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Matilda
authors.initials: M
authors.lastname: Eide
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Coll
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Science, 4301 Jones Bridge Road, Bethesda, MD 20814.
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Gorman
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005192:Family Health / Q000706:statistics & numerical data; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008889:Military Personnel; D020380:Needs Assessment; D010290:Parents; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology