title: Patient characteristics associated with treatment initiation among paediatric patients with Attention-Deficit/Hyperactivity Disorder symptoms in a naturalistic setting in Central Europe and East Asia.
abstract: BACKGROUND
  Cultural views of Attention-Deficit/Hyperactivity Disorder (ADHD), differing healthcare systems and funding mechanisms, and the availability of mental health services can greatly influence the perceptions, diagnosis, and treatment of ADHD. There is, however, lack of information about treatment practice and the treatment decision-making process for ADHD, particularly in non-Western countries. Our study compared characteristics of paediatric patients newly diagnosed with ADHD symptoms who did and who did not initiate treatment, and also examined whether any differences varied by region in Central Europe and East Asia.
  
  
  METHODS
  Data were taken from a 1-year prospective, observational study that included 1,068 paediatric patients newly diagnosed with ADHD symptoms. Clinical severity was measured using the Clinical Global Impression-ADHD-Severity (CGI-ADHD-S) scale and the Child Symptom Inventory-4 (CSI-4) checklist. Logistic regression was used to explore patient characteristics associated with treatment initiation (pharmacotherapy and/or psychotherapy) at baseline for each region.
  
  
  RESULTS
  A total of 74.3% of patients initiated treatment at baseline (78.3% in Central Europe and 69.9% in East Asia). Of these, 48.8% started with both pharmacotherapy and psychotherapy in Central Europe, and only 17.1% did so in East Asia. The level of clinical severity was highest in the combination treatment group in Central Europe, but was highest in the psychotherapy only group in East Asia. In East Asia, treatment initiation was associated with being older, being male, and having a higher CGI-ADHD-S score. In Central Europe, treatment initiation was associated with parental psychological distress, having a higher CSI-4 score, and not being involved in bullying.
  
  
  CONCLUSIONS
  Although factors associated with treatment initiation differed to some extent between Central Europe and East Asia, clinical severity appeared to be one of the most important determinants of treatment initiation in both regions. However, the choice between pharmacotherapy and psychotherapy, either alone or in combination, varied substantially across the regions.
authors.affiliation: Eli Lilly and Company, Windlesham, Surrey, UK. jihyung.hong.kr@gmail.com.
authors.forename: Jihyung
authors.initials: J
authors.lastname: Hong
authors.affiliation: Eli Lilly and Company, Windlesham, Surrey, UK. novick_diego@lilly.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Novick
authors.affiliation: Eli Lilly and Company, Neuroscience Research, Budapest, Hungary. treuer_tamas@lilly.com.
authors.forename: Tamás
authors.initials: T
authors.lastname: Treuer
authors.affiliation: Eli Lilly Australia Pty Ltd, West Ryde, Australia. montgomery_bill@lilly.com.
authors.forename: William
authors.initials: W
authors.lastname: Montgomery
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA. ginger.haynes@lilly.com.
authors.forename: Virginia S
authors.initials: VS
authors.lastname: Haynes
authors.affiliation: Eli Lilly China, Shanghai, China. wu_sheng_hu@lilly.com.
authors.forename: Shenghu
authors.initials: S
authors.lastname: Wu
authors.affiliation: Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Barcelona, Spain. 27652jha@comb.cat.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Haro
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D005202:Asia, Eastern / Q000453:epidemiology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D005060:Europe / Q000453:epidemiology; D038622:Internationality; D008605:Mental Health Services / Q000706:statistics & numerical data; D011446:Prospective Studies; D011613:Psychotherapy / Q000379:methods; D011615:Psychotherapy, Group / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants