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Clinical and social factors associated with attention-deficit hyperactivity disorder medication use: population-based longitudinal study

  • Cédric Galéra (a1), Jean-Baptiste Pingault (a2), Grégory Michel (a3), Manuel-Pierre Bouvard (a4), Maria Melchior (a5), Bruno Falissard (a6), Michel Boivin (a7), Richard E. Tremblay (a8) and Sylvana M. Côté (a9)...
Abstract
Background

The impact of longitudinal psychiatric comorbidity, parenting and social characteristics on attention-deficit hyperactivity disorder (ADHD) medication use is still poorly understood.

Aims

To assess the baseline and longitudinal influences of behavioural and environmental factors on ADHD medication use.

Method

Survival regressions with time-dependent covariates were used to model data from a population-based longitudinal birth cohort. The sample (n = 1920) was assessed from age 5 months to 10 years. Measures of children's psychiatric symptoms, parenting practices and social characteristics available at baseline and during follow-up were used to identify individual and family-level features associated with subsequent use of ADHD medication.

Results

Use of ADHD medication ranged from 0.2 to 8.6% between ages 3.5 to 10 years. Hyperactivity–inattention was the strongest predictor of medication use (hazard ratio (HR) = 2.75, 95% CI 2.35–3.22). Among all social variables examined, low maternal education increased the likelihood of medication use (HR = 2.09, 95% CI 1.38–3.18) whereas immigrant status lowered this likelihood (HR = 0.40, 95% CI 0.17–0.92).

Conclusions

Beyond ADHD symptoms, the likelihood of receiving ADHD medication is predicted by social variables and not by psychiatric comorbidity or by parenting. This emphasises the need to improve global interventions by offering the same therapeutic opportunities (including medication) as those received by the rest of the population to some subgroups (i.e. immigrants) and by diminishing possible unnecessary prescriptions.

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Copyright
Corresponding author
Dr Cédric Galéra, Department of Child and Adolescent Psychiatry, University of Bordeaux, CH Perrens, 121 rue de la Béchade, 33076 Bordeaux, France. Email: cedric.galera@u-bordeaux.fr
Footnotes
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These authors contributed equally to the work; ∗∗these authors share the senior authorship.

This study was funded by Quebec's Department of Health and Social Services, the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council of Canada, the Quebec Fund for Research on Society and Culture, the Quebec Fund for Research on Nature and Technology, the Health Research Fund of Quebec, Quebec's Ministry of Research, Science, and Technology, Human Resources Development Canada, Health Canada, the Lucie and André Chagnon Foundation, the National Science Foundation, the University of Montreal, Laval University and McGill University.

Declaration of interest

M.-P.B. has received financial support for the organisation of scientific meetings and was also the principal investigator in clinical trials for Shire and Lilly. In the past, C.G. received support from the industry to attend scientific congresses.

Footnotes
References
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1 Banaschewski, T, Coghill, D, Santosh, P, Zuddas, A, Asherson, P, Buitelaar, J, et al. Long-acting medications for the hyperkinetic disorders. A systematic review and European treatment guideline. Eur Child Adolesc Psychiatry 2006; 15: 476–95.
2 Greenhill, L, Kollins, S, Abikoff, H, McCracken, J, Riddle, M, Swanson, J, et al. Efficacy and safety of immediate-release methylphenidate treatment for preschoolers with ADHD. J Am Acad Child Adolesc Psychiatry 2006; 45: 1284–93.
3 Prasad, V, Brogan, E, Mulvaney, C, Grainge, M, Stanton, W, Sayal, K. How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2013; 22: 203–16.
4 Loe, IM, Feldman, HM. Academic and educational outcomes of children with ADHD. J Pediatr Psychol 2007; 32: 643–54.
5 Lichtenstein, P, Larsson, H. Medication for attention deficit-hyperactivity disorder and criminality. N Engl J Med 2013; 368: 776.
6 van de Loo-Neus, GH, Rommelse, N, Buitelaar, JK. To stop or not to stop? How long should medication treatment of attention-deficit hyperactivity disorder be extended? Eur Neuropsychopharmacol 2011; 21: 584–99.
7 Molina, BS, Hinshaw, SP, Eugene Arnold, L, Swanson, JM, Pelham, WE, Hechtman, L, et al. Adolescent substance use in the multimodal treatment study of attention-deficit/hyperactivity disorder (ADHD) (MTA) as a function of childhood ADHD, random assignment to childhood treatments, and subsequent medication. J Am Acad Child Adolesc Psychiatry 2013; 52: 250–63.
8 Cortese, S, Holtmann, M, Banaschewski, T, Buitelaar, J, Coghill, D, Danckaerts, M, et al. European ADHD Guidelines Group. Practitioner review: current best practice in the management of adverse events during treatment with ADHD medications in children and adolescents. J Child Psychol Psychiatry 2013; 54: 227–46.
9 Food and Drug Administration. FDA Drug Safety Communication: Safety Review Update of Medications used to treat Attention-Deficit/Hyperactivity Disorder (ADHD) in Children and Young Adults. FDA, 2011 (http://www.fda.gov/drugs/drugsafety/ucm277770.html).
10 Rey, JM, Sawyer, MG. Are psychostimulant drugs being used appropriately to treat child and adolescent disorders? Br J Psychiatry 2003; 182: 284–6.
11 National Institute for Health and Care Excellence. Attention Deficit Hyperactivity Disorder. Diagnosis and Management of ADHD in Children, Young People and Adults. NICE clinical guideline 72. NICE, 2008.
12 Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management, Wolraich, M, Brown, L, Brown, RT, DuPaul, G, Earls, M, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics 2011; 128: 1007–22.
13 International Narcotics Control Board. Report of the International Narcotics Control Board for 2012. International Narcotics Control Board, 2012 (http://www.incb.org/incb/fr/publications/annual-reports/annual-report-2012.html).
14 Scheffler, RM, Hinshaw, SP, Modrek, S, Levine, P. The global market for ADHD medications. Health Aff (Millwood) 2007; 26: 450–7.
15 Zuvekas, SH, Vitiello, B. Stimulant medication use in children: a 12-year perspective. Am J Psychiatry 2012; 169: 160–6.
16 Olfson, M, Gameroff, MJ, Marcus, SC, Jensen, PS. National trends in the treatment of attention deficit hyperactivity disorder. Am J Psychiatry 2003; 160: 1071–7.
17 Sonuga-Barke, EJ, Brandeis, D, Cortese, S, Daley, D, Ferrin, M, Holtmann, M, et al. Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 2013; 170: 275–89.
18 Singh, I. Beyond polemics: science and ethics of ADHD. Nat Rev Neurosci 2008; 9: 957–64.
19 Graham, J, Coghill, D. Adverse effects of pharmacotherapies for attention-deficit hyperactivity disorder: epidemiology, prevention and management. CNS Drugs 2008; 22: 213–37.
20 Leslie, LK, Wolraich, ML. ADHD service use patterns in youth. J Pediatr Psychol 2007; 32: 695710.
21 Bird, HR, Shrout, PE, Duarte, CS, Shen, S, Bauermeister, JJ, Canino, G. Longitudinal mental health service and medication use for ADHD among Puerto Rican youth in two contexts. J Am Acad Child Adolesc Psychiatry 2008; 47: 879–89.
22 Hjern, A, Weitoft, GR, Lindblad, F. Social adversity predicts ADHD-medication in school children–a national cohort study. Acta Paediatr 2010; 99: 920–4.
23 Lindblad, F, Ringbäck Weitoft, G, Hjern, A. Maternal and paternal psychopathology increases risk of offspring ADHD equally. Epidemiol Psychiatr Sci 2011; 20: 367–72.
24 Miller, AR, Kohen, D, Johnston, C. Child characteristics and receipt of stimulant medications: a population-based study. Ambul Pediatr 2008; 8: 175–81.
25 Romano, E, Thornhill, S, Lacourse, E. An 8-year follow-up study of profiles and predictors of methylphenidate use in a nationwide sample of boys. J Pediatr 2009; 155: 721–27.
26 Winterstein, AG, Gerhard, T, Shuster, J, Zito, J, Johnson, M, Liu, H, et al. Utilization of pharmacologic treatment in youths with attention deficit/hyperactivity disorder in Medicaid database. Ann Pharmacother 2008; 42: 2431.
27 Statistics Canada. Overview of Survey Instruments for 1994–1995 Data Collection, Cycle 1. Statistics Canada, 1995.
28 Achenbach, TM. Child Behavior Checklist. Department of Psychiatry, University of Vermont, 1991.
29 Boyle, MH, Offord, DR, Racine, Y, Sanford, M, Szatmari, P, Fleming, JE. Evaluation of the original Ontario Child Health Study scales. Can J Psychiatry 1993; 38: 397405.
30 Tremblay, RE, Desmarais-Gervais, L, Gagnon, C, Charlebois, P. The Preschool Behavior Questionnaire: stability of its factor structure between cultures, sexes, ages and socioeconomic classes. Int J Behav Dev 1987; 10: 467–84.
31 Boivin, M, Pérusse, D, Dionne, G, Saysset, V, Zoccolillo, M, Tarabulsy, GM, et al. The genetic-environmental etiology of parents' perceptions and self-assessed behaviours toward their 5-month-old infants in a large twin and singleton sample. J Child Psychol Psychiatry 2005; 46: 612–30.
32 Radloff, LS. The CESD-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385401.
33 Therneau, T (2013). A Package for Survival Analysis in S. R Package Version 2.37. (http://CRAN.R-project.org/package=survival).
34 Rucklidge, JJ. Gender differences in attention-deficit/hyperactivity disorder. Psychiatr Clin North Am 2010; 33: 357–73.
35 Galéra, C, Côté, SM, Bouvard, MP, Pingault, JB, Melchior, M, Michel, G, et al. Early risk factors for hyperactivity-impulsivity and inattention trajectories from age 17 months to 8 years. Arch Gen Psychiatry 2011; 68: 1267–75.
36 Sonuga-Barke, EJ, Halperin, JM. Developmental phenotypes and causal pathways in attention deficit/hyperactivity disorder: potential targets for early intervention? J Child Psychol Psychiatry 2010; 51: 368–89.
37 Singh, I. Doing their jobs: mothering with Ritalin in a culture of mother-blame. Soc Sci Med 2004; 59: 1193–205.
38 Singh, GK, Yu, SM, Kogan, MD. Health, chronic conditions, and behavioral risk disparities among U.S. immigrant children and adolescents. Public Health Rep 2013; 128: 463–79.
39 Knopf, H, Holling, H, Huss, M, Schlack, R. Prevalence, determinants and spectrum of attention-deficit hyperactivity disorder (ADHD) medication of children and adolescents in Germany: results of the German Health Interview and Examination Survey (KiGGS). BMJ Open 2012; 2: e000477.
40 Visser, SN, Lesesne, CA, Perou, R. National estimates and factors associated with medication treatment for childhood attention-deficit/hyperactivity disorder. Pediatrics 2007; 119 (suppl 1): S99106.
41 Pastor, PN, Reuben, CA. Racial and ethnic differences in ADHD and LD in young school-age children: parental reports in the National Health Interview Survey. Public Health Rep 2005; 120: 383–92.
42 Zima, BT, Bussing, R, Tang, L, Zhang, L, Ettner, S, Belin, TR, et al. Quality of care for childhood attention-deficit/hyperactivity disorder in a managed care Medicaid program. J Am Acad Child Adolesc Psychiatry 2010; 49: 1225–37.
43 Thomas, R, Mitchell, GK, Batstra, L. Attention-deficit/hyperactivity disorder: are we helping or harming? BMJ 2013; 347: f6172.
44 Boisjoli, R, Vitaro, F, Lacourse, É, Barker, ED, Tremblay, RE. Impact and clinical significance of a preventive intervention for disruptive boys: a 15 year follow-up. Br J Psychiatry 2007; 191: 415–9.
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Clinical and social factors associated with attention-deficit hyperactivity disorder medication use: population-based longitudinal study

  • Cédric Galéra (a1), Jean-Baptiste Pingault (a2), Grégory Michel (a3), Manuel-Pierre Bouvard (a4), Maria Melchior (a5), Bruno Falissard (a6), Michel Boivin (a7), Richard E. Tremblay (a8) and Sylvana M. Côté (a9)...
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