First Treatment Contact for ADHD: Predictors of and Gender Differences in Treatment Seeking

Abstract

Objectives For attention-deficit hyperactivity disorder (ADHD), treatment seeking is a critical first step in treatment initiation and remains insufficiently understood. The aims of this study were to estimate ADHD treatment-seeking probabilities over the lifetime and to identify predictors of treatment seeking for ADHD separately for males and females. Methods Data were drawn from 2001 to 2005 as part of the National Epidemiologic Survey on Alcohol and Related Conditions, a two-wave face-to-face survey conducted by the National Institute on Alcohol Abuse and Alcoholism (N=34,653). Results The lifetime cumulative probability of ADHD treatment seeking was estimated at 55%. Males identifying as African American, with less than 12 years of education, or paranoid personality disorder or in an older cohort (>30 years old) at the time of interview were more likely to experience delays, whereas males with comorbid alcohol dependence, dysthymic disorder, borderline personality disorder, or histrionic personality disorder were less likely. Among females, older age (>44 years) was the only predictor of a delay to first treatment seeking, whereas bipolar disorder was associated with more rapid treatment seeking. Age of onset had opposite effects on treatment-seeking delays by gender; males but not females with early-onset ADHD were more likely to experience treatment-seeking delays. Conclusions A large proportion of persons with ADHD do not seek treatment. Furthermore, treatment seeking by males was affected by a greater number of identifiable characteristics, suggesting that males might be more responsive to efforts directed toward expediting treatment entry. Future research should explore how to facilitate early access to treatment for individuals with ADHD.

International Consensus Statement on Screening, Diagnosis and Treatment of Substance Use Disorder Patients with Comorbid Attention Deficit/Hyperactivity Disorder

“…Additionally, if an individual with SUD was not diagnosed with ADHD as a child, it is less likely that the behaviour as an adult will be linked to ADHD, because these are associated with intoxication, withdrawal or the (interpersonal) consequences of substance abuse [15]. As ADHD is mostly not the reason why patients with SUD seek treatment [16], it is the clinician’s task to address and recognize ADHD in these patients. Finally, many consequences of ADHD (job loss, poor school performance) are also seen in patients with SUD, and they can be erroneously attributed to substance abuse.…”

Factors Associated with Parental Treatment Attitudes and Information-Seeking Behaviors for Childhood ADHD

“…Despite the effectiveness of evidence-based treatments and the long-term negative impact of untreated ADHD, the NCS-R revealed that only 51.8% of people who meet criteria for ADHD will ever make treatment contact (Wang et al, 2005). Data from the National Epidemiologic Survey on Alcohol and Related Conditions reported a similar predicted treatment rate, 55% (Dakwar et al, 2014). Additionally, the median delay from symptom onset to treatment for ADHD is estimated at 10.5 to 28 years with younger cohorts at the shorter end of the delay (Dakwar et al, 2014).…”

“…Data from the National Epidemiologic Survey on Alcohol and Related Conditions reported a similar predicted treatment rate, 55% (Dakwar et al, 2014). Additionally, the median delay from symptom onset to treatment for ADHD is estimated at 10.5 to 28 years with younger cohorts at the shorter end of the delay (Dakwar et al, 2014).…”

“…However, despite (a) the considerable public health problem represented by ADHD, (b) the availability and evidence base for effective treatments (e.g., stimulant medications) (Faraone, 2003), and (c) negative long-term impacts of untreated ADHD (Shaw et al, 2012), there is still a significant delay to treatment as well as low rate of lifetime treatment contact in the ADHD population (Dakwar et al, 2014;Wang et al, 2005).…”

Mental health services use among adults with or without mental disorders: Do development stages matter?

“…For borderline personality disorder, 60% have concurrently a mood disorder, 58% an anxiety disorder and 51% a substance use disorder (Grant et al, 2008). Concerning adults with attention deficit hyperactivity disorder (ADHD) in the general population, 49%-54% have concurrently a mood disorder, 50% have an anxiety disorder, 41%-59% have an alcohol use disorder and 53%-63% have a drug use disorder (Dakwar et al, 2014). Therefore, this high rate of comorbidity in psychiatry suggests that by assessing common MD, the sample would have also included individuals with other non-assessed disorders.…”