Gender- and age-stratified analyses of ADHD medication use in children and adolescents in Finland using population-based longitudinal data, 2008–2018

Abstract

<jats:p> Aims: This study examined medication use for attention-deficit/hyperactivity disorder (ADHD) among children and adolescents by gender in Finland during 2008–2018. Methods: Aggregated data on medication use for ADHD from 2008 to 2018 were extracted from the nationwide register on reimbursed prescriptions. The annual prevalence of ADHD medication use was calculated as the number of children (6–12 years) and adolescents (13–17 years) per calendar year with at least one ADHD medication purchase divided by the number of children and adolescents in the population. Population prevalence for children was also examined by birth month. Results: In 2008, the prevalence rates for males were 1.26% in children and 0.93% in adolescents, and for females 0.21% and 0.14%, respectively. In 2018, the prevalence rates for males were 4.42% in children and 4.21% in adolescents, and for females 0.99% and 1.28%, respectively. Male-to-female ratios decreased during the study period from 6.0:1 to 4.5:1 (children) and from 6.6:1 to 3.3:1 (adolescents). ADHD medication use was more common among males and females (aged 6–12 years) born in May–August or September–December than among males and females born in January–April. Conclusions: The prevalence of ADHD medication use has continued to increase in Finland. Although use has increased more rapidly among females resulting in lower male-to-female ratios, medication use among females is considerably lower compared with males. Consequently, gender discrepancy in 2018 was relatively large, particularly among children. Future studies should also consider reporting annual prevalence by children’s birth month. </jats:p>

Multi-center nationwide study on pediatric psychiatric inpatients 2000–2018: length of stay, recurrent hospitalization, functioning level, suicidality, violence and diagnostic profiles

“…The use of child and adolescent psychiatric (CAP) services has increased worldwide [1][2][3][4][5][6] and this has led to the expansion of open care services [7,8]. These include parent training [9,10], cognitive-behavioral therapy [11,12], school-based contingency management [13] and pharmacotherapy [14][15][16][17]. There are also a growing number of services for those who need more intensive open care treatment, due to the severity of their condition [2,18], and these include specific multisystemic treatment models [19].…”

Children’s Relative Age and ADHD Medication Use: A Finnish Population-Based Study

“…6,24 For example, prevalence rates of ADHD medication use among the child population in Finland have been relatively low, particularly among girls, 24,25 but the rates of ADHD diagnoses and medication use are increasing relatively rapidly. 26 Sex differences are also important to consider because the rates of ADHD vary by sex in middle childhood. Emotion dysregulation and externalizing behaviors drive referral for ADHD.…”

“…Altogether, with our study, we add to the global understanding of the RAE in ADHD by providing a more-complete picture of the phenomenon from a single jurisdiction where the rates of children with ADHD have increased somewhat rapidly and delayed school entry has decreased. 13,26 First, we hypothesized that with delayed school entry being somewhat rare in Finland, there would be at least a modest RAE in prescribing ADHD medication for children. Second, given that difference in maturity is more extreme at young ages, we expected that the RAE in ADHD medication use would be stronger at ages 6 to 7, when children start primary education.…”

ADHD overdiagnosis and the role of patient gender among Iranian psychiatrists

“…With respect to ADHD diagnosis, as patient gender moderates symptom manifestations, boys are more likely to receive an ADHD diagnosis even when not all the criteria have been met (false-positive diagnostic error), while girls are less likely to receive a diagnosis of ADHD even when they fulfill the criteria (false-negative diagnostic error). Therefore, considering the heuristics effect in the diagnostic process is another possible explanation for the differences we observe between clinical and epidemiological data in ADHD [13,24].…”

“…A large body of ADHD research shows that children born close to kindergarten or school cut-off dates, and who are therefore up to a year younger than their classmates, are 30 to 60% more likely to be diagnosed with ADHD [11][12][13][14]. In this regard, there is evidence that a child's birthdate influences considerably the subjective evaluations of teachers in identifying whether that child is exhibiting ADHD symptoms.…”