Prevalence of Prescribed Attention-Deficit Hyperactivity Disorder Medications and Diagnosis among Canadian Preschoolers and School-Age Children: 1994–2007

Brault, Marie-Christine; Lacourse, Éric

doi:10.1177/070674371205700206

Cited by 93 publications

(120 citation statements)

References 45 publications

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“…There has been a reported increase in the prescription of stimulants [35][36][37] and antidepressants 10,36-40 for children and adolescents in recent years.…”

mentioning

confidence: 99%

Time trends in symptoms of mental illness in children and adolescents in Canada

McMartin

Kingsbury

Dykxhoorn

et al. 2014

CMAJ

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Interpretation:With the exception of hyperactivity, the prevalence of symptoms of mental illness in Canadian children and adolescents has remained relatively stable from 1994/95 to 2008/09. Conflicting reports of escalating rates of mental illness in Canada may be explained by differing methodologies between studies, an increase in treatment-seeking behaviour, or changes in diagnostic criteria or practices. AbstractResearch CMAJ, December 9, 2014, 186(18) E673 Methods Study designThis study used data from the National Longitudinal Survey of Children and Youth, which involves a population-based cohort of Canadian children and adolescents followed prospectively every 2 years by Statistics Canada since 1994/95. 14 The cohort is considered nationally representative, with the exception of children living on First Nations reserves or Crown lands, in institutions and in some remote regions. This study was designed to collect information about multiple aspects of child health and development. The follow-up rate for the National Longitudinal Survey of Children and Youth from cycle 1 (1994/95) to cycle 8 (2008/2009) was 61%.15 Further details about the cohort, including study design and response rates (mostly above 80% at each wave), are described elsewhere. 14,15 The survey included numerous assessments related to child and adolescent mental health. The behaviour scale was adapted from questionnaires used in the Montreal Longitudinal Survey and the Ontario Child Health Study, which were designed to identify children who would most likely qualify for a psychiatric diagnosis based on symptom criteria for the revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders. 16 This scale has been used in previous studies of child and adolescent adjustment, and has shown good psychometric properties. 17,18 In each cycle, participants aged 10 years or older were asked to self-report the frequency of various feelings and behaviours in the past week, with 3 possible responses ranging from "never or not true" to "often or very true." Each item was assigned a score of 0 to 2 (higher scores indicating a greater degree of mental health problems). Questionnaires were completed on paper, at home in a private setting, and sealed in envelopes to ensure confidentiality.Composite scores were created by summing item scores on each of 4 subscales relevant to adolescent mental illness: conduct disorder (6 items, e.g., "I kick or hit other people my age"), hyperactivity (7 items, e.g., "I am impulsive, I act without thinking"), indirect aggression (5 items, e.g., "When I am mad at someone, I say bad things behind his/her back"), and symptoms of depression/anxiety (7 items, e.g., "I am not as happy as other people my age" and "I worry a lot"). 19 The same items were collected at each cycle, with the exception of 1 hyperactivity item and 1 depression/anxiety item, which were dropped in cycle 4. In the interest of comparability over time, these items were not included in composite scores. All items comprising the final scale...

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“…There has been a reported increase in the prescription of stimulants [35][36][37] and antidepressants 10,36-40 for children and adolescents in recent years.…”

mentioning

confidence: 99%

Time trends in symptoms of mental illness in children and adolescents in Canada

McMartin

Kingsbury

Dykxhoorn

et al. 2014

CMAJ

View full text Add to dashboard Cite

show abstract

“…Not only do studies commonly reference the contribution of the pharmaceutical industry to the increased effort toward diagnosis of disorders such as ADHD and subsequent treatment by prescription medication [4,13] but also one study by Brault and Lacourse references the increasing role of school professionals in medicalization as they hand misbehaving children to medical professionals [2,[18][19][20]. This could lead to a child's potential diagnosis and then subsequent acquisition of medication, providing evidence of the link between changing ADHD prevalence rates and prescribed medication prevalence rates.…”

Section: Demographic Trends In Attention Deficit Hyperactivity Disordmentioning

confidence: 99%

“…Boys are known to have a greater prevalence of ADHD and are prescribed more medications than girls [2]. Joelsson et al also noted that sex distribution is different when measured in clinical versus population samples [7].…”

Section: Demographic Trends In Attention Deficit Hyperactivity Disordmentioning

confidence: 99%

“…Attention deficit hyperactivity disorder (ADHD) is the most common mental disorder in the pediatric population [1,2]. ADHD is a developmental condition with patterns of hyperactivity, impulsivity, and inattention in various settings, including home and school, that lead to different levels of impairment [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…With an annual estimated societal cost of illness for ADHD in children of approximately $42.5 billion, ADHD constitutes a significant financial burden on the global community [6]. The estimated prevalence of ADHD worldwide is approximately 5% [1,7], with time trends revealing a notable increase in its diagnosis [2,[8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Demographic trends in ADHD diagnosis in U.S. children using NHANES data between 2004 and 2012

Zamil¹,

Wang²,

Vadhariya³

et al. 2017

J Behav Health

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Background: Attention deficit hyperactivity disorder (ADHD) is the most common mental disorder in the pediatric population and affects education, finances, and medication. ADHD diagnostic criteria and resultant prevalence rates are also of special interest to the global psychiatric community. ADHD diagnosis rates and the corresponding demographic distributions through different years are thus an issue of great public health concern and debate. The objective of this study is to characterize changes in the demographic distribution of ADHD diagnosis from 2004 to 2012 in the United States. Methods: ADHD diagnosis data was extracted from the National Health and Nutrition Examination Survey (NHANES) Summary Health Statistics for United States Children, a source of nationally representative data on children in the United States. The ADHD cases were identified based on ICD9-CM diagnosis codes. Chi-square tests were used to investigate differences in ADHD diagnosis rates by demographic characteristics (age, race, and gender) within each year and simple linear regression was applied to determine the extent of change over time. Results: The ADHD diagnosis rate was higher among males, whites, and school-aged children and adolescents (vs. preschoolers aged 3-4) in each year examined. The total number of ADHD cases as well as all demographic groups with the exception of African Americans and preschoolers aged 3-4 exhibited an increasing trend between 2004 and 2012. Conclusions: ADHD diagnosis among youth showed a significant increase in the United States between 2004 and 2012. Notable increases and group differences were also observed among demographic subgroups. These findings indicate a need for future research in reasons for such group differences as well as treatment differences.

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Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2021

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IMPORTANCE Reported increases in attention-deficit/hyperactivity disorder (ADHD) diagnoses are accompanied by growing debate about the underlying factors. Although overdiagnosis is often suggested, no comprehensive evaluation of evidence for or against overdiagnosis has ever been undertaken and is urgently needed to enable evidence-based, patient-centered diagnosis and treatment of ADHD in contemporary health services. OBJECTIVE To systematically identify, appraise, and synthesize the evidence on overdiagnosis of ADHD in children and adolescents using a published 5-question framework for detecting overdiagnosis in noncancer conditions. EVIDENCE REVIEW This systematic scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Methodology, including the PRISMA-ScR Checklist. MEDLINE, Embase, PsychINFO, and the Cochrane Library databases were searched for studies published in English between January 1, 1979, and August 21, 2020. Studies of children and adolescents (aged Յ18 years) with ADHD that focused on overdiagnosis plus studies that could be mapped to 1 or more framework question were included.Two researchers independently reviewed all abstracts and full-text articles, and all included studies were assessed for quality. FINDINGS Of the 12 267 potentially relevant studies retrieved, 334 (2.7%) were included. Of the 334 studies, 61 (18.3%) were secondary and 273 (81.7%) were primary research articles. Substantial evidence of a reservoir of ADHD was found in 104 studies, providing a potential for diagnoses to increase (question 1). Evidence that actual ADHD diagnosis had increased was found in 45 studies (question 2). Twenty-five studies showed that these additional cases may be on the milder end of the ADHD spectrum (question 3), and 83 studies showed that pharmacological treatment of ADHD was increasing (question 4). A total of 151 studies reported on outcomes of diagnosis and pharmacological treatment (question 5). However, only 5 studies evaluated the critical issue of benefits and harms among the additional, milder cases. These studies supported a hypothesis of diminishing returns in which the harms may outweigh the benefits for youths with milder symptoms. CONCLUSIONS AND RELEVANCEThis review found evidence of ADHD overdiagnosis and overtreatment in children and adolescents. Evidence gaps remain and future research is needed, in particular research on the long-term benefits and harms of diagnosing and treating ADHD in youths with milder symptoms; therefore, practitioners should be mindful of these knowledge gaps, especially when identifying these individuals and to ensure safe and equitable practice and policy.

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Prevalence of Prescribed Attention-Deficit Hyperactivity Disorder Medications and Diagnosis among Canadian Preschoolers and School-Age Children: 1994–2007

Abstract: The upward trend in the prevalence of prescribed ADHD medications and ADHD diagnosis currently observed in contemporary societies is also occurring in Canada, except with preschoolers.

Cited by 93 publications

References 45 publications

Time trends in symptoms of mental illness in children and adolescents in Canada

Time trends in symptoms of mental illness in children and adolescents in Canada

Demographic trends in ADHD diagnosis in U.S. children using NHANES data between 2004 and 2012

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

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