Clinical factors associated with decision to recommend methylphenidate treatment for children with ADHD in France

Courtabessis, Élodie; Pupier, Florence; Surig, Laurie; Picot, Marie‐Christine; Nogué, Erika; Macioce, Valérie; Stein, Elizabeth; Purper-Ouakil, Diane

doi:10.1007/s00787-017-1061-4

Cited by 13 publications

(15 citation statements)

References 37 publications

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“…In accordance with the large clinical ADHD Observational Research in Europe (ADORE) study (Novik et al 2006 ), this study found no significant gender difference in the use of medication (77% in both boys and girls), although we replicated the well-known male preponderance of ADHD diagnoses (Thapar and Cooper 2016 ). The similar use in boys and girls is contrary to several previous findings where male gender was a significant predictor of medication use (Garbe et al 2012 ; Galera et al 2014 ; Courtabessis et al 2018 ).…”

Section: Discussioncontrasting

confidence: 99%

“…In line with two recent studies (Courtabessis et al 2018 ; Scholle et al 2020 ), this study did not find that comorbid emotional disorders (axis I) were more frequent in those who used medication. However, the medicated children were considered to be more globally impaired (axis VI, CGAS).…”

Section: Discussionsupporting

confidence: 90%

“…By comparing children who were medicated and unmedicated for ADHD, we found the ADHD diagnostic subtype hyperactive conduct disorder (F90.1) to be associated with use of medication, while children with the inattentive subtype (F98.8) used medication less frequently ( Table 1 ). Our finding is in line with the ADORE study (Falissard et al 2010 ), a longitudinal population-based cohort study (Scholle et al 2020 ), and the clinical study of factors related to the decision of recommending methylphenidate for children with ADHD (Courtabessis et al 2018 ). It is reasonable that for parents and teachers, children with the inattentive subtype of ADHD may be perceived as less impaired and their behavior less problematic compared to children with disruptive behavioral problems.…”

Section: Discussionsupporting

confidence: 88%

“…None of the above studies has investigated predictors of ADHD medication controlling for the influence of a clinical ADHD diagnosis per se, and therefore, they do not entirely address whether the predictors pertain to the ADHD diagnosis or to medication use. Their findings also differ somewhat from two clinical studies, based on German health insurance data (Garbe et al 2012), and data from a French outpatient psychiatric clinic (Courtabessis et al 2018), where a small, but increased risk for comorbid behavioral/emotional disorders was found in the medicated children diagnosed with ADHD compared to the unmedicated children.…”

Section: Introductioncontrasting

confidence: 88%

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Child and Parental Characteristics of Medication Use for Attention-Deficit/Hyperactivity Disorder

Oerbeck

Furu

Aase

et al. 2020

Journal of Child and Adolescent Psychopharmacology

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Objectives: To investigate child and parental characteristics of medication use for attention-deficit/hyperactivity disorder (ADHD). Methods: Participants were part of the prospective population-based Norwegian Mother, Father and Child Cohort study (MoBa) (n = 114,500 children, 95,000 mothers, and 75,000 fathers). This cohort was linked to the Norwegian Prescription Database (NorPD) and the Norwegian Patient Registry (NPR) to compare child and parental characteristics in children medicated and not medicated for ADHD during years 2008-2013. Results: One thousand seven hundred and sixty-four children (74% boys) with ADHD (International Classification of Diseases [ICD-10]: F90 and F98.8) were identified. One thousand three hundred and sixty-two (77%) used medication. Boys and girls did not differ in the use of ADHD medication (both 77%). Mean age at first prescription was 9 years in both boys and girls, and age at ADHD diagnosis was 8 years in medicated and unmedicated children. Significantly more hyperkinetic conduct disorders (F90.1), and significantly fewer with attention-deficit disorder (F98.8) were found among the medicated children compared to the unmedicated children. The medicated children also had a significantly lower global functioning (Child Global Assessment Scale). Child disruptive symptoms reported in the MoBa child age 3 year questionnaire were significantly higher in children who used medication compared to the nonusers (t = 2.2, p = 0.03), and group differences in ADHD symptoms at age 3 years were close to significant (t = 1.8, p = 0.07). Other preschool child and parental characteristics were not significantly different in the two groups. Conclusion: In this large birth cohort study, where a great majority of children with ADHD used medication, only child characteristics were significantly associated with the use of medication. We could not replicate previous findings suggesting that ''environmental factors,'' such as parental education and psychopathology, drive medication use. The small differences between medicated and unmedicated children in this cohort study, where a majority used medication, might be due to strong established clinical practices where medication is offered as a treatment option, particularly for hyperkinetic conduct disorder in an egalitarian high-income society.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 88%

Section: Introductioncontrasting

confidence: 88%

See 2 more Smart Citations

Child and Parental Characteristics of Medication Use for Attention-Deficit/Hyperactivity Disorder

Oerbeck

Furu

Aase

et al. 2020

Journal of Child and Adolescent Psychopharmacology

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“…This may be reflected by the differences in ADHD symptoms between boys and girls [8][9][10]. Apart from child characteristics, the prescribing behavior of physicians as well as the availability of non-pharmacological treatment options to the family are important [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Maternal Sociodemographic Factors Are Associated with Methylphenidate Initiation in Children in the Netherlands: A Population-Based Study

Cheung

Marroun

Dierckx

et al. 2020

Child Psychiatry Hum Dev

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Multiple factors may contribute to the decision to initiate methylphenidate treatment in children such as maternal sociodemographic factors of which relatively little is known. The objective was to investigate the association between these factors and methylphenidate initiation. The study population included 4243 children from the Generation R Study in the Netherlands. Maternal sociodemographic characteristics were tested as determinants of methylphenidate initiation through a timedependent Cox regression analysis. Subsequently, we stratified by mother-reported ADHD symptoms (present in 4.2% of the study population). When ADHD symptoms were absent, we found that girls (adjusted HR 0.25, 95%CI 0.16-0.39) and children born to a mother with a non-western ethnicity (compared to Dutch-Caucasian) (adjusted HR 0.42, 95%CI 015-0.68) were less likely to receive methylphenidate. They were more likely to receive methylphenidate when their mother completed a low (adjusted HR 2.29, 95%CI 1.10-4.77) or secondary (adjusted HR 1.71, 95%CI 1.16-2.54) education. In conclusion, boys and children born to a mother of Dutch-Caucasian ethnicity were more likely to receive methylphenidate, irrespective of the presence of ADHD symptoms.

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Barriers and predictors of medication use for childhood ADHD: findings from a UK population-representative cohort

Russell

Ford

Russell

2019

Soc Psychiatry Psychiatr Epidemiol

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PurposeLittle is known about sociodemographic and clinical factors that predict and act as barriers to ADHD medication independently of symptom severity. We examined the proportion of children using medication for ADHD, age of initiation of medication, and predictors of medication use in a population-representative cohort.MethodsData from the Millennium Cohort Study on child ADHD, medication use for ADHD at age 14 (in 2014–2015) and child, parent and sociodemographic variables were collated. Logistic regression models were used to identify factors that predict medication use for ADHD (the main outcome measure), adjusting for symptom severity at age seven.ResultsThe weighted prevalence of ADHD was 3.97% (N = 11,708). 45.57% of children with ADHD (N = 305) were taking medication. The median age at initiation was 9 years (range 3–14). Male gender (AOR 3.66, 95% CI 1.75, 7.66) and conduct problems at age seven (AOR 1.24 95% CI 1.04, 1.47) and 14 predicted medication use at age 14 after adjusting for symptom severity.ConclusionsOur study is the first to assess predictors of medication whist adjusting for ADHD symptom severity. Girls with ADHD were less likely to be prescribed medication, even when they displayed similar ADHD symptom levels to boys. Conduct problems also predicted medication independently of ADHD symptoms. ADHD may be more often medicated in boys because clinicians may think a prototypical ADHD child is male, and perhaps conduct problems make boys more disruptive in the classroom, leading to boys being more often treated.

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Clinical factors associated with decision to recommend methylphenidate treatment for children with ADHD in France

Cited by 13 publications

References 37 publications

Child and Parental Characteristics of Medication Use for Attention-Deficit/Hyperactivity Disorder

Child and Parental Characteristics of Medication Use for Attention-Deficit/Hyperactivity Disorder

Maternal Sociodemographic Factors Are Associated with Methylphenidate Initiation in Children in the Netherlands: A Population-Based Study

Barriers and predictors of medication use for childhood ADHD: findings from a UK population-representative cohort

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