National trends in the treatment of attention deficit hyperactivity disorder
Abstract
OBJECTIVE: Nationally representative descriptive data were presented regarding recent trends in the outpatient treatment of attention deficit hyperactivity disorder (ADHD) in children. METHOD: Service use data were analyzed in children ages 3 to 18 years from two nationally representative surveys of the U.S. general population, the 1987 National Medical Expenditure Survey, and the 1997 Medical Expenditure Panel Survey. Trends in the rates of treatment for ADHD were presented by age, gender, race, family income, and health insurance status. Trends in ADHD treatment were also determined by annual numbers of visits, use of pharmacotherapies, and types of health care professionals. RESULTS: The rate of outpatient treatment for ADHD increased from 0.9 per 100 children in 1987 to 3.4 per 100 children in 1997. Significant increases in the rates of treatment for ADHD were evident across nearly all sociodemographic groups, with the largest increases among children from poor, near-poor, and low-income families and children ages 12 to 18. Among children who received treatment for ADHD, there was a significant decrease in the number of treatment visits but an increase in the number of stimulant prescriptions between 1987 and 1997. CONCLUSIONS: During the decade, there was a marked and broad expansion in access to treatment of children with ADHD but a decline in intensity of treatment, as measured by number of visits. These changes occurred during a period of expanding access to special education services, growth of managed behavioral healthcare, and increased public acceptance of effective psychotropic medications.
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In one study of children aged 3-7 years taking immediate-release methylphenidate, 54.0% received only one prescription and 10.9% received five or more prescriptions over one year.
“one study of children (N = 1,635; aged 3Y7 years) taking methylphenidate (MPH) immediate-release revealed that 54.0% of the subjects received only one prescription, and only 10.9% received five or more prescriptions during a 1-year period.19”
From Medication Adherence in the MTA: Saliva Methylphenidate Samples Versus Parent Report and Mediating Effect of Concomitant Behavioral Treatment (2009) · cites this paper as [19]
Diagnoses for both ADHD and autism have been on the rise over the past several decades.
“Diagnoses for both have been on the rise over the past several decades86–88.”
From Maternal and Early-Life Circadian Disruption Have Long-Lasting Negative Consequences on Offspring Development and Adult Behavior in Mice (2017) · cites this paper as [86]
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- Authors
- Olfson, M., Gameroff, M. J., Marcus, S. C., & Jensen, P. S.
- Affiliations
- New York State Psychiatric Institute (US)
- Venue
- American Journal of Psychiatry
- Published
- 2003-06-01
- Volume
- 160
- Issue
- 6
- Pages
- 1071-1077
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2104212239
- Cited by
- 394
- References
- 35
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 4 · 2022: 1 · 2021: 7 · 2020: 4 · 2019: 10 · 2018: 6 · 2017: 49 · 2016: 14 · 2015: 14 · 2014: 17 · 2013: 19 · 2012: 31
- FWCI
- 14.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (P60MD000206)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- attention deficit hyperactivity disorder, outpatient care, children, treatment trends, access to treatment, stimulant medication, psychotropic drugs, treatment intensity, health insurance status, sociodemographic disparities, special education services
- MeSH terms
- Adolescent, Ambulatory Care, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Combined Modality Therapy, Delivery of Health Care, Drug Utilization, Health Expenditures, Female, Health Maintenance Organizations, Humans, Male, Mental Health Services, Office Visits, Psychotherapy, Psychotropic Drugs, United States, Health Care Surveys
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