Magazine article Clinical Psychiatry News

Specialists More Likely to Spot ADHD Comorbidity

Magazine article Clinical Psychiatry News

Specialists More Likely to Spot ADHD Comorbidity

Article excerpt

NEW ORLEANS -- Specialty care providers were significantly more likely to diagnose comorbidity in children with attention-deficit hyperactivity disorder than were primary care providers, Dr. Angela LaRosa said at the Southern regional meeting of the American Federation for Medical Research.

Patients with attention-deficit hyperactivity disorder (ADHD) who have comorbidity may respond differently to treatment than those without comorbidity, and they are at greater risk for developing long-term psychopathologies, said Dr. LaRosa of the Medical University of South Carolina, Charleston.

The prevalence of ADHD in schoolaged children ranges from 2% to 12%, and about one-third of those diagnosed have one or more coexisting conditions, including depression, oppositional defiant disorder, conduct disorder, and anxiety, based on data from the National Ambulatory Medical Care Survey for 1996-1998.

The study presented at the meeting evaluated the differences between specialty care providers and primary care providers in their management of ADHD patient visits. The researchers reviewed 260 visits to specialty care providers (psychiatrists or neurologists) and 141 visits to primary care providers (pediatricians or family physicians) by children aged less than 1 year to 18 years who had been diagnosed with ADHD. Significant diagnostic differences appeared between the two groups in the use of behavior therapy (30% of specialty care visits vs. 8% of primary care visits) and mental health referrals (52% of specialty care visits vs. 17% of primary care visits).

Stimulants were the most frequently prescribed medications in both groups--in 83% of specialty care visits and 88% of primary care visits. Antidepressants were the next most popular medication; they were prescribed significantly more often in specialty care visits (24%) than in primary care visits (7%). …

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