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

Autor: Diane Purper-Ouakil, Valérie Macioce, Elizabeth Stein, Laurie Surig, Marie-Christine Picot, Élodie Courtabessis, Florence Pupier, Erika Nogue
Přispěvatelé: Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CIC Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi-Institut National de la Santé et de la Recherche Médicale (INSERM)
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Pediatrics
Adolescent
[SDV]Life Sciences [q-bio]
Attention-deficit hyperactivity disorder (ADHD)
Logistic regression
03 medical and health sciences
0302 clinical medicine
Stimulant medication
Developmental and Educational Psychology
medicine
Child and adolescent psychiatry
Humans
0501 psychology and cognitive sciences
Neuropsychological assessments
Medical prescription
Child
Psychiatry
Evidence-based treatment guidelines
Intelligence quotient
Methylphenidate
05 social sciences
General Medicine
medicine.disease
3. Good health
030227 psychiatry
Test (assessment)
Psychiatry and Mental health
Attention Deficit Disorder with Hyperactivity
Conduct disorder
Child
Preschool
Pediatrics
Perinatology and Child Health
Learning disability
Central Nervous System Stimulants
Female
France
medicine.symptom
Psychology
050104 developmental & child psychology
medicine.drug
Zdroj: European Child and Adolescent Psychiatry
European Child and Adolescent Psychiatry, Springer Verlag (Germany), 2018, 27 (3), pp.367--376. ⟨10.1007/s00787-017-1061-4⟩
ISSN: 1435-165X
1018-8827
DOI: 10.1007/s00787-017-1061-4
Popis: International audience; European guidelines advise on best practices for the diagnosis and non-pharmacological and pharmacological treatment of attention-deficit hyperactivity disorder (ADHD). This study aimed to (1) assess whether clinician's decisions to initiate methylphenidate treatment in children diagnosed with ADHD are in accordance with European guidelines and (2) identify clinical factors associated with the decision to recommend methylphenidate prescription. 5 to 13-year-old patients with an ADHD diagnosis were consecutively evaluated in an outpatient child and adolescent psychiatry clinic in France. Patients underwent a multidisciplinary evaluation including a diagnostic interview, symptom severity assessments with parent questionnaires, and IQ testing. We compared children with (n~=~105) and without (n~=~55) recommended methylphenidate treatment using Student's t test or Wilcoxon Mann-Whitney test and Chi-square or Fisher's test. Multivariate logistic regression was implemented to determine the respective influence of each variable on treatment recommendation. Recommendation to initiate methylphenidate treatment was associated with (1) ADHD combined presentation, (2) co-occurring Oppositional Defiant Disorder/Conduct Disorder (ODD/CD), Developmental Coordination Disorder (DCD) and Learning Disorder (LD), (3) clinical severity and impairment indicated on parent questionnaires, and (4) reduced perceptual reasoning. Using a multivariate regression model, ADHD combined presentation [combined versus predominantly hyperactive/impulsive and unspecified OR 4.52 (1.23-16.55), p~=~0.023], age [OR 1.46 (1.14-1.88), p~=~0.003], ODD/CD [OR 5.53 (2.19-14.01), p~\textless~0.001], DCD [OR 4.22 (1.70-10.48), p~=~0.002], PRI [OR 0.97 (0.94-0.99), p~=~0.01] were significantly associated with recommendation of methylphenidate treatment. Our results indicate that clinicians' treatment decision-making complies with European guidelines and is furthermore associated with the type and severity of ADHD symptoms but also with co-occurring disorders.
Databáze: OpenAIRE
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