Are psychostimulant drugs being used appropriately to treat child and adolescent disorders?

• Published in: British journal of psychiatry Vol. 182; no. 4; pp. 284 - 286
• Main Authors: Rey, Joseph M, Sawyer, Michael G
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01-04-2003
• Subjects: Academic achievement; Adolescent; Adolescent Behavior; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - epidemiology; Attention deficit hyperactivity disorder; Australia - epidemiology; Behavior problems; Behaviour disordered children; Central Nervous System Stimulants - therapeutic use; Child; Child Behavior Disorders - drug therapy; Child Behavior Disorders - epidemiology; Children; Children & youth; Compliance; Conduct disorder; Emotional behavior; Epidemiology; Health care industry; Households; Humans; Hyperactivity; Impulsivity; Medical diagnosis; Misdiagnosis; Noncompliance; Patient participation; Pediatrics; Practice Guidelines as Topic; Psychiatry; School districts; Stimulants; United Kingdom - epidemiology; United States - epidemiology; Canada; United Kingdom > UK; Australia; United States > US
• ISSN: 0007-1250; 1472-1465
• DOI: 10.1192/bjp.182.4.284

The combined subtype is similar (but not identical) to ADHD in DSM—III—R and to hyperkinetic disorder in ICD—10 (World Health Organization, 1992), corresponds to the traditional construct of ADHD, and is the better researched and validated form of the condition (almost all treatment studies involve the participation of patients with this syndrome). [...]the most appropriate rate to consider when comparing these studies may be that observed when only the combined subtype is included. [...]the troublesome behaviour of some children may be misdiagnosed (e.g. by mistaking non-compliance, learning or conduct problems for ADHD). [...]clinicians in ordinary practice may prescribe stimulant drugs not only for ADHD but also for other emotional and behavioural problems in an attempt to manage difficult children or to enhance school performance. [...]most importantly — it may be that stimulant treatment had reduced the symptoms experienced by children with ADHD; hence, they would not meet criteria for diagnosis at the time of interview in epidemiological studies.