Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:128

Review

Massuti, Rafael^1,2  Moreira-Maia, Carlos Renato^1,2  Campani, Fausto^1,2  Sonego, Marcio^1,2  Amaro, Julia^1,2  Akutagava-Martins, Glaucia Chiyoko³  Tessari, Luca⁴  Polanczyk, Guilherme, V⁵  Cortese, Samuele^4,6,7,8  Rohde, Luis Augusto^1,2,9 

[1] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, ADHD Outpatient Program, Porto Alegre, RS, Brazil

[2] Univ Fed Rio Grande do Sul, Hosp Clin Porto Alegre, Dev Psychiat Program, Porto Alegre, RS, Brazil

[3] Univ Fed Mato Grosso, Coll Med, Cuiaba, Brazil

[4] Univ Southampton, Fac Environm & Life Sci Clin & Expt Sci CNS & Psy, Fac Med, Ctr Innovat Mental Hlth, Southampton, Hants, England

[5] Univ Sao Paulo, Fac Med FMUSP, Sao Paulo, SP, Brazil

[6] Solent NHS Trust, Southampton, Hants, England

[7] NYU Langone, Hassenfeld Childrens Hosp, Dept Child & Adolescent Psychiat, New York, NY USA

[8] Univ Nottingham, Sch Med, Div Psychiat & Appl Psychol, Nottingham, England

[9] Natl Inst Dev Psychiat, Porto Alegre, RS, Brazil

关键词: ADHD;    Prevalence;    Treatment;    Stimulants;    Pharmacological interventions;   

DOI  :  10.1016/j.neubiorev.2021.06.001

来源: Elsevier

【 摘 要 】

A controversy exists on whether there is an over or underuse of medications for Attention-Deficit/Hyperactivity Disorder (ADHD). We conducted the first meta-analysis to estimate the rate of ADHD pharmacological treatment in both diagnosed and undiagnosed individuals. Based on a pre-registered protocol (CRD42018085233), we searched a broad set of electronic databases and grey literature. After screening 25,676 abstracts, we retained 36 studies including 104,305 subjects, from which 18 studies met our main analysis criteria. The pooled pharmacological treatment rates were 19.1 % and 0.9 % in school-age children/adolescents with and without ADHD, respectively. We estimated that for each individual using medication without a formal ADHD diagnosis, there are three patients with a formal diagnosis who might benefit from medication but do not receive it in the US. Our results indicate both overtreatment/misuse of medication in individuals without ADHD and pharmacological undertreatment in youths with the disorder. Our findings reinforce the need for public health policies improving education on ADHD and discussions on the benefits and limitations of ADHD medications.

【 授权许可】

Free