The University of Southampton
University of Southampton Institutional Repository

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

Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis
Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis
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.
ADHD, Pharmacological interventions, Prevalence, Stimulants, Treatment
0149-7634
64-73
Massuti, Rafael
adc46d21-0bbf-4471-85a5-2ed1d25aa16b
Moreira-maia, Carlos Renato
8014d8ac-92fa-4900-929d-20fd8631ce0f
Campani, Fausto
c4c86b4b-5cfa-4af4-9cc9-49c5c72ef90e
Sônego, Márcio
bfb2108e-fffb-4bc8-8ade-c0e2ece23155
Amaro, Julia
06d4d905-f310-4e0c-aca9-f8c66fa32fac
Akutagava-martins, Gláucia Chiyoko
36491141-3476-4b46-91cb-dd9dcf312a27
Tessari, Luca
2a879481-c19e-4fc9-8af0-474970992083
Polanczyk, Guilherme V.
794ddae7-f894-48fc-a90a-af190ab728a8
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Rohde, Luis Augusto
cd2ba2dc-686e-4ad4-9073-a9419846e8c8
Massuti, Rafael
adc46d21-0bbf-4471-85a5-2ed1d25aa16b
Moreira-maia, Carlos Renato
8014d8ac-92fa-4900-929d-20fd8631ce0f
Campani, Fausto
c4c86b4b-5cfa-4af4-9cc9-49c5c72ef90e
Sônego, Márcio
bfb2108e-fffb-4bc8-8ade-c0e2ece23155
Amaro, Julia
06d4d905-f310-4e0c-aca9-f8c66fa32fac
Akutagava-martins, Gláucia Chiyoko
36491141-3476-4b46-91cb-dd9dcf312a27
Tessari, Luca
2a879481-c19e-4fc9-8af0-474970992083
Polanczyk, Guilherme V.
794ddae7-f894-48fc-a90a-af190ab728a8
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Rohde, Luis Augusto
cd2ba2dc-686e-4ad4-9073-a9419846e8c8

Massuti, Rafael, Moreira-maia, Carlos Renato, Campani, Fausto, Sônego, Márcio, Amaro, Julia, Akutagava-martins, Gláucia Chiyoko, Tessari, Luca, Polanczyk, Guilherme V., Cortese, Samuele and Rohde, Luis Augusto (2021) Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 128, 64-73. (doi:10.1016/j.neubiorev.2021.06.001).

Record type: Review

Abstract

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.

Text
Assessing undertreatment and overtreatment_misuse of ADHD medications - Author's Original
Download (121kB)

More information

Accepted/In Press date: 1 June 2021
e-pub ahead of print date: 3 June 2021
Published date: 1 September 2021
Additional Information: Funding Information: This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001, and by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazilian public funding agencies. Funding Information: This study was financed in part by the Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - Brasil (CAPES) - Finance Code 001, and by the Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq), Brazilian public funding agencies. Publisher Copyright: © 2021 Elsevier Ltd
Keywords: ADHD, Pharmacological interventions, Prevalence, Stimulants, Treatment

Identifiers

Local EPrints ID: 451000
URI: http://eprints.soton.ac.uk/id/eprint/451000
ISSN: 0149-7634
PURE UUID: 247eeb07-67cd-4bdd-8bf9-4c6b2b28d399
ORCID for Samuele Cortese: ORCID iD orcid.org/0000-0001-5877-8075

Catalogue record

Date deposited: 01 Sep 2021 16:31
Last modified: 17 Mar 2024 03:37

Export record

Altmetrics

Contributors

Author: Rafael Massuti
Author: Carlos Renato Moreira-maia
Author: Fausto Campani
Author: Márcio Sônego
Author: Julia Amaro
Author: Gláucia Chiyoko Akutagava-martins
Author: Luca Tessari
Author: Guilherme V. Polanczyk
Author: Samuele Cortese ORCID iD
Author: Luis Augusto Rohde

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×