General News Research — 25 July 2013

Adults with ADHD are struggling to find psychiatrists who can treat them, with many continuing to see a paediatrician well into their 20s, a new study shows.

The idea that patients “grow out of” ADHD may be exacerbating a gap in mental health services for patients who should be transitioning out of paediatric care in their teens, said lead researcher Dr Daryl Efron, a paediatrician at the Royal Children’s Hospital Melbourne.

Many paediatricians are treating ADHD patients up to 24 years of age, and shouldering an age range of 3-19 years, found the practice audit of almost 200 paediatricians and 1,500 consultations.

“We find it difficult to know who to refer young adults to because there are so few psychiatrists who specialise in adult ADHD,” said Dr Efron.

“It’s something paediatricians struggle with day-in, day-out. In the adult world there’s no one ready to run with the ball,” he said.

Almost one in five children who saw a paediatrician were diagnosed with ADHD, the authors reported in Academic Paediatrics, giving some sense of the potential size of the service gap as patients transitioned into adult care.

The study also found 80% of ADHD diagnoses were given to boys– a much higher proportion than seen in communitybased studies, suggesting girls were under referred and missing out on treatment.

The result “highlighted the ongoing issue of under referral of girls with ADHD for clinical services,” said Dr Efron.

“This might be happening due to gender bias or that they exhibit hyperactivity differently than boys. We just don’t know, but it means we probably don’t worry enough about girls,” he said.

Stimulant medications were prescribed to 1 in 4 children when they were first diagnosed, rising to 80% during subsequent consultations, the report showed.

Older children are more likely to be prescribed medication, suggesting paediatricians prioritised non-pharmacological interventions in younger children.

A higher proportion of patients with ADHD were seen in private practice, suggesting problems accessing public paediatric health care.

“Alternatively it is possible that parents from higher income backgrounds are more likely to seek an assessment of their children for ADHD.”

As first appeared in Psychiatry Update, 24 July 2013. Source: Academic Peadiatrics


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