Scientific and clinical interest in attention-deficit hyperactivity disorder (ADHD) is increasing worldwide. This article presents data from a cross-national workshop and survey related to questions of variability in diagnostic and, particularly, treatment procedures.

Methods:

Representatives of nine nations (Australia, Brazil, Canada, China, Germany, Israel, the Netherlands, Norway, and the United Kingdom), plus the United States, who attended a 2010 workshop on ADHD, responded to a survey that addressed diagnostic procedures for ADHD; treated prevalence of medication approaches, as well as psychosocial interventions; types of medications and psychosocial treatments in use; payment systems; beliefs and values of the education system; trends related to adult ADHD; and cultural and historical attitudes and influences related to treatment.

Results:

Use of both medication and psychosocial treatment for ADHD varies widely within and across nations. More expensive long-acting formulations of medications are becoming more widespread. Nations with socialized medical care provide a wide array of evidence-based interventions. Economic, historical, and political forces and cultural values are related to predominant attitudes and practices. Strong antipsychiatry and antimedication voices remain influential in many nations.

Conclusions:

There is considerable variation in implementation of care for ADHD. Recognition of the social context of ADHD is an important step in ensuring access to evidence-based interventions for this prevalent, chronic, and impairing condition. (Psychiatric Services 62:459–464, 2011)

Volume 62
Issue 5

May 2011
Pages 459-464

Metrics

Acknowledgments and disclosures

Work on this article was partly supported by an Investigator Award in Policy Research from the Robert Wood Johnson Foundation. Additional funds were provided by the Center for Child and Youth Policy, the Nicholas C. Petris Center, and the Department of Psychology, all of the University of California, Berkeley. The authors gratefully acknowledge Brad Berman, M.D., Glen Elliott, M.D., Ph.D., Howard Goldman, M.D., Ph.D., Peter Jensen, M.D., and Tony Philipps, M.D., who moderated sessions and facilitated discussion at the workshop described in this article. Stephen Robitaille, B.A., provided valuable assistance preparing the survey. Amy Nuttbrock, B.A., facilitated all aspects of the workshop. Candy Pareja, B.A., provided editorial assistance and B. Tate Guelzow, M.A., Fred Loya, M.A, Liat Tikotzky, Ph.D., and Chandrakala Ganesh, Ph.D., provided assistance in note taking.

Dr. Banaschewski has served in an advisory or consultancy role for Desitin, Eli Lilly and Company, Medice, Novartis, Pfizer, Shire, UCB, and Viforpharma; has received conference attendance support or speaker's fees from Lilly, Janssen McNeil, Medice, Novartis, Shire, and UCB; and has been involved in clinical trials conducted by Lilly, Shire, and Novartis. Dr. Mattos is on the advisory board of Novartis, Janssen-Cilag, and Shire and has received research funds from Shire and Novartis. Dr. Sergeant is on the advisory boards of Lilly, Novartis, and Shire; has a research grant from Lilly; and has received speaker's fees from Shire, Lilly, and Janssen-Cilag. Dr. Weiss has received research funds from and has had consultation and speaker arrangements with Purdue, Shire, Lilly, and Janssen. The other authors report no competing interests.

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History

Published online 1 May 2011

Published in print 1 May 2011

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International Variation in Treatment Procedures for ADHD: Social Context and Recent Trends

Abstract

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