LeFever G B, Dawson K V, Morrow A L
Center for Pediatric Research, Children's Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, USA.
Am J Public Health. 1999 Sep;89(9):1359-64. doi: 10.2105/ajph.89.9.1359.
The purpose of this study was to determine the extent of medication use for attention deficit-hyperactivity disorder (ADHD) in southeastern Virginia.
Students enrolled in grades 2 through 5 in school districts in city A (n = 5767 students) and city B (n = 23,967 students) were included. Nurses recorded students who received ADHD medication in school.
The proportion of students receiving ADHD medication was similar in both cities (8% and 10%) and was 2 to 3 times as high as the expected rate of ADHD. Receipt of drug therapy was associated with social and educational characteristics. Medication was used by 3 times as many boys as girls and by twice as many Whites as Blacks. Medication use increased with years in school, and by fifth grade 18% to 20% of White boys were receiving ADHD medication. Being young for one's grade was positively associated with medication use (P < .01). The prevalence of ADHD was 12% in district A, 63% in district B.
These findings suggest that criteria for diagnosis of ADHD vary substantially across US populations, with potential overdiagnosis and overtreatment of ADHD in some groups of children.
本研究旨在确定弗吉尼亚州东南部注意力缺陷多动障碍（ADHD）的药物使用情况。
纳入了A市（n = 5767名学生）和B市（n = 23967名学生）学区2至5年级的学生。护士记录了在学校接受ADHD药物治疗的学生。
两个城市接受ADHD药物治疗的学生比例相似（分别为8%和10%），是ADHD预期发病率的2至3倍。接受药物治疗与社会和教育特征有关。使用药物的男孩人数是女孩的3倍，白人人数是黑人的2倍。药物使用随在校年数增加，到五年级时，18%至20%的白人男孩在接受ADHD药物治疗。同年级中年龄较小与药物使用呈正相关（P < .01）。A区ADHD患病率为12%，B区为63%。
这些发现表明，美国不同人群中ADHD的诊断标准差异很大，一些儿童群体可能存在ADHD的过度诊断和过度治疗情况。
