TY  - JOUR
T1  - DIagnosis of attention-deficit/hyperactivity disorder and use of psychotropic medication in very young children
AU  - Rappley MD, Mullan PB, Alvarez FJ, Eneli IU, Wang J, Gardiner JC
Y1  - 1999/10/01
N1  - 10.1001/archpedi.153.10.1039
JO  - Archives of Pediatrics & Adolescent Medicine
SP  - 1039
EP  - 1045
VL  - 153
IS  - 10
N2  - Context 
    Increases in diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) have elicited public and professional concern. Research suggests that this trend warrants the inclusion of previously underdiagnosed children and adults. It is not clear whether this trend includes young children.Objective 
    To identify patterns of diagnosis and treatment of ADHD in very young children over time.Design 
    Descriptive study of Michigan Medicaid claims data.Patients 
    Inclusion criteria included recorded ADHD diagnosis, continuous Medicaid eligibility during a 15-month period, and age 3 years or younger at the first date of service.Main Outcome Measures 
    Diagnoses of ADHD, conditions commonly comorbid with ADHD, other chronic health conditions, and injuries; treatments such as psychological services and psychotropic medication; and the number of ambulatory visits.Results 
    We identified 223 children aged 3 years or younger diagnosed with ADHD. Many had conditions commonly comorbid with ADHD (44%), other chronic health conditions (41%), and injuries (40%). More than half received psychotropic medication (57%); fewer received psychological services (27%). Twenty-two different psychotropic medications were used. Patterns included more than 1 psychotropic medication (46%) in 30 combinations of simultaneous use and 44 combinations of sequential use. The mean number of ambulatory visits was 18.Conclusions 
    Children aged 3 years or younger had ADHD diagnosed and received markedly variable psychotropic medication regimens. Little information is available to guide these practices. The presence of comorbid conditions and injuries attests to these children's vulnerability. Resources must be identified that will enable physicians to better respond to the compelling needs of these children and their families.
SN  - 1072-4710
M3  - doi: 10.1001/archpedi.153.10.1039
UR  - http://dx.doi.org/10.1001/archpedi.153.10.1039
ER  -