Attention-deficit/hyperactivity disorder: Are we medicating for social disadvantage? (Against)
Version of Record online: 18 AUG 2006
Journal of Paediatrics and Child Health
Volume 42, Issue 9, pages 548–551, September 2006
How to Cite
Efron, D. (2006), Attention-deficit/hyperactivity disorder: Are we medicating for social disadvantage? (Against). Journal of Paediatrics and Child Health, 42: 548–551. doi: 10.1111/j.1440-1754.2006.00920.x
- Issue online: 18 AUG 2006
- Version of Record online: 18 AUG 2006
- Accepted for publication 28 March 2006.
- attention-deficit/hyperactivity disorder;
- child psychiatry;
- stimulant medication
Abstract: The functional impairments seen in attention deficit hyperactivity disorder (ADHD) are the result of a complex interplay between biological vulnerability and environmental influences. In children with ADHD from social disadvantaged families the latter often appear to predominate. Stimulant medication is the intervention with the largest demonstrable effect size in decreasing the core symptoms of ADHD, irrespective of social context. However, medication alone will not effectively treat common comorbidities, such as oppositional behaviour, anxiety, or learning disabilities. Nor can medication be expected to diminish major family discord or psychosocial adversity. Stimulant medication is one key therapy modality in children with ADHD. Data on prescribing rates do not support the assertion that there is systematic overprescribing of stimulants in Australia. There is, however, a serious problem with access to family support and appropriate services in schools for children with ADHD. Paediatricians have a responsibility to provide evidence-based medical treatment for children with ADHD (i.e. stimulant medication), while advocating across sectors for services to enhance family resilience and function.