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1、ADHDAssessmentandTreatmentinPrimaryCareBHCOutreachMeetingDecember10,2004OverviewCurrentStateofAffairsInformationandEducationforPhysiciansRoleofBehavioralHealthSpecialistAssessmentTreatmentCurrentResearchonImplementationFutureResearchQuestionsCurrentAf
2、fairsMajorityofhealthcarevisitsformentalhealtharetoprimarycare(60%).CurrentAffairsMajorityofhealthcarevisitsformentalhealtharetoprimarycare(60%).“Attentionalproblems”greatestincreaseofallmentalhealthproblemsinPCsince1979.CurrentAffairsMajorityofhealth
3、carevisitsformentalhealtharetoprimarycare(60%).“Attentionalproblems”greatestincreaseofallmentalhealthproblemsinPCsince1979.ADHDdiagnosisa2.3-foldincreaseinpopulation-adjustedratefrom1990-95.CurrentAffairsMajorityofhealthcarevisitsformentalhealtharetop
4、rimarycare(60%).“Attentionalproblems”greatestincreaseofallmentalhealthproblemsinPCsince1979.ADHDdiagnosisa2.3-foldincreaseinpopulation-adjustedratefrom1990-95.ChildrenwithADHDuseprimarycaremore,costmore.CurrentAffairsCopeland,Wolraich,Lindgren,Milich,
5、&Woolson,1987Howisdiagnosismade?79%“activityinoffice”47%“neurologicsoftsigns”33%“aggressive/antisocialactivity”58%parentratingscales,62%teacherratingscales77%stimulantresponseCurrentAffairsCopeland,Wolraich,Lindgren,Milich,&Woolson,1987Whattreatmentre
6、commendationsaremade?84%usestimulantsmoderately-frequently73%getparentreportforperiodicre-evaluation56%getteacherratingsforperiodicre-evaluation33%treatpreschoolers70%behaviormodificationothertherapiesrarelyrecommended26%neverrefertomentalhealthclinic
7、sCurrentAffairsWhattreatmentrecommendationsaremade?Inpediatricvisits,whenmedsprescribed,counselingofferedin68%cases.Hoagwood,Jensen,Feil,Vitiello,&Bhatara,200050%physicianssurveyedreferredtomentalhealthprofessionals.Jensen,Xenakis,Shervette,&Bain,1989
8、.InchildrenwithADHDunder3y.o.,57%receivedstimulants,butfewerpsychservices.Rappley,et.al(1999)CurrentAffairsWhattreatmentrecommendationsaremade?NoindicationthatADHDisoverdiagnosedorthatstimulantmedicationsareoverprescribed(Safer,Zito,&Fine,1996
