Pearce, A. , Henery, P., Katikireddi, S. V. , Dundas, R. , Leyland, A. H. , Nicholls, D., Viner, R. M., Fenton, L. and Hope, S. (2024) Childhood attention-deficit hyperactivity disorder (ADHD): socio-economic inequalities in symptoms, impact, diagnosis and medication. Child and Adolescent Mental Health, (doi: 10.1111/camh.12707) (Early Online Publication)
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Abstract
Background Children from disadvantaged backgrounds are at greater risk of attention-deficit hyperactivity disorder (ADHD)-related symptoms, being diagnosed with ADHD, and being prescribed ADHD medications. We aimed to examine how inequalities manifest across the ‘patient journey’, from perceptions of impacts of ADHD symptoms on daily life, to the propensity to seek and receive a diagnosis and treatment. Methods We investigated four ‘stages’: (1) symptoms, (2) caregiver perception of impact, (3) diagnosis and (4) medication, in two data sets: UK Millennium Cohort Study (MCS, analytic n ~ 9,000), with relevant (parent-reported) information on all four stages (until 14 years); and a population-wide ‘administrative cohort’, which includes symptoms (child health checks) and prescriptions (dispensing records), born in Scotland, 2010–2012 (analytic n ~ 100,000), until ~6 years. We described inequalities according to maternal occupational status, with percentages and relative indices of inequality (RII). Results The prevalence of ADHD symptoms and medication receipt was considerably higher in the least compared to the most advantaged children in the administrative cohort (RIIs of 5.9 [5.5–6.4] and 8.1 [4.2–15.6]) and the MCS (3.08 [2.68–3.55], 3.75 [2.21–6.36]). MCS analyses highlighted complexities between these two stages, however, those from least advantaged backgrounds, with ADHD symptoms, were the least likely to perceive impacts on daily life (15.7% vs. average 19.5%) and to progress from diagnosis to medication (44.1% vs. average 72.5%). Conclusions Despite large inequalities in ADHD symptoms and medication, parents from the least advantaged backgrounds were less likely to report impacts of ADHD symptoms on daily life, and their children were less likely to have received medication postdiagnosis, highlighting how patient journeys differed according to socioeconomic circumstances.
| Item Type: | Articles |
|---|---|
| Additional Information: | This work was supported by an award to AP from Well-come (205412/Z/16/Z). AP, SVK, AL and RD are also supported by the Medical Research Council(MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU17). |
| Status: | Early Online Publication |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Katikireddi, Professor Vittal and Leyland, Professor Alastair and Henery, Mr Paul and Pearce, Dr Anna and Dundas, Professor Ruth |
| Authors: | Pearce, A., Henery, P., Katikireddi, S. V., Dundas, R., Leyland, A. H., Nicholls, D., Viner, R. M., Fenton, L., and Hope, S. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
| Journal Name: | Child and Adolescent Mental Health |
| Publisher: | Wiley |
| ISSN: | 1475-357X |
| ISSN (Online): | 1475-3588 |
| Published Online: | 18 March 2024 |
| Copyright Holders: | Copyright: © 2024 The Authors |
| First Published: | First published in Child and Adolescent Mental Health 2024 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
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