Abstract
Assessing whether symptoms of attention-deficit hyperactivity disorder (ADHD) in children are age-inappropriate is essential. Hence, comparing children within one school grade is problematic and the risk of applying relative standards is inherent. Being young-for-grade increases the likelihood of receiving medication in countries with high prevalence of ADHD medication. We test the same hypothesis in a cohort of 418,396 children and find no difference between children who are young-for-grade and old-for-grade. The Danish system, with its restrictive approach to medication and clear diagnostic guidelines seems to have avoided a systematic bias of ADHD medication in young children reported in other countries.
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References
Dalsgaard S (2013) Attention-deficit/hyperactivity disorder (ADHD). Eur Child Adolesc Psychiatry 22(Suppl 1):S43–S48
Dalsgaard S, Humlum MK, Nielsen HS, Simonsen M (2012) Relative standards in ADHD diagnoses: the role of specialist behavior. Econ Lett 117:663–665
Dalsgaard S, Nielsen HS, Simonsen M (2013) Five-fold increase in national prevalence rates of ADHD medications for children and adolescents with autism spectrum disorder, attention-deficit/hyperactivity disorder and other psychiatric disorders. J Child Adolesc Psychopharmacol 23:432–439
Elder TE (2010) The importance of relative standards in ADHD diagnoses: evidence based on exact birth dates. J Health Econ 29:641–656
Evans WN, Morrill MS, Parente ST (2010) Measuring inappropriate medical diagnosis and treatment in survey data: the case of ADHD among school-age children. J Health Econ 29:657–673
Goodman R, Gledhill J, Ford T (2003) Child psychiatric disorder and relative age within school year: cross sectional survey of large population sample. BMJ 327:472
Jinks PC (1964) An investigation into the effect of date of birth on subsequent school performance. Educat Res 6:220–225
Miller AR, Lalonde CE, McGrail KM, Armstrong RW (2001) Prescription of methylphenidate to children and youth, 1990–1996. CMAJ 165:1489–1494
Morrow RL, Garland EJ, Wright JM, Maclure M, Taylor S, Dormuth CR (2012) Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children. CMAJ 184:755–762
Mors O, Perto GP, Mortensen PB (2011) The Danish psychiatric central research register. Scand J Public Health 39:54–57
Pedersen CB, Gøtzsche H, Møller JØ, Mortensen PB (2006) The Danish civil registration system: a cohort of eight million persons. Dan Med Bull 53:441–449
Wattie N, Cobley S, Baker J (2008) Towards a unified understanding of relative age effects. J Sports Sci 26:1403–1409
Zoega H, Valdimarsdottir UA, Hernandez-Diaz S (2012) Age, academic performance, and stimulant prescribing for ADHD: a nationwide cohort study. Pediatrics 130:1012–1018
Acknowledgments
We thank Kasper Jørgensen for excellent research assistance, the Danish Psychiatric Central Register for access to data and the funding sources for the financial support. The study was funded by grants from the Danish Council for Independent Research (Sapere Aude Starting Grant, 10-079597),“Slagtermester Wörzner og Hustru Inger Wörzners mindelegat til fordel for forskning af sindslidelser” and The Lundbeck Foundation.
Conflict of interest
Drs. Humlum, Nielsen and Simonsen have no conflicts of interests. Dr. Dalsgaard is a consultant for The Danish Health and Medicines Authority.
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Dalsgaard, S., Humlum, M.K., Nielsen, H.S. et al. Common Danish standards in prescribing medication for children and adolescents with ADHD. Eur Child Adolesc Psychiatry 23, 841–844 (2014). https://doi.org/10.1007/s00787-013-0508-5
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DOI: https://doi.org/10.1007/s00787-013-0508-5