TY - JOUR
T1 - Longitudinal mental health service and medication use for ADHD among Puerto Rican youth in two contexts
AU - Bird, Hector R.
AU - Shrout, Patrick E.
AU - Duarte, Cristiane S.
AU - Shen, Sa
AU - Bauermeister, José J.
AU - Canino, Glorisa
PY - 2008/8
Y1 - 2008/8
N2 - Objective: The study describes prevalence and rates of services and medication use and associated factors over time among Puerto Rican youths with attention-deficit/hyperactivity disorder (ADHD). Method: Longitudinal data are obtained on Puerto Rican children ages 5 through 13 years in the south Bronx in New York (n = 1,138) and two metropolitan areas in Puerto Rico (n = 1,353). The Diagnostic Interview Schedule for Children-IV is the diagnostic tool. Five composite measures of risk factors: negative family influences, ineffective structuring, environmental risks, child risks, and maternal acceptance are constructed to relate services and medication use to risk variables. Results: ADHD prevalence is similar in Puerto Rico and the south Bronx. Overall mental health services, medication, and psychostimulant use is lower in Puerto Rico across three time points. Most participants never received treatment at any time point. More environmental risks, negative child traits, and low maternal warmth are associated with more services, even after adjusting for comorbidity. When risk variables are controlled, the effects of ADHD on services use decrease. Previous treatment is a strong predictor of subsequent treatment. Conclusions: Rates of services and medication use are lower in Puerto Rico. Context seems to be more important than ethnicity in predicting mental health services and medication use among Puerto Rican children with ADHD. Other psychiatric diagnoses and general risk variables are important correlates of services and medication use.
AB - Objective: The study describes prevalence and rates of services and medication use and associated factors over time among Puerto Rican youths with attention-deficit/hyperactivity disorder (ADHD). Method: Longitudinal data are obtained on Puerto Rican children ages 5 through 13 years in the south Bronx in New York (n = 1,138) and two metropolitan areas in Puerto Rico (n = 1,353). The Diagnostic Interview Schedule for Children-IV is the diagnostic tool. Five composite measures of risk factors: negative family influences, ineffective structuring, environmental risks, child risks, and maternal acceptance are constructed to relate services and medication use to risk variables. Results: ADHD prevalence is similar in Puerto Rico and the south Bronx. Overall mental health services, medication, and psychostimulant use is lower in Puerto Rico across three time points. Most participants never received treatment at any time point. More environmental risks, negative child traits, and low maternal warmth are associated with more services, even after adjusting for comorbidity. When risk variables are controlled, the effects of ADHD on services use decrease. Previous treatment is a strong predictor of subsequent treatment. Conclusions: Rates of services and medication use are lower in Puerto Rico. Context seems to be more important than ethnicity in predicting mental health services and medication use among Puerto Rican children with ADHD. Other psychiatric diagnoses and general risk variables are important correlates of services and medication use.
KW - Attention-deficit/hyperactivity disorder
KW - Epidemiology
KW - Psychostimulant use
UR - http://www.scopus.com/inward/record.url?scp=58149195608&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58149195608&partnerID=8YFLogxK
U2 - 10.1097/CHI.0b013e318179963c
DO - 10.1097/CHI.0b013e318179963c
M3 - Article
C2 - 18596555
AN - SCOPUS:58149195608
SN - 0890-8567
VL - 47
SP - 879
EP - 889
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 8
ER -