Commentary

Abstract

The study by Angold et al., 2000 Angold A Erkanli A Egger HL Costello EJ Stimulant treatment for children: a community perspective. J Am Acad Child Adolesc Psychiatry. 2000; 39: 975-984 Abstract Full Text Full Text PDF PubMed Scopus (275) Google Scholar addresses an extremely important and timely question: How appropriate is the use of stimulant medications for treating children with attention-deficit hyperactivity disorder (ADHD) in our communities? Available indicators point to a substantial increase in stimulant prescriptions during the early and mid-1990s ( Pincus et al., 1998 Pincus HA Tanielian TL Marcus SC et al. Prescribing trends in psychotropic medications: primary care, psychiatry, and other medical specialties. JAMA. 1998; 279: 526-531 Crossref PubMed Scopus (371) Google Scholar , Robison et al., 1999 Robison LM Sclar DA Skaer TL Galin RS National trends in the prevalence of attention-deficit/hyperactivity disorder and the prescribing of methylphenidate among school-age children: 1990–1995. Clin Pediatr (Phila). 1999; 38: 209-217 Crossref PubMed Scopus (202) Google Scholar , Safer et al., 1996 Safer DJ Zito JM Fine EM Increased methylphenidate usage for attention deficit disorder in the 1990s. Pediatrics. 1996; 98: 1084-1088 PubMed Google Scholar , Zito et al., 1999 Zito JM Safer DJ dosReis S Magder LS Gardner JF Zarin DA Psychotherapeutic medication patterns for youths with attention-deficit/ hyperactivity disorder. Arch Pediatr Adolesc Med. 1999; 153: 1257-1263 Crossref PubMed Scopus (139) Google Scholar , Zito et al., 2000 Zito JM Safer DJ dosReis S Gardner JF Boles M Lynch F Trends in the prescribing of psychotropic medications to preschoolers. JAMA. 2000; 283: 1025-1030 Crossref PubMed Scopus (752) Google Scholar ). These pharmacoepidemiological studies have provided valuable descriptions of trends in medication use but have not informed on the clinical appropriateness of this use. Angold and colleagues add a new perspective by studying the relationship among symptoms, diagnosis, and stimulant use in a representative sample of 9- to 16-year-old children in 11 counties of western North Carolina during the years 1992-1996.