Management of ADHD in Hispanic Patients

Management of ADHD in Hispanic Patients

INTRODUCTION

Epidemiologic data on the prevalence of ADHD in the Hispanic population are lacking because few population-based studies have been performed. One estimate by the National Center for Health Statistics reported that the prevalence of ADHD is 3.3% in Hispanics and 6.5% in whites. Of those Hispanics who are diagnosed, many are undertreated. A national study analyzed data from 26,000 office- and hospital-based primary care visits and reported that Hispanic children were significantly less likely than white children to be treated with a stimulant medication. Similarly, a study of children in Maryland public schools reported that Hispanic students received methylphenidate at approximately one-third the rate of white students. Also of concern are data from parent questionnaires, which suggest that treatment regimens are not adhered to by Hispanic patients with ADHD. One survey of almost 2,000 island-Puerto-Rican caregivers reported that only 3.6% of children with ADHD who received stimulants during the previous year were adhering to treatment one year later. The treatment of ADHD in Hispanic patients must be improved, since untreated ADHD has been associated with multiple negative outcomes, such as comorbid conduct disorder, school failure, mood disorders, substance abuse and the development of adult antisocial personality.

Possible reasons for the disparities in the diagnosis and treatment of ADHD in the Hispanic population may be partly explained by language barriers that interfere with the ability to report ADHD symptoms to the physician, degree of acculturation (less acculturated mothers may not recognize symptoms of ADHD), different developmental expectations by Hispanic mothers or physician bias that may cause dismissal of concerns regarding ADHD symptoms in the Hispanic population. It is also possible that Hispanic patients are being diagnosed with more severe conditions or behavioral problems when the underlying diagnosis is actually ADHD. An example of this may be observed in the African-American population, as studies suggest that African Americans are overdiagnosed with schizophrenia compared with whites. If a similar situation exits in Hispanic patients with ADHD, it is possible that these patients are receiving inappropriate treatment. Alternatively, the incidence of ADHD may truly be lower in Hispanic children, although data from a number of studies suggest that the incidence of ADHD is similar between Hispanic and non-Hispanic white children. Save on your pharmacy bills. Buy cialis 20 mg online

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