ADHD

Updated 14 June 2017

ADHD: Link between meds and socio economic background

A study has linked ADHD to low maternal education, lone parents and welfare benefits.

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Study covers 1.16 million children aged 6 to 19

A major study of more than a million children has found strong links between receiving medication for attention deficit hyperactivity disorder (ADHD) and limited maternal education, single parent families and welfare benefits, according to the June issue of Acta Paediatrica

Swedish experts teamed up to carry out what they believe is the first study of risk factors for ADHD in a national cohort of school children, based on 1.16 million children on the country's Prescribed Drug Register.

"We identified 7,960 Swedish-born children, aged between six and 19, using a prescription for ADHD medication as our indicator of severe ADHD" explains lead author Professor Anders Hjern from the Centre for Health Equity Studies, a collaboration between the Karolinska Institutet and Stockholm University.

"We then tracked their records through other registers, using the unique ten digit reference number all Swedish residents are given at birth, to determine a number of other factors."

ADHD is a common, treatable childhood illness that can affect areas of the brain connected to problem solving, planning ahead, understanding others' actions and controlling impulses. The primary symptoms of the condition are hyperactivity, impulsivity and inattention.

Key findings

"Genes are also known to play an important role in the development of ADHD and studies of identical twins show that they are very likely to exhibit the same ADHD traits" says Professor Hjern, who carried out the study when he was based at the National Board of Health and Welfare.

Key findings of the Swedish study include:

- Boys were three times more likely to be on ADHD medication than girls, with medication use highest in boys aged between 10 and 15.

- Women who had only received the most basic education were 130 per cent more likely to have a child on ADHD medication than women with university degrees.

- Children were 54 per cent more likely to be on ADHD medication if they came from a single parent family rather than having both parents at home.

- Coming from a family on welfare benefits increased the risk of ADHD medication by 135 per cent when compared with households not claiming benefits.

- There were no statistically significant differences between the effects that socioeconomic factors had on boys or girls in the study.

When the researchers examined the total impact of the socioeconomic factors, they found that the impact was similar to that reported in twin studies.

Potent predictors

"Our study showed that almost half of the cases could be explained by the socioeconomic factors included in our analysis, clearly demonstrating that these are potent predictors of ADHD-medication in Swedish schoolchildren" says Professor Hjern.

"There are several ways that family factors may influence ADHD. For example, low parental education is associated with general social disadvantage, a higher number of stress factors and a greater risk of childhood adversity.

"Lack of time and money are more common in single parent families, as are lack of social support and family conflict, including separation, divorce and parental absence.

"We believe that further research into ADHD should focus on the interaction between genes and environmental factors in order to determine the reasons why some children develop ADHD and how it could be prevented."

Read more:

Parents and kids with ADHD

Emotional ADHD



 

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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation (www.gb4adhd.co.za) She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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