The online version of this article (https://doi.org/10.1186/s12888-017-1572-z) contains supplementary material, which is available to authorized users.
Child psychiatric treatment facilities vary greatly worldwide and are virtually non-existent in many low-income countries. One of the most common psychiatric disorders in childhood is ADHD, with an estimated prevalence of 3–5% in Sweden. Previous studies have shown a similar prevalence of ADHD in minority and majority children in Sweden and the UK. However, clinical studies demonstrated that children from immigrant families living in Sweden received less psychiatric care than those of native-born parents. We tested the hypothesis that the consumption of child psychiatric care in immigrant families would be determined by the availability of such treatment in the parents’ country of origin. Patterns of medication for attention-deficit hyperactivity disorder (ADHD) were studied as a proxy for child psychiatric care.
This was a register study of dispensed stimulant medication during 2013–2014 in Swedish national birth cohorts from 1995–2009. The study population, consisting of nearly 1.4 million children, was divided by national income of the parental country of origin and whether the parents were native Swedes, European immigrants, non-European immigrants or a mixture. Logistic regression was used to calculate the odds ratios of having been dispensed at least one ADHD drug during 2013, with adjustments for gender, family status indicating whether the child is living with both parents, household income and area of residence.
Having parents born in low-income (OR [95% confidence interval] 0.27 [0.24–0.29]) or middle-income (European: OR 0.23 [0.20–0.26], non-European: OR 0.39 [0.34–0.41]) countries was associated with lower ADHD treatment levels than having parents born in high-income countries (European: OR 0.60 [0.54–0.66], non-European: OR 0.68 [0.59–0.79]), when compared to children of parents born in Sweden. In families with a background in low or middle income countries, there was no significant association between household income and ADHD medication, while in children with Swedish and mixed backgrounds high level of disposable income was associated with lower levels of ADHD medication.
The use of child psychiatric care by immigrant families in Sweden was largely associated with the income level of the country of origin.
Additional file 1: Table S1. Logistic regression of ADHD diagnosis (DOCX 12 kb)12888_2017_1572_MOESM1_ESM.docx
Wiking E: Health care on equal terms for immigrants in Sweden: Inst för neurobiologi, vårdvetenskap och samhälle/Dept of neurobiology, care sciences and Society; 2012.
Hjern A, Haglund B, Persson G, Rosen M. Is there equity in access to health services for ethnic minorities in Sweden? Eur J Pub Health. 2001;11(2):147–52. CrossRef
Ivert AK, Svensson R, Adler H, Levander S, Rydelius PA, Torstensson Levander M. Pathways to child and adolescent psychiatric clinics: a multilevel study of the significance of ethnicity and neighbourhood social characteristics on source of referral. Child Adolesc Psychiatry Ment Health. 2011;5(1):6. CrossRefPubMedPubMedCentral
Mossler K, Kadesjö B, Hellgren L. Kort om ADHD hos barn och vuxna En sammanfattning av Socialstyrelsens kunskapsöversikt. Socialmedicinsk tidskrift. 2014;81(2):164–6.
Green H, McGinnity Á, Meltzer H, Ford T, Goodman R: Mental health of children and young people in great Britain, 2004. In: Basingstoke: Palgrave Macmillan; 2005.
Jablonska B, Kosidou K, de Leon AP, Wettermark B, Magnusson C, Dal H, Dalman C. Neighborhood socioeconomic characteristics and utilization of ADHD medication in schoolchildren a population multilevel study in Stockholm County. J Atten Disord. 2016:1087054716643257.
World Health Organization: Mental health atlas 2005: World Health Organization. Dept. of mental health and Substance Abuse; 2005.
How does the World Bank classify countries? - World bank data helpdesk [ https://datahelpdesk.worldbank.org/knowledgebase/articles/378834-how-does-the-world-bank-classify-countries].
Wettermark B, Hammar N, Fored CM, Leimanis A, Otterblad Olausson P, Bergman U, Persson I, Sundstrom A, Westerholm B, Rosen M. The new Swedish prescribed drug register--opportunities for pharmacoepidemiological research and experience from the first six months. Pharmacoepidemiol Drug Saf. 2007;16(7):726–35. CrossRefPubMed
Salmi P, Bergman GJ. Användningen av centralstimulantia vid ADHD Utvecklingen regionalt och i riket. In: Socialstyrelsen. 2015;
Stein SM, Christie D, Shah R, Dabney J, Wolpert M. Attitudes to and knowledge of CAMHS: differences between Pakistani and white British mothers. Child Adolesc Mental Health. 2003;8(1):29–33. CrossRef
Freitag CM, Retz W. Family and twin studies in attention-deficit hyperactivity disorder. In: Attention-Deficit Hyperactivity Disorder (ADHD) in Adults. Volume 176. Basel: Karger publishers; 2009. p. 38–57.
- ADHD medication in offspring of immigrants — does the income level of the country of parental origin matter?
- BioMed Central
Neu im Fachgebiet Psychiatrie
Meistgelesene Bücher aus dem Fachgebiet
e.Med Kampagnen-Visual, Mail Icon II