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Journal of Public Health

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Open Access 23-09-2022 | Original Article

Is it all about knowledge? A survey of attitudes toward ADHD among German pediatricians

Authors: Marie E. Fechner, Yuliya Mazheika, Folkert Fehr, Ronny Jung, Peter Borusiak

Published in: Journal of Public Health | Issue 11/2023

Abstract

Aim

Sometimes treatment is not necessarily according to guidelines, which is partly due to attitudes rather than lack of knowledge. In Germany, regional differences concerning prevalence rates of ADHD exist without valid explanation. We contribute with our data to the question of attitudes toward ADHD among pediatricians in Germany.

Method

A specially designed questionnaire based on the Knowledge of Attention Deficit Disorders Scale and previous surveys was sent to pediatricians. In addition to descriptive statistics, we performed factor analysis and multiple linear regression analysis.

Results

The vast majority (85.5%) of 581 respondents have a positive attitude toward ADHD, i.e., ADHD exists and should be treated appropriately. Physicians with positive attitudes were older and more often had a neuropediatric specialization.

Conclusion

Most of the pediatricians surveyed in Germany assess ADHD and treatment in line with medical guidelines and treat as part of multimodal therapy.

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In our opinion, the designations as “positive” and “negative” are somewhat unfortunate, as they imply a classification. We would rather prefer “in accordance with current guidelines” and “deviating from current guidelines,” (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaft (AWMF) 2017) but use the designations chosen so far because of the previous publications.

Adamis D, Tatlow-Golden M, Gavin B, McNicholas F (2018) General practitioners’ (GP) attitudes and knowledge about attention deficit hyperactivity disorder (ADHD) in Ireland. Ir J Med Sci 113:231–239. https://doi.org/10.1007/s11845-018-1804-3CrossRef

Akmatov MK, Steffen A, Holstiege J, Hering R, Schulz M, Bätzing J (2018) Trends and regional variations in the administrative prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Germany. Sci Rep 8:17029. https://doi.org/10.1038/s41598-018-35048-5CrossRefPubMedPubMedCentral

Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, (AWMF) [Association of the Scientific Medical Societies in Germany] (2017) Long version of the interdisciplinary, evidence- and consensus-based (S3) guidelines “Attention Deficit Hyperactivity Disorder (ADHD) in children, adolescents and adults” (AWMF-Registernummmer 028-045) https://www.awmf.org/fileadmin/user_upload/Leitlinien/028_D_G_f_Kinder-_und_Jugendpsychiatrie_und_-psychotherapie/028-045eng_S3_ADHS_2020-12.pdf

Bachmann CJ, Philipsen A, Hoffmann F (2017) ADHD in Germany: trends in diagnosis and pharmacotherapy. Deutsches Arzteblatt Int 114(9):141–148. https://doi.org/10.3238/arztebl.2017.0141CrossRef

Bethlehem J (2010) Selection Bias in web surveys. Int Stat Rev 78:161–188. https://doi.org/10.1111/j.1751-5823.2010.00112.xCrossRef

Canu WH, Mancil EB (2012) An examination of teacher trainees’ knowledge of attention-deficit/hyperactivity disorder. School Mental Health: A Multidisciplin Res Pract J 4:105–114. https://doi.org/10.1007/s12310-012-9071-3CrossRef

DosReis S, Barksdale CL, Sherman A, Maloney K, Charach A (2010) Stigmatizing experiences of parents of children with a new diagnosis of ADHD. Psychiatr Serv 61:811–816. https://doi.org/10.1176/ps.2010.61.8.811CrossRefPubMed

Fitzgerald M, McNicholas F (2014) Attitudes and practices in the management of ADHD among healthcare professionals who responded to a European survey. Ir J Psychol Med 31:31–37. https://doi.org/10.1017/ipm.2013.45CrossRefPubMed

Ghanizadeh A, Zarei N (2010) Are GPs adequately equipped with the knowledge for educating and counseling of families with ADHD children? BMC Fam Pract 11(5). https://doi.org/10.1186/1471-2296-11-5

Gilmore L (2010) Community knowledge and beliefs about ADHD. Aust Educ Dev Psychol 27(1):20–30. https://doi.org/10.1375/aedp.27.1.20CrossRef

Göbel K, Baumgarten F, Kuntz B, Hölling H, Schlack R (2018) ADHS bei Kindern und Jugendlichen in Deutschland – Querschnittsergebnisse aus KiGGS Welle 2 und Trends. J Health Monit 3:46–52. https://doi.org/10.17886/RKI-GBE-2018-085CrossRef

Goffman E (1963) Stigma; notes on the management of spoiled identity. Englewood Cliffs, Prentice-Hall

Grobe TG (2017) Regionale Unterschiede von ADHS-Diagnoseraten in Krankenkassendaten 2005 bis 2015. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 60:1336–1345. https://doi.org/10.1007/s00103-017-2640-8CrossRef

Gulliver A, Griffiths KM, Christensen H (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiat 10:113. https://doi.org/10.1186/1471-244X-10-113CrossRef

Hinshaw S, Sheffler RM, Fulton BD, Aase H, Banaschewski T, Cheng W, Mattos P, Holte A, Levy F, Sadeh A, Sergeant JA, Taylor E, Weiss MD (2011) International variation in treatment procedures for ADHD: social context and recent trends. Psychiatr Serv 62:459–464. https://doi.org/10.1176/ps.62.5.pss6205_0459CrossRefPubMed

Jiang Y, Gurm M, Johnston C (2014) Child impairment and parenting self-efficacy in relation to mothers’ views of ADHD treatments. J Atten Disord 18:532–541. https://doi.org/10.1177/1087054712443412CrossRefPubMed

Mueller AK, Fuermaier AB, Koerts J, Tucha L (2012) Stigma in attention deficit hyperactivity disorder. Atten Defic Hyperact Disord 4(3):101–114. https://doi.org/10.1007/s12402-012-0085-3CrossRefPubMedPubMedCentral

NICE guideline (2018) Attention deficit hyperactivity disorder: diagnosis and management. https://www.nice.org.uk/guidance/ng87. Accessed 10 Aug 2021

Pescosolido BA, Martin JK, Lang A, Olafsdottir S (2008) Rethinking theoretical approaches to stigma: a framework integrating normative influences on stigma (FINIS). Soc Sci Med 67(3):431–440. https://doi.org/10.1016/j.socscimed.2008.03.018CrossRefPubMed

Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA (2014) ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol 43(2):434–442. https://doi.org/10.1093/ije/dyt261CrossRefPubMedPubMedCentral

Power TJ, Eiraldi RB, Clarke AT, Mazzuca LB, Krain AL (2005) Improving mental health service utilization for children and adolescents. Sch Psychol Q 20(2):187–205. https://doi.org/10.1521/scpq.20.2.187.66510CrossRef

Rodrigo MD, Perera D, Eranga VP, Williams SS, Kuruppuarachchi KA (2011) The knowledge and attitude of primary school teachers in Sri Lanka towards childhood attention deficit hyperactivity disorder. Ceylon Med J 56:51–54. https://doi.org/10.4038/cmj.v56i2.3108CrossRefPubMed

Salt N, Parkes E, Scammell A (2005) GPs’ perceptions of the management of ADHD in primary care: a study of Wandsworth GPs. Primary Health Care Res Dev 6(2):162–171. https://doi.org/10.1191/1463423605pc239oaCrossRef

Sayal K, Goodman R, Ford T (2006) Barriers to the identification of children with attention deficit/hyperactivity disorder. J Child Psychol Psychiatry 47(7):744–750. https://doi.org/10.1111/j.1469-7610.2005.01553.xCrossRefPubMed

Schmiedeler S (2013) Wissen und Fehlannahmen von deutschen Lehrkräften über die Aufmerksamkeitsdefizit- / Hyperaktivitätsstörung (ADHS). Psychol Erzieh Unterr 60:143–153. https://doi.org/10.2378/peu2013.art12dCrossRef

Sciutto MJ, Terjesen MD, Bender Frank AS (2000) Teachers' knowledge and misperceptions of attention-deficit/hyperactivity disorder. Psychol Sch 37(2):115–122. https://doi.org/10.1002/(SICI)1520-6807(200003)37:2%3C115::AID-PITS3%3E3.0.CO;2-5CrossRef

Sciutto MJ, Terjesen MD, Kučerová A, Michalová Z, Schmiedeler S, Antonopoulou K, Shaker NZ, Lee J-Y, Alkahtani K, Drake B, Rossouw J (2016) Cross-national comparisons of teachers’ knowledge and misconceptions of ADHD. Int Perspect Psychol: Res, Pract, Consultation 5(1):34–50. https://doi.org/10.1037/ipp0000045CrossRef

Shaw KA, Mitchell GK, Wagner IJ, Eastwood HL (2002) Attitudes and practices of general practitioners in the diagnosis and management of attention-deficit/hyperactivity disorder. J Paediatr Child Health 38(5):481–486. https://doi.org/10.1046/j.1440-1754.2002.00033.xCrossRefPubMed

Tatlow-Golden M, Prihodova L, Gavin B, Cullen W, McNicholas F (2016) What do general practitioners know about ADHD? Attitudes and knowledge among first-contact gatekeepers: systematic narrative review. BMC Fam Pract 17:129. https://doi.org/10.1186/s12875-016-0516-xCrossRefPubMedPubMedCentral

Taylor LE, Antshel KM (2021) Factors associated with parental treatment attitudes and information-seeking behaviors for children with ADHD. J Atten Disord 25:607–617. https://doi.org/10.1177/1087054718821734CrossRefPubMed

Tremmery S, Buitelaar JK, Steyaert J, Molenberghs G, Feron FJ, Kalff AC, Hurks PP, Hendriksen JG, Vles JS, Jolles J (2007) The use of health care services and psychotropic medication in a community sample of 9-year-old schoolchildren with ADHD. Eur Child Adolescent Psychiat 16(5):327–336. https://doi.org/10.1007/s00787-007-0604-5CrossRef

Vallée M (2011) Resisting American Psychiatry: French Opposition to DSM-III, Biological Reductionism, and the Pharmaceutical Ethos. In: McGann P, D. Hutson D (ed) Sociology of Diagnosis Emerald Group. Publishing Limited, pp 85–110

Wolraich ML, Hagan JF Jr, Allan C, Chan E, Davison D, Earls M, Evans SW, Flinn SK, Froehlich T, Frost J, Holbrook JR, Lehmann CU, Lessin HR, Okechukwu K, Pierce KL, Winner JD, Zurhellen W Subcommittee on Children and Adolescents with Attention-Deficit/Hyperactive Disorder (2019) Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4). https://doi.org/10.1542/peds.2019-2528

Title: Is it all about knowledge? A survey of attitudes toward ADHD among German pediatricians
Authors: Marie E. Fechner
Yuliya Mazheika
Folkert Fehr
Ronny Jung
Peter Borusiak
Publication date: 23-09-2022
Publisher: Springer Berlin Heidelberg
Published in: Journal of Public Health / Issue 11/2023
Print ISSN: 2198-1833
Electronic ISSN: 1613-2238
DOI: https://doi.org/10.1007/s10389-022-01758-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Is it all about knowledge? A survey of attitudes toward ADHD among German pediatricians

Abstract

Aim

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Method

Results

Conclusion

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