Diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD) in African-American and Hispanic patients.
Year: 2005
Type: article
Abstract: A ttention-deficit /hyperactivity disorder (ADHD)isaneurobehavioral disorder characterized byhyperactivity, impulsivityandinattention. Theetiology ofADHD isthought toinvolve genetic factors anddysfunction ofthedopamine and orepinephrine neurotransmitter systems inthefrontostriatal circuitry. Comorbidities, such asconduct disorder, oppositional defiant disorder, depression, anxiety, learning disabilities, andalcohol ordrugaddiction, areoften noted inpatients with untreated ADHD.Primary goals oftherapy forADHD aretodecrease disruptive behaviors, enhance academic performance, improve relationships with family andpeers, improve self-esteem andpromote independence. Theprevalence ofADHD inAfrican Americans ismostlikely similar tothat amongthegeneral population (3-5%); however, fewer African Americans arediagnosed andtreated forADHD.'-5 Similarly, theprevalence inHispanics studied hasbeen found tobelower, around 3.3%. Like African Americans, manyHispanics diagnosed areuntreated andundiagnosed.6 Thereasonsforthese findings havenotbeenfully detailed. Investigators exploring theeffects ofethnicity onADHD treatment inthe Multimodal Treatment Study ofChildren with ADHD (the MTA Study) demonstrated that response tomedication management alone wasgreater than that forbehavioral management, combined (medication andbehavioral) orroutine community care.7 TheAfrican-American andLatino families inthestudy demonstrated greater benefit fromthecombined (medication and behavioral) management compared with medication alone. Thetreatment response, however, didnotdiffer significantly byethnicity after controlling forpublic assistance. This suggests that improvements seen with behavioral therapy mayrelate moreto socioeconomic status than ethnicity. Efforts mustbemadetoexplore thebarriers ofdiagnosis andtreatment ofADHD,awarenessamonghealthcare providers, andtheAfrican-American andHispanic communities. Thissupplement studies issues involved inthediagnosis andmanagement ofADHD inAfrican Americans andHispanics. Improving knowledge ofcultural practices mayimprove therelationships between patients andclinicians, helpfacilitate the diagnosis ofADHD,allow healthcare providers tomakeproper treatment recommendations, andaidinlanguage barriers and physician bias that cancause dismissal ofADHD symptom concerns. Culture canbeviewed asoneofourgreatest assets for healing andmental wellness.8 Efforts toward improving symptoms ofADHD andits treatment needtobemadetoincrease awareness intheAfrican-American andHispanic communities. Ethnic andcultural sensitivity involves abroad understanding ofcultural concepts andissues andawareness ofcultural differences inperception ofdiseases, disorders, responses andcare for theneeds ofthepatients.8
Source: PubMed Central
Author: Rahn K Bailey
Institution: Bryce Hospital
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2143773092