gms | German Medical Science

10. Jahrestagung der GAA Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

16. bis 17.10.2003, Bonn

Drug treatment of children with hyperkinetic disorder: A population based epidemiological study with insurance data (1998-2001)

Medikamentöse Behandlung der hyperkinetischen Störung bei Kindern- und Jugendlichen: Eine versorgungsepidemiologische Studie auf der Basis von GVK-Daten

Meeting Abstract

  • corresponding author Ingrid Schubert - PMV forschungsgruppe Universität zu Köln Herderstraße 52-54, 50931 Köln. Tel.: 0221-478-6545, Fax: 478-6766
  • I. Köster - PMV forschungsgruppe Universität zu Köln Herderstraße 52-54, 50931 Köln
  • Chr. Adam - Child and Adolescent Psychiatry, University of Cologne
  • P. Ihle - PMV forschungsgruppe Universität zu Köln Herderstraße 52-54, 50931 Köln
  • M. Döpfner - Child and Adolescent Psychiatry, University of Cologne
  • G. Lehmkuhl - Child and Adolescent Psychiatry, University of Cologne

Gesellschaft für Arzneimittelanwendungsforschung u. Arzneimittelepidemiologie (GAA) e.V.. 10. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie (GAA) e.V.. Bonn, 16.-17.10.2003. Düsseldorf, Köln: German Medical Science; 2003. Doc03gaa19

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Veröffentlicht: 16. Oktober 2003

© 2003 Schubert et al.
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Background and Aim

Hyperkinetic Disorder (HD; ICD 10) and especially its (drug) treatment are discussed controversially within the health profession as well as in the public. The increase in prescribing of methylphenidate raised the question whether the drug is prescribed according to guidelines. To date, little is known about health care utilisation and drug treatment of HD-children in every day care in Germany. The aim of this study is to estimate medication prevalence for boys and girls with a claims form diagnosis for HD and to describe kind and duration of the treatment.


18.75 % random sample of 1.9 million persons insured by a local sickness fund of Hesse. (Versichertenstichprobe AOK Hessen/ KV Hessen) with about 60,000 children and adolescents (age 3 to 15) per year. Data: person related pseudononymised diagnosis (worded and ICD-1), services, prescription data. Period of observation: 1998-2001. Study population: Birth cohort 1983 until 1998, continually insured from 1998 to 2001 or born in 1998 and insured at least until 2002. Definition of children with HD according to claims diagnosis (relevant wording for the year 1998 and 1999) and ICD-10: F.90 in 2000 and 2001. In 2001 2,4% of the children aged 3 to 15 received a HD-diagnosis (boys: 3.8%, n=699 and girls 1.0%, n= 170). Analysed drugs: ATC Psycholeptics N05 and Psychoanaleptics N06.


The percentage of HD-children treated with psychotropic drugs raised from 24% in 1998 to 32% in the year 2001. About 2/3 of the HD-children received no drug therapy.

Methylphenidate is the mostly prescribed drug. As expected the treatment prevalence of the 3 to 15 year old HD-children rose from 15.9 % [95% CI: 14.2-17.7] in 1998 to 25.2% [95% CI 23.7-26.7] in 2001. The percentage of children with methylphenidate younger than 6 years decreased from 4.8% [95%CI: 2.4-7.1] in 1998 to 0.8% in 2001 [0.0-1.6]. Psycholeptics (N05) were prescribed to 7% of the HD-children, in most cases (6%) Sedativa (herbal or homoeopathic drugs). Antidepressants were found by 1% of the HD-children; three children received imipramine and 4 children St. John's wort. Psycholeptics and antidepressants (0.9%) were prescribed shortly (mean number of DDD: 33) in contrast to methylphenidate (mean number of DDD: 123). Analysing the first year of treatment with methylphenidate 15% got one prescription. A treatment duration for more than 280 days (according to first and last prescription) was found in half of the children (52%), but only 8% of the HD-children received during this time window one defined daily dose of methylphenidate (30 mg ). A treatment period of shorter than 6 months, but more than one prescription, could be found by 20% of the HD-children with methylphenidate.


The analysis of the treatment of HD-children shows the expected increase in the prescribing of methylphenidate but as well it could be demonstrated, that two third of the HD-children are not treated with psychotropic drugs. Whether the children are diagnosed properly has to be answered by different study types. However, the data of the statutory health insurance is suitable for pharmacoepidemiological studies and valuable for monitoring purposes in public health.