MedicalResearch.com Interview with:
Anna Chorniy PhD
Postdoctoral Research Associate
Center for Health and Wellbeing
Princeton NJ 08544
MedicalResearch.com: What is the background for this study?
Response: Attention-deficit/hyperactivity disorder (ADHD) is one of the common chronic mental conditions affecting children. In the U.S., 11% of children ages 4–17 (6.4 million) are estimated to have an ADHD diagnosis and almost 70% of them report taking medication for the condition (e.g. Visser et al., 2014). However, little evidence exists on the effects of ADHD treatment on children’s outcomes.
We use a panel data set of South Carolina Medicaid claims paid out in 2003–2013 to investigate the effects of ADHD medication treatment on a seldom studied set of outcomes associated with this condition: adolescent risky behaviors and the incidence of injuries.
The occurrence of injuries allows us to evaluate short-term effects of ADHD treatment, while substance abuse and risky sexual behavior outcomes speak for the long-term effects of medication. Second, we use Medicaid spending on treatment of these negative events to evaluate the impact of ADHD drugs on the severity of ADHD, and compare the cost of ADHD treatment with the costs of negative health events.
MedicalResearch.com: What are the main findings?
Response: Our results suggest that pharmacological treatment reduces the probability of every negative health and behavioral outcome that we identified in the data. If a patient is treated with ADHD medication the probability of contracting an STD decreases by 3.6 percentage points (5.8 percentage points if we include STD screening), having a substance abuse disorder decreases by 7.3 percentage points, becoming injured by 2.3 percentage points each year and annual injury spending decreases by $88.4, or 0.054 of a standard deviation. Finally, the probability of teenage pregnancy decreases by 2.3 percentage points, though the effect is not statistically significant.
MedicalResearch.com: What should readers take away from your report?
Response: While previous research has demonstrated the effectiveness of medications in treating the core symptoms of ADHD, little has been known about the effects of treatment on health, behavioral and educational outcomes in the long run. Evidence so far points to positive effects on some outcomes but not others. Currie et al. (2014) find such treatment was actually associated with a decrease in academic performance, deterioration in relationship with parents and an increased likelihood of depression. Other work has shown some reduction in hospital visits and police interactions.
This paper provides non-experimental evidence on a novel set of outcomes to show that pharmacological treatment reduces the probability of negative outcomes of risky behaviors of treated children and teens compared to diagnosed but untreated patients.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: This paper is the one of my ongoing research projects on children with ADHD. More research is needed to shed light on the reasons behind ADHD’s explosion and the effects of ADHD medication on academic attainment and outcomes that are typically unavailable in administrative data, e.g. growth, weight.
Given that disadvantaged children and teens enrolled in Medicaid, a public insurance program, are disproportionately diagnosed with ADHD, these are important policy questions to address: why are there more children taking ADHD drugs today than a decade ago, what benefits do they deliver and at what cost.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Anna Chorniy, Leah Kitashima. Sex, drugs, and ADHD: The effects of ADHD pharmacological treatment on teens’ risky behaviors. Labour Economics, 2016; DOI:10.1016/j.labeco.2016.06.014
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