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A comparison between South African psychiatrists' and paediatricians' knowledge, attitudes and current practices regarding the management of children with Attention Deficit/Hyperactivity Disorder

The objective of this study was to determine the knowledge, attitudes and current practices of psychiatrists and paediatricians in South Africa regarding the management of children with Attention Deficit/Hyperactivity Disorder (ADHD), to determine if there are significant differences between them. Three hundred and forty psychiatrists and 517 paediatricians were identified from the address list of the Health Professionals Council of South Africa. Each specialist was sent a survey questionnaire with a letter explaining the objectives and aims of the research. The questionnaire explored four themes: demographic data; attitudes to caring for children with ADHD; management of these children and knowledge about the use of stimulants. One hundred and seventy three (57.6%) psychiatrists and 316 (61%) paediatricians responded. Of these 145 and 278 respectively were practising medicine, and 51.7% (75) of the psychiatrists and 61% (169) of the paediatricians indicated that they manage children with ADHD. The results of the survey indicate that paediatricians and psychiatrists have adequate knowledge of ADHD and its management. Possibly because of the organisation of their practices psychiatrists were not as concerned as paediatricians about the time spent on each patient, but they were less likely to refer to other professionals. On the other hand, paediatricians had more of an interdisciplinary approach to the management of children with ADHD, but found them time consuming, remuneration inadequate and had little time to prepare extensive reports or liase with other professionals or schools. Psychiatrists appear to function within a neuro-biological model and have more knowledge on neuro-pharmacology and physiology. Paediatricians have a greater educational and family awareness, possibly reflecting differences in training. Both groups use methylphenidate as the medication of choice and both have adequate knowledge of its benefits, side effects and contra-indications.