{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T11:07:12Z","timestamp":1789556832835,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>National trends in ADHD medication use in Norway have recently been described. Less is known about whether children and adolescents in different counties have followed similar or diverging medication-dispensing trajectories over time. We therefore examined county-level variation and county-level trajectories in ADHD medication dispensing among Norwegian children and adolescents from 2005 to 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide retrospective drug-utilisation study using aggregated data from the Norwegian Prescription Database and population denominators from Statistics Norway. The study included individuals aged 6\u201317 years who redeemed at least one prescription for an ADHD medication between 2005 and 2022. Annual dispensing prevalence was calculated by county, sex, and age group and expressed as users per 1,000 inhabitants. Analyses were stratified into children aged 6\u201311 years and adolescents aged 12\u201317 years. To quantify regional variation, we calculated the lowest and highest county rates, absolute rate differences, and high-to-low county rate ratios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ADHD medication dispensing increased in all sex and age strata, but county-level trajectories differed over time. In 2022, dispensing prevalence among girls aged 6\u201311 years ranged from 4.6 per 1,000 inhabitants in Oslo to 15.1 per 1,000 in M\u00f8re og Romsdal, corresponding to a 3.25-fold difference. Among boys aged 6\u201311 years, rates ranged from 14.6 per 1,000 in Oslo to 39.9 per 1,000 in Nordland, corresponding to a 2.74-fold difference. Among adolescents aged 12\u201317 years, rates ranged from 15.3 per 1,000 in Agder to 35.2 per 1,000 in Tr\u00f8ndelag among girls, and from 25.1 per 1,000 in Oslo to 62.4 per 1,000 in Tr\u00f8ndelag among boys, corresponding to 2.30-fold and 2.49-fold differences, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study extends previous Norwegian register-based work by showing substantial county-level variation in ADHD medication dispensing among children and adolescents. National averages may conceal important regional differences in recognition, referral pathways, diagnostic practice, treatment thresholds, prescribing practice, or service organisation. Further studies linking prescription data with diagnostic, clinical, service-level, and socioeconomic information are needed to clarify the drivers and consequences of these regional differences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1861616","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:26:20Z","timestamp":1788236780000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["County-level variation and trajectories in ADHD medication dispensing among Norwegian children and adolescents, 2005-2022: a nationwide prescription register study"],"prefix":"10.3389","volume":"17","author":[{"given":"Espen","family":"Anker","sequence":"first","affiliation":[{"name":"Klinikk Toppetasjen","place":["Oslo, Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bothild","family":"Bendiksen","sequence":"additional","affiliation":[{"name":"Klinikk Toppetasjen","place":["Oslo, Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gro Janne","family":"Wergeland","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Medicine, University of Bergen","place":["Bergen, Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per Hove","family":"Thomsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aarhus University","place":["Aarhus, Denmark"]},{"name":"Aarhus University Hospital","place":["Aarhus, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"B1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","year":"2013"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.164.6.942","article-title":"The worldwide prevalence of ADHD: a systematic review and metaregression analysis","volume":"164","author":"Polanczyk","year":"2007","journal-title":"Am J Psychiatry"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/jcpp.12381","article-title":"Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents","volume":"56","author":"Polanczyk","year":"2015","journal-title":"J Child Psychol Psychiatry"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e994","DOI":"10.1542\/peds.2014-3482","article-title":"Prevalence of attention-deficit\/hyperactivity disorder: systematic review and meta-analysis","volume":"135","author":"Thomas","year":"2015","journal-title":"Pediatrics"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-012-0135-8","article-title":"The prevalence of DSM-IV ADHD: a meta-analytic review","volume":"9","author":"Willcutt","year":"2012","journal-title":"Neurotherapeutics"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-201003000-00005","article-title":"Sex and age differences in ADHD symptomatology across the lifespan","volume":"49","author":"Ramtekkar","year":"2010","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1177\/108705470200500302","article-title":"A meta-analytic review of gender differences in ADHD","volume":"5","author":"Gershon","year":"2002","journal-title":"J Atten Disord"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2022.101780","article-title":"Attention-deficit\/hyperactivity disorder medication consumption in 64 countries and regions from 2015 to 2019: a longitudinal study","volume":"58","author":"Chan","year":"2023","journal-title":"EClinicalMedicine"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14207338","article-title":"Global trends in ADHD medication use: multiple contexts and rising concerns-a narrative review","volume":"14","author":"Rzeszutek","year":"2025","journal-title":"J Clin Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-010508","article-title":"Latest trends in ADHD drug prescribing patterns in children in the UK: prevalence, incidence and persistence","volume":"6","author":"Beau-Lejdstrom","year":"2016","journal-title":"BMJ Open"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(17)30167-0","article-title":"ADHD in children and young people: prevalence, pathogenesis, and treatment","volume":"5","author":"Sayal","year":"2018","journal-title":"Lancet Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1917069","article-title":"Pharmacologic treatment of ADHD","volume":"383","author":"Cortese","year":"2020","journal-title":"N Engl J Med"},{"key":"B13","volume-title":"Attention Deficit Hyperactivity Disorder: Diagnosis and Management. 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