Evidence map›Paper›PMID 41803733›Full record

ArticleBMC psychiatry2026

Stimulant shortage in children with ADHD: greater vulnerability among those with comorbidity.

Tuğba Acehan, Esra Güngör Bağlıcakoğlu, Ecem Selin Akbaş Aliyev, Huriye Berna Devecioğlu, Merve Canlı, Yusuf Selman Çelik, Ayşegül Efe, Yusuf Öztürk

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Article in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Tuğba AcehanDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey. tugbaacehan@gmail.com.
Esra Güngör BağlıcakoğluDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey.
Ecem Selin Akbaş AliyevDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey.
Huriye Berna DevecioğluDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey.
Merve CanlıDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey.
Yusuf Selman ÇelikDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey.
Ayşegül EfeDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey.
Yusuf ÖztürkDepartment of Child and Adolescent Psychiatry, Ankara Etlik City Hospital, University of Health Sciences, Varlık Neighborhood, Halil Sezai Erkut Street Yenimahalle, Ankara, 06170, Turkey.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe aim of this study was to examine stimulant access difficulties among school-aged children with attention-deficit/hyperactivity disorder (ADHD) in Turkey, family strategies to obtain medications, and access-related medication changes, and to evaluate their associations with irritability, emotional, behavioral, social, academic, and sleep difficulties by psychiatric comorbidity.

methodsA cross-sectional study was conducted with 149 children aged 6-16 years diagnosed with ADHD and treated with methylphenidate-based stimulants, the only stimulant medications available for pediatric ADHD in Turkey, for at least three months. Data were collected using a sociodemographic form, the Medication Shortage Experience Assessment Form, and standardized parent-report scales, including the DSM-5 Level 2 Irritability Scale, Strengths and Difficulties Questionnaire (SDQ), and Sleep Disturbance Scale for Children (SDSC). Group comparisons were performed according to medication change and comorbidity status, followed by multivariable Generalized Linear Models (GZLM) to evaluate interaction effects between these variables.

resultsNearly all parents (97.3%) reported difficulties, and 55.7% required medication switching due to shortages. Medication changes were associated with significantly greater perceived impacts on physical and mental health (77.1% vs. 42.4%, p < .001) and on academic and social functioning (69.9% vs. 51.5%, p = .022). In children who underwent medication changes, those with psychiatric comorbidities showed significantly higher irritability, emotional symptoms, conduct problems, peer relationship issues, and total SDQ difficulty scores compared with non-comorbid peers. GZLM interaction analyses formally confirmed these findings, showing that the combination of medication change and psychiatric comorbidity significantly predicted higher irritability (B = 2.65, p = .017), sleep arousal disorders (B = 1.12, p = .028), and total sleep disturbances (B = 9.56, p = .043). Notably, interaction coefficients were positive across nearly all psychometric scales, indicating a synergistic worsening of symptoms, except for prosocial behavior, which showed an expected negative coefficient.

conclusionsStimulant shortage is highly prevalent and disrupt treatment continuity in children with ADHD in Turkey. Those with psychiatric comorbidities appear particularly sensitive to medication changes, with our findings formally demonstrating a synergistic interaction that amplifies clinical vulnerability. These results highlight the need for coordinated supply systems and targeted psychosocial support to mitigate the emotional and functional consequences of stimulant unavailability.

Indexed as

Attention Deficit Disorder with HyperactivityCentral Nervous System StimulantsHealth Services AccessibilityMethylphenidateAdolescentChildComorbidityCross-Sectional StudiesFemaleHumansIrritable MoodMaleSleep Wake DisordersTurkeyCentral Nervous System StimulantsMethylphenidateAttention-deficit/hyperactivity disorderEmotional and behavioral difficultiesMedication access barriersPsychiatric comorbidityStimulant shortageTreatment continuity

Identifiers

PMID41803733
PMCPMC13085576

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.