Prevalence Of Attention Deficit Hyperactivity Disorder Diagnoses Research Articles

Attention-deficit hyperactivity disorder diagnoses and prescriptions in UK primary care, 2000-2018: population-based cohort study.

Rates of diagnosed attention-deficit hyperactivity disorder (ADHD) may be increasing in the UK. Estimate incidence and prevalence of ADHD diagnoses and ADHD prescriptions in UK adults and children in primary care. We conducted a cohort study using IQVIA Medical Research Data, a UK primary care database. Rates of ADHD diagnoses and ADHD prescriptions were calculated between 2000 and 2018 for individuals aged 3-99 years, analysed by age, gender, social deprivation status and calendar year. Of 7 655 931 individuals, 35 877 (0.5%) had ADHD diagnoses; 18 518 (0.2%) received ADHD medication prescriptions. Diagnoses and prescription rates were greater in men versus women, children versus adults, and deprivation status (nearly double in most deprived versus least deprived quintile). By 2018, the proportion of ADHD diagnoses was 255 per 10 000 (95% CI 247-263) in boys and 67.7 per 10 000 (95% CI 63.5-71.9) in girls; for adults, it was 74.3 per 10 000 (95% CI 72.3-76.2) in men and 20 per 10 000 (95%CI 19.0-21.0) in women. Corresponding figures for prescriptions were 156 per 10 000 (95% CI 150-163) in boys, 36.8 per 10 000 (95% CI 33.8-40.0) in girls, 13.3 per 10 000 (95% CI 12.5-14.1) in men and 4.5 per 10 000 (95% CI 4.1-5.0) in women. Except among 3- to 5-year-olds, the incidence and prevalence of ADHD diagnoses and prescriptions have increased from 2000 to 2018 in all age groups. The absolute increase was highest in children, but the relative increase was largest among adults (e.g. among men aged 18-29 years, approximately 20-fold and nearly 50-fold increases in diagnoses and prescriptions, respectively). The incidence and prevalence of both ADHD diagnoses and medication are highest among children. Proportionally, rates increased most among adults during 2000-2018. ADHD diagnoses and prescriptions are associated with socioeconomic deprivation.

Disparities in the prevalence of ADHD diagnoses, suspicion, and medication use between Flanders and Québec from the lens of the medicalization process.

The prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnoses and medication use has increased over time around the world, but significant regional differences remain. This paper aims to determine and explain disparities in ADHD prevalence and medication use among school-aged children in two distinct school systems, in Flanders (Belgium) and Québec (Canada). We present detailed descriptive and comparative analyses of data from 35 schools, 114 teachers, and 1046 parents (children) that were collected as part of a comparative international project. The data concern teacher and parent suspicions, teachers' ratings of ADHD-related behaviors in children, teachers' views of medication use, and teachers' beliefs about ADHD. The results show that, compared with Flanders, Québec had significantly more children diagnosed with ADHD and more frequent suspicions of ADHD in children by teachers and parents. We refer to the conceptual, institutional, and interactional levels of medicalization to interpret our findings and conclude that social and cultural readings of children's behaviors differ greatly between regions. Medicalization of children's behaviors is more common in Québec than in Flanders.

Prevalence of attention-deficit/hyperactivity disorder in pediatric brain tumor survivors.

10572 Background: Pediatric brain tumor survivors (PBTS) often have neurodevelopmental late effects, including attention and concentration deficits, which may impact cognitive and academic functioning. Such symptoms are also seen in attention-deficit/hyperactivity disorder (ADHD), which affects ~5-8% of children and adolescents. This study examined the prevalence of ADHD diagnosis and ADHD medication use in PBTS and identified higher risk subsets of patients. Methods: A retrospective chart review was completed of PBTS (n = 106), diagnosed from 1999-2013, who were at least 2 years from the end of tumor-directed therapy (surgery, chemotherapy and/or radiation therapy) and without a multi-system genetic disorder or severe developmental delay prior to brain tumor diagnosis. Subjects were already screened for or enrolled in 3 other studies of PBTS late effects. Statistical analysis involved chi-squared analysis. Results: Among the 106 patients, 55.7% were male, with an average age at time of brain tumor diagnosis of 5.9 years (0-12.2 years). The most common tumor types were glioma (51.9% with 47.2% low grade, 4.7% high grade), medulloblastoma (13.2%) and ependymoma (11.3%), with 50% of tumors supratentorial, 46.2% infratentorial and 3.8% either extending or multifocal across the tentorium. Of the patients, 42.5% received radiation therapy, 38.7% chemotherapy and 86.8% surgery. Nineteen patients (17.9%) had ADHD diagnoses, and 20 (18.9%) had been on ADHD medications. Clinical factors associated with an ADHD diagnosis were supratentorial vs. infratentorial tumors (28.3% vs. 6.1%, p = 0.013), no radiation therapy vs. radiation therapy (27.9% vs. 4.4%, p = 0.002) and no chemotherapy vs. chemotherapy (24.6% vs. 7.3%, p = 0.024). ADHD diagnosis was not associated with age of brain tumor diagnosis or surgical treatment. Conclusions: Our study suggests that PBTS have over twice the ADHD prevalence as the general population, most notably in patients with supratentorial tumors or without a history of radiation therapy or chemotherapy. The results suggest that a closer look at this population is warranted and that select patients may benefit from behavioral or pharmacologic ADHD treatments to optimize functioning.

Prevalence and Incidence of Attention Deficit Hyperactivity Disorder Among Children and Adolescents in Slovenia From 1997 to 2012: an Epidemiological Study From a National Perspective

Introduction Attention deficit hyperactivity disorder (ADHD) is still underdiagnosed in many EU countries. Despite its relevance in terms of public health, the incidence and prevalence of this disorder is not well researched. Objectives The national incidence and prevalence of ADHD diagnosis in children and adolescents has not yet been reported in any South Eastern European country. Aim The main aim of this study was to investigate the incidence and prevalence of ADHD diagnosis among children and adolescents in Slovenia in 2012, based on national data from 1997 to 2012. Different epidemiological models were built. Methods The data from the National Institute of Public Health of the Republic of Slovenia for the years 1997–2012 were analyzed. The yearly database includes all newly diagnosed outpatients with ADHD in Slovenia. Results In 1997, the annual incidence rate of ADHD diagnosis was 0.0317 % and increased to 0.0469 % in 2000 and to 0.0823 % in 2012. The prevalence rate of ADHD diagnosis was estimated between 722 and 767 per 100,000 children and adolescents. If the increase persists, the prevalence of ADHD diagnosis in 2020 will be 6.3-fold higher than in 1997 and 1.3-fold higher than in 2012. Conclusions ADHD is a common mental health disorder in Slovenia, but it is still underdiagnosed in comparison with Western countries. Results indicate a need for improved timely interventions in Slovenia, not only in child and adolescent psychiatry but also in primary settings and adult psychiatry, where ADHD should be recognized efficiently.

PMH7 - Comparing the influence of month of birth and gender in two academic years on attention deficit hyperactivity disorder diagnoses (ADHD) among children in the health improvement network (thin) UK data

Long-term costs follow a diagnosis of ADHD; therefore it is important to examine factors influencing diagnosis. This study determines the prevalence of ADHD among children according to month of birth and gender across two academic years. Children aged 5-15 years in the academic years Sep 2010-Aug 2011 (Year 1) and Sep 2011-Aug 2012 (Year 2) in The Health Improvement Network (THIN) were assessed for ADHD using diagnoses and prescriptions. Percentages were calculated and differences across month of birth assessed using chi squared tests for trend. Children with later months of birth (Mar-Aug) were compared to earlier months of birth (Sep-Feb), and males to females using relative risks (RR). 436,299 children in Year 1 and 398,718 in Year 2 were included with 0.75% and 0.76% diagnosed with ADHD respectively. There was evidence at the 5% level of an increasing trend in ADHD prevalence in both academic years (p<0.001, p=0.005 in Year 1, Year 2 respectively). Younger children were 14% more likely (RR=1.14, 95% CI 1.07-1.23) in Year 1 and 12% more likely (RR=1.12 95% CI 1.04-1.20) in Year 2 to have ADHD than older children. Males were around five times more likely to have an ADHD diagnosis in both years (RR=5.00 95% CI 4.56-5.49, RR=4.92 95% CI 4.47-5.42 in Year 1, Year 2 respectively). There was good agreement across academic years both in the percentage with ADHD diagnosis, and the increasing trend through the academic year. Younger children were more likely to be diagnosed with ADHD than their older peers. This may partly be due to them appearing to lack the maturity of their older classmates. Males were more likely to have an ADHD diagnosis than females in both years. Further work could assess the differences in different age groups and be extended to include other conditions.

Stimulant Medication Use by Primary Care Physicians in the Treatment of Attention Deficit Hyperactivity Disorder

Treatment of attention deficit hyperactivity disorder (ADHD), one of the most common behavioral disorders in children in the United States, remains controversial because of concern about stimulant medication use. Extending a previous study of pediatricians, the present study surveyed a random national sample of family practitioners and then directly screened 457 patients of 10 pediatricians and family practitioners in two small midwestern cities. Responses to the national survey indicated that stimulant medication remains the main treatment prescribed by primary care physicians for children with ADHD. In the direct patient screening, the prevalence of ADHD diagnoses was 5.3% (pediatricians) and 4.2% (family practitioners) of all elementary-school-aged children screened. Eighty-eight percent of these children were treated with methylphenidate. Although medication was considered an effective treatment by the parents of 85% of the children given the medication, efficacy was unrelated to the accuracy of diagnosis. When explicit DSM-III-R criteria were used, only 72% of those assigned a diagnosis of ADHD by the physicians would have received that diagnosis based on a structured psychiatric interview with the parents and only 53% received that diagnosis based on teacher report of symptoms, even when the child was not receiving medication. Although the majority of physicians (in both the surveys and the direct screenings) reported using at least some behavioral treatments with their patients, parents reported infrequent use of nonpharmacologic forms of therapy, such as behavior modification. These data thus indicate a relatively modest rate of stimulant medication use for ADHD, but a serious underuse of systematic behavioral treatments in primary care.(ABSTRACT TRUNCATED AT 250 WORDS)