Attention-deficit/hyperactivity Disorder Prevalence Rates Research Articles

Prevalence of Undiagnosed Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in the Young Adult Population of the United Arab Emirates: A National Cross-Sectional Study

BackgroundAttention deficit hyperactivity disorder (ADHD), a globally prevalent behavioural disorder, remains underdiagnosed, particularly among adults. This issue is exacerbated in the Arab region due to stigma and insufficient healthcare facilities and professionals. Despite the United Arab Emirates (UAE) efforts to improve mental healthcare, shortcomings persist. No studies in the UAE currently assesses the appropriateness of the screening system for ADHD and other behavioural issues. Furthermore, prevalence rates of ADHD, particularly within the young adult population, are absent.AimTo estimate the prevalence of ADHD amongst young adults attending university in UAE and examine its relationship with gender and academic outcomes.MethodsA cross-sectional, correlational design was used. Young adults in their first year at university were recruited from different academic institutions across the UAE. The study utilized the Adult ADHD Self-Report Scale (ASRS) for data collection.ResultsA sample of 406 young adults, aged between 18 and 20 years of age were recruited. Approximately, 34.7% (n = 141) reported symptoms suggestive of probable ADHD. Significantly lower grade point average marks were observed in participants with ADHD symptoms (M = 3.15) compared to those without (M = 3.35). Females reported symptoms of probable ADHD at higher rates than males, indicating possibly a potential screening deficiency and a potential stigma consequence.ConclusionsThe study demonstrates a high prevalence of probable ADHD in young adults, particularly among females attending university in the United Arab Emirates. Implications for early screening, service provision, and greater professional health training on this disorder are required.

Epidemiology of mental health comorbidity in patients with atopic dermatitis: An analysis of global trends from 1998 to 2022.

The prevalence rates of attention deficit hyperactivity disorder (ADHD), depression, anxiety and suicide are increasing in patients with atopic dermatitis (AD), although no research has systematically examined these trends yet. Here, we explore the prevalence of the occurrence of comorbidities, such as ADHD, depression, anxiety and suicide with AD. We searched seven electronic databases from inception to October 2022 to identify relevant studies, and the Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Scale (NOS) tools were used to assess the quality of observational studies. Statistical analysis was performed using R software. Publication bias was evaluated using Egger's and Begg's linear tests. The global prevalence rates of ADHD, depression, anxiety and suicidal ideation in patients with AD were 7%, 17%, 21% and 13%, respectively, between 1998 and October 2022. Among children (aged <18 years), North American children with AD had the highest prevalence rates of ADHD (10%), depression (13%) and anxiety (20%). Among the adult (aged ≥18 years) population, patients with AD in Africa had the highest prevalence rates of depression (36%) and anxiety (44%), while Asian adults with AD had the highest prevalence rates of ADHD (7%) and suicidal ideation (20%). These results highlight the high prevalence and comorbidity rates of mental illnesses with AD, which should be brought to the attention of patients with AD and their physicians.

Attention-deficit/hyperactivity disorder medication consumption in 64 countries and regions from 2015 to 2019: a longitudinal study

Timely recognition and appropriate treatment of attention-deficit/hyperactivity disorder (ADHD) are essential to enhance long-term outcomes of individuals with ADHD. This study aimed to evaluate the multinational trends and patterns of ADHD medication consumption. In this longitudinal trend study, we used pharmaceutical sales data of ADHD medication from the IQVIA-Multinational Integrated Data Analysis System between 2015 and 2019, covering 64 countries across the world. Consumption rates of ADHD medication were expressed as defined daily dose per 1000 child and adolescent inhabitants (aged 5-19) per day (DDD/TID). Linear mixed models were used to estimate the multinational, regional, and income level trend changes. The results showed that multinational ADHD medication consumption increased by+9.72% (95% confidence interval [CI],+6.25%,+13.31%) per year, from 1.19 DDD/TID in 2015 to 1.43 DDD/TID in 2019 across the 64 countries with marked differences between geographical locations. When stratified by countries' income levels, increases in ADHD medication consumption were observed in high-income countries but not in middle-income countries. In 2019, the pooled consumption rates of ADHD medication were 6.39 DDD/TID (95% CI, 4.63, 8.84) in high-income countries, 0.37 DDD/TID (95% CI, 0.23, 0.58) in upper-middle-income countries and 0.02 DDD/TID (95% CI, 0.01, 0.05) in lower-middle-income countries. Current ADHD prevalence estimates and rates of ADHD medication consumption in most middle-income countries are lower than the global epidemiological prevalence. It is therefore imperative to evaluate the potential barriers to diagnosis and treatment in these countries to minimise the risk of negative outcomes from undiagnosed and untreated ADHD. This project was funded by a grant from the Hong Kong Research Grants Council Collaborative Research Fund (project number C7009-19G).

Prevalence of Attention Deficit Hyperactivity Disorder Among Children in Makkah Region, Saudi Arabia.

Introduction Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children and is described as a disease involving loss of self-control. The core symptoms of ADHD are inattentiveness, impulsivity, and motor unrest. Furthermore, poor concentration, distraction, hyperactivity, and poor academic achievement at school or at home are other symptoms. ADHD, like other prevalent medical disorders such as asthma and schizophrenia, may be impacted by several genes and has multiple contributing causes that are not all related to each other. The management of ADHD contains multimodal treatments, starting with psycho-education for parents and the child or adolescent patient in an age-appropriate manner called cognitive behavioral therapy. The worldwide prevalence rate of ADHD among children is 7.2% and, in some countries, can be higher and reach 15.5%; studies show the average prevalence of ADHD in the Kingdom of Saudi Arabia(KSA) is 9.2%. Method A descriptive cross-sectional study was conducted from December 2022 to January 2023 among children who live in Makkah between the ages of 4 and 14 years old via an online survey that contained the ADHD Rating Scale-IV for parents/teachers, and caregivers based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. The scale was translated into Arabic and contains 18 questions about ADHD symptoms. Result The overall prevalence of combined ADHD among children in Makkah is 52.5% (n=203 out of 387); most of them were males (30.8%) and 21.7% were females (P=0.09), and most of the combined ADHD prevalence was between the ages of 11 and 14 (20.4%), then the age of 4-7 (16.8%), and 15.3% of them were between 8 and 10 years old. Additionally, the results show a higher prevalence of combined ADHD in Makkah city (33.1%) (n=121) in comparison to rural areas 19.4% (n=82) (P=0.132). Conclusion The aim of the study was to measure the prevalence rate of ADHD in the Makkah region. The study showed a high prevalence rate of ADHD (52.5%) among children in Makkah; the study was carried out online using an ADHD scale, and more accurate results could be found by using face-to-face interviews and including both parents and teachers.

Prevalence and treatment differences between Vietnamese and American children with attention-deficit/hyperactivity disorder

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common and pervasive childhood disorders worldwide. Although the United States is currently leading in prevalence of this disorder, the research demonstrates that racial and ethnic disparities in prevalence and treatment exist in the United States. However, some American minorities do not represent a full range of socioeconomic levels as they exist in their countries of origin, e.g., Vietnam. Thus, we compared children with ADHD ages 5 to 17 in Vietnam and the United States to examine the prevalence and treatment differences between the two countries. The data were obtained via interviews of professionals, Centers for Disease Control and Prevention website, and other studies. Notable differences were found between the two countries with regard to the prevalence rates of ADHD in children, gender differences, availability of the diagnostical and treatment services for ADHD, kinds of treatments used, and cultural factors responsible for the differences in the two countries. Vietnam is a predominantly rural society with a lack of awareness of the problem of ADHD and with a lack of treatment facilities and governmental support as compared to the United States. Suggestions were made to improve the diagnosis, treatment, and treatment outcomes for the children with ADHD in Vietnam.

IS ADHD UNDER-DIAGNOSED IN BOSNIA AND HERZEGOVINA? COMPARISON OF CLINICALLY CONFIRMED CASES VS. PARENT-REPORTED PREVALENCE OF ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a frequent neurodevelopmental disorder characterized by hyperactivity, inattention, and impul- sivity. The issue of whether ADHD is a socially constructed disorder has received much attention. The goal of the present study was to examine the clinical prevalence of ADHD in Bosnia and Herzegovina (BIH). An additional goal was to investigate the prevalence of school-aged children who fulfill the criteria for the condition but do not have a clinical diagnosis. For the first research goal, the sample consisted of five University Clinical Centers in BIH that provided data on the prevalence. For the second goal, the sample consisted of 1935 parents of children aged 6 to 15 years. Parents of 1935 school-aged children from the Federation BIH completed the questionnaire regarding ADHD symptoms. Children ranged in age from 6 to 15 years. The mean age of children was 10.2 years (SD- 2.1 years). There were 1061 girls and 874 boys in the sample. Five hospitals in the Federation BIH (4 University Clinical Centers and 1 Cantonal Hos- pital) were sent a questionnaire to provide us with information on how many school-aged children were diagnosed with ADHD and their basic demographic data. In addition, the Clinical Centers were asked to provide information on what treatment they provide to children with ADHD. The results of this study indicated that clinical diagnosis of ADHD is infrequent. The number of clinically confirmed cases of ADHD in the Federation BIH was 138 or less than 0.001%. On the other hand, accord ing to survey data, there is a prevalence rate of ADHD indicated like that observed in western countries. According to the parents’ reports, there were 97 children or 5% who fulfilled the criteria for ADHD diagnosis. In relation to gender distribution of ADHD, there were more boys (88 boys) than girls (50 girls) with a clinically confirmed diagnosis of ADHD and boys were 1.76 times more likely to have a ADHD diagnosis than were girls. On the other hand there were more girls than boys who had ADHD according to parents’ reports, but this difference, according to the Chi square test, was not statistically significant (ꭓ 2 = 0.14; p = ,70). The results of this study have clearly shown that ADHD is underdiag- nozed in Bosnia and Herzegovina. There is a huge discrepancy between the clinically diagnosed children and the parent-reported symptoms of ADHD. Given the burden that ADHD has on children and their families it should be of the utmost importance to provide timely diagnosis and proper treatment. One way to improve the current situation is through a better cooperation between school staff (psychologists, teachers), parents, and medical professionals.

Prevalence rate of attention deficit hyperactivity disorder (ADHD)\xa0and computer vision syndrome\xa0(CVS) symptoms predisposition among digital device users of Bangladesh

BackgroundAround 5.29% of the world population is suffering from ADHD, and 60 million people are suffering from CVS, with an increasing rate of prevalence of these disorders. This study aimed to determine the prevalence rate of ADHD and CVS symptoms among the Bangladeshi population.ResultsTo assess the aim of the study, a cross-sectional survey was conducted online through stratified sampling, and 197 responses were collected from the participants. Our survey method follows these criteria where the ARSV1.1 standard questionnaire was followed for the ADHD questionnaire, and a self-administered questionnaire was established based on the symptoms of CVS. The male age ranges from 18–24 have the highest value of ADHD (34%) coincided with > 6 h digital device usage (51%), and the Stroop effect is significantly correlated with the ADHD score (0.498, p < 0.01). The Stroop effect value is also higher among the males aged 18–24, digital device users for > 6 h (48%).ConclusionsWith the advent of science, it is impossible to avoid digital devices as necessary. Notwithstanding, safe and appropriate use of digital media is a must for healthy living.

Association of ADHD and Obesity in Hispanic Children on the US-Mexico Border: A Retrospective Analysis.

Pediatric obesity and Attention Deficit Hyperactivity Disorder (ADHD) are rising health concerns in the United States, especially among Hispanic children and adolescents. Research on Hispanic children and adolescents indicates disproportionately higher prevalence rates of obesity in this community but scant data on ADHD prevalence rates. In contrast, a plethora of research studies across the general population examines the relationship between childhood obesity and ADHD. In addition, there is a lack of research that examines the role of ethnicity and sub-ethnic group correlations in ADHD, particularly in the Hispanic population. Existing studies in the general population indicate ADHD may be a risk factor for being overweight compared to normal controls. The objective of the present study is to examine the prevalence of obesity in children with ADHD compared to children in the general population in a predominately Hispanic sample on the US-Mexico border. A total of 7,270 pediatric medical records were evaluated. The retrospective analysis included Body Mass Index (BMI) and related health variables, and ethnicity and showed that children with ADHD are more likely to be underweight. In conclusion, no significant relationship existed between obesity and ADHD among Hispanic children on the US-Mexico Border, and instead we found the opposite correlation.

The association between maternal perfluoroalkyl substances exposure and early attention deficit hyperactivity disorder in children: a systematic review and meta-analysis.

Some studies have shown that maternal exposure to perfluoroalkyl substances (PFASs) may be associated with early attention deficit hyperactivity disorder (ADHD) in children. The purpose of this systematic review and meta-analysis is to verify this association by reviewing existing studies and to provide a strong basis for preventing ADHD. The researchers searched electronic databases such as PubMed, Science Direct, Scopus, Google Scholar, Web of Science, and Embase for all studies published before October 2020. Finally, we included nine articles for analysis. Our meta-analysis showed that maternal exposure to PFASs was not significantly associated with the prevalence rate of early childhood ADHD (perfluorooctanoic acid (PFOA), odds ratio (OR) = 1.00, 95% confidence interval (95% CI) = 0.75-1.25; perfluorooctane sulfonate (PFOS), OR = 1.01, 95% CI = 0.88-1.14; perfluorohexane sulfonate (PFHxS), OR = 1.08, 95% CI = 0.80-1.09; perfluorononanoic acid (PFNA), OR = 1.13, 95% CI = 0.99-1.28; perfluorodecanoic acid (PFDA), OR = 1.23, 95% CI = 0.15-2.32). Due to significant heterogeneity, we subsequently performed subgroup analysis and sensitivity analysis. Through subgroup analysis, we found that PFOS concentration of children's blood and the prevalence rate of early childhood ADHD were statistically positively correlated, and there was also a positive correlation between PFOS exposure and the prevalence rate of early childhood ADHD in the America. Moreover, there was also a statistically positive correlation between PFNA concentration in maternal blood and the prevalence rate of early childhood ADHD. Sensitivity analysis showed that the final results did not change much, the sensitivity was low, and the results were relatively stable. In conclusion, a causal relationship between maternal PFASs exposure and ADHD in children was unlikely. Among them, PFOS, PFNA, and ADHD might have positive associations worthy of further investigation.

Prevalence of Attention Deficit Hyperactivity Disorder among Primary School Children in Tikrit City, Iraq

Background: Attention-deficit/hyperactivity disorder (ADHD) is the most widely recognizedneurobehavioral problem of children, which can interfere with the social and academic level.Objectives: To detect the prevalence of ADHD among primary school students in Tikrit city,Iraq, and to find the effect of the disease on school performance.Materials and methods: A cross-sectional study was done among students in 6 primary schoolsfor boys and girls during the studying year 2012-2013. The criteria of diagnosis were done accordingto the American Psychiatric Association. Students who fulfill the criteria were included andthe following parameters were studied including age, gender, family history, mother education,socioeconomic status of the family, and school performance.Results: The prevalence rate of ADHD in this study was 8.67%. Boys were mostly affected (65%).Most of them were under 9 years old (49%). Inattention subtype was mostly found in this study(38%) followed by combined (34%) and then hyperactive (28%). Positive family history was foundin (43%) of cases. The education level of their mothers was intermediate or secondary school level(37%). The majority of the cases were from the middle socioeconomic status (53%). Poor schoolperformance was seen in 69% of the cases.Conclusion: ADHD is a big problem among students of primary schools in Tikrit city with asignificant effect on the academic state

The Prevalence of Attention Deficit Hyperactivity Disorder (ADHD) Among Elementary School Children: The Effect of Certain Demographic Variables

The study aimed to determine the prevalence of ADHD symptoms in Saudi children aged 6 to 13 years in Jeddah city. The study also explored the effect of variables namely teacher's knowledge, years of experience and teachers' gender on reported ADHD symptoms among primary grade students. A questionnaire survey methodology was adopted for the study. 550 children were included in the teachers' survey. Teachers assessed the ADHD symptoms in children using an 18-item scale based on DSM-V. The results indicated that the prevalence rates of ADHD among school-age differed according to ADHD subtypes. The Inattention type was rated by 35.34%, Hyperactivity/Impulsivity type was rated by 28.60%, and ADHD-C type was rated by 21.3% of the respondents. According to gender, for the Inattention subtype, the ratio between boys and girls was 1.7:1, for the Hyperactivity/Impulsivity subtype, the ratio between boys and girls was 2.03:1, and for combined subtype, the ratio between boys and girls was 2.2:1. According to the grade level, the highest prevalence of ADHD overall was found in grade three and the lowest prevalence was in grade six in all ADHD types. The present findings indicated that teachers' knowledge and gender (female) successfully predicted teacher-rated ADHD status.

A review of changes to the attention deficit/hyperactivity disorder age of onset criterion using the checklist for modifying disease definitions

BackgroundWidening definitions of health conditions have the potential to affect millions of people and should only occur when there is strong evidence of benefit. In the last version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5 Committee changed the Attention Deficit Hyperactivity Disorder (ADHD) age of onset criterion in two ways: raising the age of symptom onset and removing the requirement for symptoms to cause impairment. Given concerns about ADHD prevalence and treatment rates, we aimed to evaluate the evidence available to support these changes using a recently developed Checklist for Modifying Disease Definitions.MethodsWe identified and analysed research informing changes to the DSM-IV-TR ADHD age of onset criterion. We compared this evidence to the evidence recommended in the Checklist for Modifying Disease Definitions.ResultsThe changes to the DSM-IV-TR age of onset criterion were based on a literature review (publicly available as a 2 page document with online table of included studies), which we appraised as at high risk of bias. Estimates of the change in ADHD prevalence resulting from change to the age of onset criterion were based on a single study that included only a small number of children with ADHD (n = 68) and only assessed the impact of change to the age component of the criterion. No evidence was used by, or available to the Committee regarding the impact on prevalence of removal of the requirement for impairment, or the effect of the criterion changes on diagnostic precision, the prognosis of, or the potential benefits or harms for individuals diagnosed by the new, but not old criterion.ConclusionsThe changes to the age of onset criterion were based on minimal research evidence that suffered from either high risk of bias or poor applicability. The minimal documentation available makes it difficult to judge the rigor of the process behind the criterion changes. Use of the Checklist for Modifying Disease Definitions would assist future proposed modifications of the DSM ADHD criteria, provide guidance on the studies needed to inform potential changes and would improve the transparency and documentation of the process.

The positive end of the polygenic score distribution for ADHD: a low risk or a protective factor?

Polygenic scores (PGS) are widely used to characterize genetic liability for heritable mental disorders, including attention-deficit/hyperactivity disorder (ADHD). However, little is known about the effects of a low burden of genetic liability for ADHD, including whether this functions as a low risk or protective factor for ADHD and related functional outcomes in later life. The current study examines the association of low ADHD PGS and functional outcomes in adulthood. Participants were from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health) (N = 7088; mean age = 29, s.d. = 1.74). ADHD PGS was computed from an existing genome-wide association study, and adult functional outcomes, including cognition, educational attainment, mental health, and physical health were assessed during in-home interviews. Individuals at the lowest end of the ADHD PGS distribution (i.e. lowest 20th percentile) had the lowest probabilities of ADHD, exhibiting a 17-19% reduction in risk for ADHD relative to the observed 8.3% prevalence rate of ADHD in Add Health. Furthermore, individuals with low ADHD PGS had higher cognitive performance, greater levels of educational attainment, and lower BMI relative to individuals representing the rest of the ADHD PGS distribution, including those who were in the medium and high-PGS groups. Findings indicate that psychiatric PGS likely capture far more than just the risk and the absence of risk for a psychiatric outcome; where one lies along the PGS distribution may predict diverging functional consequences, for better and for worse.

Mini Review: Socio-Cultural Influences on the Link Between ADHD and SUD.

Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for the development and persistence of substance use disorders (SUD). The prevalence of ADHD in patients with SUD varies across countries and cultures. So far, cross-cultural variance in ADHD prevalence rates among SUD patients was mainly ascribed to methodological differences between studies, leaving the role of societal and cultural practices in the ADHD-SUD link hardly acknowledged. The aim of the present mini review is to address this gap in the literature by providing evidence for the effect of socio-cultural practices on the ADHD-SUD link and suggesting directions for future research. To achieve this goal, we map the influence of socio-cultural factors on the ADHD-SUD link along three lines of research. The first line is concerned with the role of socio-cultural factors in the recognition, diagnosis and treatment of childhood ADHD. The second line of research is concerned with socio-cultural influences on substance use (e.g., religion, ethnic identity, acculturation, and socio-economic status). Finally, we describe potential socio-cultural factors which may operate as mechanisms for reducing or increasing access to substance abuse treatment (e.g., ethnic disparities in health care utilization). Identifying socio-cultural influences on the ADHD-SUD link may provide further insight into the bidirectional association between ADHD and SUD in different contexts and encourage future research in the field.

Attention Deficit Hyperactivity Disorder (ADHD) among Children Aged 6 to 17 Years Old Living in Girja District, Rural Ethiopia.

Objective Attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood with long-term outcomes. Although ADHD is the most studied behavioral disorders of childhood in developed countries, few studies have been conducted in Ethiopia. The aim of this study was to determine the prevalence of ADHD in rural parts of Ethiopia. Method A cross-sectional study was conducted from May to June 2015 among children aged 6 to 17 years living in rural areas. A multistage cluster sampling technique was used to select 1302 participants. The Disruptive Behavior Disorder Rating Scale was used to collect the data. Logistic regression analysis was used to see statistically significant variables. Result The prevalence rate of attention deficit hyperactivity disorder (ADHD) among children was 7.3%. Being male (Adjusted Odds Ratio (AOR) = 1.81, 95% CI: (1.13, 2.91)); living with a single parent (AOR = 5.0, 95% CI: (2.35, 10.65)); child birth order/rank (AOR = 2.35, 95% CI: (1.30, 4.25)); and low family socioeconomic status (AOR = 2.43, 95% CI: (1.29, 4.59)) were significantly associated with ADHD. Conclusion The ADHD prevalence rate was found to be similar with global reports. Prevention and early management of maternal complications is important to reduce the prevalence of ADHD among children.

Prevalence of behavioral disorders and attention deficit/hyperactive disorder among school going children in Southwestern Uganda

BackgroundDisruptive Behavioral Disorders (DBDs) and Attention Deficit/Hyperactivity Disorder (ADHD) are chronic, impairing, and costly child and adolescent mental health challenges which, when untreated, can result in disruptions in school performance, friendships and family relations. Yet, there is dearth of prevalence data on child and adolescent behavioral challenges within sub-Saharan Africa, including Uganda. This study aims to estimate the prevalence rate of behavioral challenges and ADHD among young school going children and early adolescents (ages 8–13 at study enrollment), utilizing a school-based sample in southwest Uganda.MethodsWe present screening results from a 5-year scale-up study titled SMART Africa-Uganda (2016–2021), set across 30 public primary schools located in the greater Masaka region in Uganda, a region heavily impacted by poverty and HIV/AIDS. Specifically, we draw on screening data from caregivers of 2434 children that used well-established standardized measures that had been pre-tested in the region. These were: 1) oppositional defiant disorder (ODD) and conduct disorder (CD) subscales of the Disruptive Behavior Disorders (DBD) scale; and 2) the Iowa Connors and Impairment scales. Slightly over half of the children in the sample were female (52%), with a mean age of 10.27 years.ResultsOf the 2434 participants screened for disruptive behaviors: 1) 6% (n = 136) scored positive on ODD and 2% (n = 42) scored positive on CD subscales of the DBD scale; 2) 9.61% (n = 234), and 2.67% (n = 65) were reported to have elevated symptoms of ODD and ADHD on the Iowa Connors caregiver report scale respectively. Twenty-five percent (n = 586) of children were described by their caregivers as having experienced some form of impairment in at least four domains of the Impairment scale.ConclusionThe results indicate the presence of behavioral challenges and ADHD among school going children, aged 8–13 years, in Uganda. Given the negative outcomes associated with behavioral challenges as children transition to adolescence and adulthood, detecting these emerging behavioral challenges early is critical in developing appropriate interventions. School settings could be considered as one of the contextually-relevant, culturally-appropriate, and non-stigmatizing venues to implement screening procedures and to detect emerging behavioral challenges and to make necessary referrals.

Potential Explanations for Increasing Methylphenidate Use in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder in Germany From 2004 to 2013.

Despite a decreasing population of children and adolescents, the cumulative total amount of dispensed methylphenidate (MPH), the first-choice treatment of attention-deficit/hyperactivity disorder (ADHD) in this age group, has increased dramatically in Germany. We investigated potential reasons for this increase such as changes in the ADHD prevalence over time and other potential explanations including the cumulative amount of dispensed MPH per person. Based on German claims data, we calculated standardized annual ADHD prevalence rates, proportions of ADHD cases treated with MPH and/or psychotherapy, and mean cumulative defined daily doses of ADHD drugs for 3- to 17-year-old children and adolescents from 2004 to 2013. The ADHD prevalence increased continuously from 2004 to 2011 and remained stable thereafter. In ADHD cases, there was little variation in the proportion of individuals treated with drugs and in the frequency of psychotherapeutic treatment during the whole study period. The annual cumulative mean amount of MPH defined daily doses increased by approximately 30% from 2004 to 2008. Our analyses suggest that the increase in MPH use in Germany was mainly influenced by an increasing ADHD prevalence and increasing amounts of dispensed MPH per person.

Prevalence of Attention Deficit Hyperactivity Disorder in Detention Settings: A Systematic Review and Meta-Analysis.

Background: Previous studies have reported a high prevalence of attention deficit hyperactivity disorder (ADHD) among people living in detention (PLD) corresponding to a five- to ten-fold increase compared to the general population. Our main study objective was to provide an updated ADHD prevalence rate for PLD, including PLD in psychiatric units. Sub-objectives included (i) comparing different ways of assessing ADHD, including DSM-5 criteria and (ii) identifying which types of PLD are more likely to have ADHD.Methods: We conducted a systematic review and meta-analysis following the PRISMA guidelines and the MOOSE checklist. PubMed/Medline, PsycINFO, and Web of Sciences were searched combining “ADHD” and “prison” keywords and synonyms for articles published between January 1, 1966 and January 2, 2018. Potential sources of variation to the meta-analytic ADHD prevalence rate were investigated using meta-regressions and subgroups analyses.Results: The meta-analysis pooled 102 original studies including 69,997 participants. The adult ADHD prevalence rate was 26.2% (95% confidence interval: 22.7–29.6). Retrospective assessments of ADHD in childhood were associated with an increased prevalence estimate (41.1, 95% confidence interval: 34.9–47.2, p < 0.001). There was no significant difference in the prevalence estimate between screenings and clinical interviews in adulthood. Only three studies used the DSM-5 definition of ADHD and results were non-significantly different with other DSM versions. We found no difference according to participants' characteristics.Conclusion: Our results confirmed the high prevalence rate of ADHD among PLD, corresponding to a five-fold increase compared to the general population. In light of such high ADHD prevalence, our results reinforce the importance of addressing this critical public health issue by (i) systematically offering ADHD screening and diagnosis to all individuals entering detention, and (ii) delivering treatment, monitoring, and care for ADHD during and after detention. These strategies may help reduce recidivism and reincarceration, as well as violence in detention settings, in addition to improving the health and wellbeing of people living in detention. Additionally, our study suggests that using screening scales may be a reliable way of assessing ADHD, although caution is needed because a complete evaluation by an experienced clinician is required to provide a formal diagnosis.

Attention Deficit Hyperactivity Disorder and Parental Factors in School Children Aged Nine to Ten Years in Muscat, Oman.

The objectives of this study were to determine the prevalence of attention deficit hyperactivity disorder (ADHD) and specific parental risk factors that may contribute to the development of ADHD in children. The study was conducted in Oman among fourth-grade students (aged nine to 10 years). A standardized Arabic version of the National Initiative for Children's Health Quality Vanderbilt Assessment Scale (Teachers questionnaire) was used to determine the presence of ADHD. Parental factors such as socioeconomic status, education, and occupation were documented. The prevalence rate of ADHD was 8.8%. Poor maternal education status, low familial socioeconomic status, and paternal occupation were significantly associated with an increased risk of ADHD. This was the first study that examined familial and parental characteristics of children with ADHD as potential risk factors for the condition. Such psychosocial factors could be employed to further the development of more proficient preventative measures and remedial services.

Biases in Understanding Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder in Japan

Recent research has shown high rates of comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and difficulties regarding differential diagnosis. Unlike those in Western countries, the Japanese ADHD prevalence rate is lower relative to that of ASD. This inconsistency could have occurred because of cultural diversities among professionals such as physicians. However, little is known about attitudes toward ADHD and ASD in non-Western cultural contexts. We conducted two experiments to identify biases in ASD and ADHD assessment. In Study 1, we examined attitudes toward these disorders in medical doctors and mental health professionals, using a web-based questionnaire. In Study 2, medical doctors and clinical psychologists assessed four fictional cases based on criteria for ADHD, ASD, oppositional defiant disorder, and disinhibited social engagement disorder (DSED). Diagnosis of ASD was considered more difficult relative to that of ADHD. Most participants assessed the fictional DSED case as ASD, rather than DSED or ADHD. The results provide evidence that Japanese professionals are more likely to attribute children’s behavioral problems to ASD, relative to other disorders. Therefore, Japanese therapists could be more sensitive to and likely to diagnose ASD, relative to therapists in other countries. These findings suggest that cultural biases could influence clinicians’ diagnosis of ADHD and ASD.