PMV forschungsgruppe, angegliedert an die Klinik für Kinder- und Jugendpsychiatrie der Universität zu Köln, Köln, Germany.
Dtsch Arztebl Int. 2010 Sep;107(36):615-21. doi: 10.3238/arztebl.2010.0615. Epub 2010 Sep 10.
The goal of this study is to assess changes in the prevalence of attention-deficit/hyperactivity disorder (ADHD) and methylphenidate prescriptions over the period 2000 to 2007 on the basis of data from a German statutory health insurance carrier.
In a cross-sectional study, we analyzed data from a random sample of insurees of the AOK health insurance company in the German state of Hesse for the years 2000 to 2007. Per calender year, 50,000 to 63,000 children and adolescents were retrospectively observed with respect to the documentation of ADHD diagnosis (ICD-10 diagnosis F90) and the prescribing of methylphenidate (ATC: N06BA04).
In 2007, the overall prevalence of ADHD in all age groups (0-18 years) was 2.21% (95% CI: 2.09-2.34). This figure was 45% greater than the corresponding figure for the year 2000. The prevalence increased by a larger amount among girls aged 6 to 18 years than among boys in the same age group (+69% vs. +53%). In 2007, 1.06% (95% CI: 0.98-1.16) of the children/adolescents received at least one prescription for methylphenidate; this was a 96% increase over the prescription rate for 2000. A comparison of the two years 2000 and 2007 reveals a clear prevalence shift towards the older age groups, as well as an 82% increase in the average number of daily doses per recipient. Outpatient departments of child and adolescent psychiatry initiated more treatments in 2007 than in 2000.
The 1% prevalence of methylphenidate use among children and adolescents that was found in this study is the same as that reported in other European countries, such as Switzerland, the Netherlands, and Norway. A drawback of our study is its limitation to a single insurance carrier in a single region. Nonetheless, data of this type are useful for monitoring. The findings suggest further issues worth studying, e.g., off-label use or the indications for treatment in older age groups.
本研究旨在根据德国法定健康保险公司的数据，评估 2000 年至 2007 年期间注意力缺陷/多动障碍（ADHD）的患病率和哌醋甲酯处方的变化。
在一项横断面研究中，我们分析了德国黑森州 AOK 健康保险公司的随机抽样参保人员 2000 年至 2007 年的数据。在每个历年，回顾性观察 5 万至 6.3 万名儿童和青少年，以记录 ADHD 诊断（ICD-10 诊断 F90）和哌醋甲酯处方（ATC：N06BA04）。
2007 年，所有年龄组（0-18 岁）的 ADHD 总体患病率为 2.21%（95%CI：2.09-2.34）。这一数字比 2000 年相应数字高出 45%。在 6 至 18 岁的女孩中，患病率的增幅大于同年龄组的男孩（+69%对+53%）。2007 年，有 1.06%（95%CI：0.98-1.16）的儿童/青少年至少开了一张哌醋甲酯处方；这比 2000 年的处方率增加了 96%。对 2000 年和 2007 年两年的比较显示，患病率明显向年龄较大的年龄组转移，每位接受者的平均日剂量增加了 82%。2007 年，儿童和青少年精神病学的门诊部门比 2000 年启动了更多的治疗。
本研究发现，儿童和青少年中哌醋甲酯使用率为 1%，与瑞士、荷兰和挪威等其他欧洲国家报告的使用率相同。本研究的一个缺点是仅局限于一个地区的单一保险公司。尽管如此，这种类型的数据对于监测是有用的。研究结果表明，还有其他值得研究的问题，例如标签外使用或在年龄较大的年龄组中的治疗指征。
