Department of Research and Evaluation, Kaiser Permanente Southern California Medical Group, 100 S Los Robles Ave,Second Floor, Pasadena, CA 91101, USA.
JAMA Pediatr. 2013 Mar 1;167(3):282-8. doi: 10.1001/2013.jamapediatrics.401.
OBJECTIVE To examine trends in attention-deficit/hyperactivity disorder (ADHD) by race/ethnicity, age, sex, and median household income. DESIGN An ecologic study of trends in the diagnosis of ADHD using the Kaiser Permanente Southern California (KPSC) health plan medical records. Rates of ADHD diagnosis were derived using Poisson regression analyses after adjustments for potential confounders. SETTING Kaiser Permanente Southern California, Pasadena. PARTICIPANTS All children who received care at the KPSC from January 1, 2001, through December 31, 2010 (n = 842 830). MAIN EXPOSURE Period of ADHD diagnosis (in years). MAIN OUTCOME MEASURES Incidence of physician-diagnosed ADHD in children aged 5 to 11 years. RESULTS Rates of ADHD diagnosis were 2.5% in 2001 and 3.1% in 2010, a relative increase of 24%. From 2001 to 2010, the rate increased among whites (4.7%-5.6%; relative risk [RR] = 1.3; 95% CI, 1.2-1.4), blacks (2.6%- 4.1%; RR = 1.7; 95% CI, 1.5-1.9), and Hispanics (1.7%-2.5%; RR = 1.6; 95% CI, 1.5-1.7). Rates for Asian/Pacific Islander and other racial groups remained unchanged over time. The increase in ADHD diagnosis among blacks was largely driven by an increase in females (RR = 1.9; 95% CI, 1.5-2.3). Although boys were more likely to be diagnosed as having ADHD than girls, results suggest the sex gap for blacks may be closing over time. Children living in high-income households were at increased risk of diagnosis. CONCLUSIONS The findings suggest that the rate of ADHD diagnosis among children in the health plan notably has increased over time. We observed disproportionately high ADHD diagnosis rates among white children and notable increases among black girls.
按种族/族裔、年龄、性别和家庭收入中位数分析注意力缺陷多动障碍（ADHD）的趋势。
利用 Kaiser Permanente Southern California（KPSC）健康计划的医疗记录，对 ADHD 诊断趋势进行生态研究。在调整了潜在混杂因素后，使用泊松回归分析得出 ADHD 诊断率。
Kaiser Permanente Southern California，帕萨迪纳。
2001 年 1 月 1 日至 2010 年 12 月 31 日期间在 KPSC 接受治疗的所有儿童（n=842830）。
ADHD 诊断的时间段（年）。
5 至 11 岁儿童中经医生诊断的 ADHD 发生率。
2001 年的 ADHD 诊断率为 2.5%，2010 年为 3.1%，相对增加了 24%。从 2001 年到 2010 年，白人（4.7%-5.6%；相对风险[RR]为 1.3；95%置信区间，1.2-1.4）、黑人和西班牙裔（2.6%-4.1%；RR 为 1.7；95%置信区间，1.5-1.9）的诊断率均有所上升。而亚洲/太平洋岛民和其他种族群体的比率则保持不变。黑人中 ADHD 诊断率的增加主要是由于女性（RR 为 1.9；95%置信区间，1.5-2.3）的增加所致。尽管男孩被诊断为 ADHD 的可能性高于女孩，但结果表明，黑人的性别差距可能随着时间的推移而缩小。高收入家庭的孩子更有可能被诊断为患有 ADHD。
研究结果表明，该健康计划中儿童的 ADHD 诊断率随时间显著增加。我们观察到白人儿童的 ADHD 诊断率异常高，黑人群体中女孩的 ADHD 诊断率显著增加。
