Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan; School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan; Department of Recreation and Health-Care Management, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan.
PLoS One. 2014 Apr 15;9(4):e95014. doi: 10.1371/journal.pone.0095014. eCollection 2014.
We used insurance claims of a nationally representative population-based cohort to assess the longitudinal treated prevalence and incidence of attention-deficit/hyperactivity disorder (ADHD) in children, adolescents and adults.
Participants were identified from among National Health Insurance enrollees in Taiwan from 1999 to 2005. We identified study subjects who had at least one service claim during these years with a principal diagnosis of ADHD. A total of 6,173 patients were recorded in the treated ADHD cohort during the 6-year study.
There was a significant increase in the treated prevalence rate of ADHD during the study period, from 64.65 per 100,000 in 2000 to 145.40 per 100,000 in 2005 (p = .001). An increase in the treated incidence rate of ADHD, from 44.67 per 100,000 in 2000 to 81.20 per 100,000 in 2005, was also observed (p = .013). However, the treated prevalence of ADHD was still lower than that of the community data in Taiwan. The peak treated prevalence of ADHD was at age 7-12 years for both males and females, and the peak treated incidence of ADHD was at age 0-6 for females and age 7-12 for males. Overall, the treated incidence and prevalence rates dropped abruptly after age 13-18 (both p<.001) for males and females (p<.001 for both). Male vs. female ratios of treated prevalence and incidence were both above 1 before age 25-30 years, but below 1 thereafter.
Although an increasing number of people with ADHD sought treatment during 1999-2005 in Taiwan, the treated prevalence of ADHD was still lower than that of the community data. The treated incidence and prevalence of ADHD fell dramatically after age 13-18. However, more women than men sought treatment in adulthood. There may be under-diagnosis and under-treatment of ADHD, especially among females and adults.
我们利用全国代表性人群队列的保险理赔数据，评估儿童、青少年和成人注意缺陷多动障碍（ADHD）的纵向治疗患病率和发病率。
参与者来自于台湾的全民健康保险参保人员，研究对象在研究期间至少有一次与 ADHD 主要诊断相关的服务索赔。在 6 年的研究中，共有 6173 例患者被记录在 ADHD 治疗队列中。
在研究期间，ADHD 的治疗患病率显著增加，从 2000 年的每 100,000 人 64.65 例增加到 2005 年的每 100,000 人 145.40 例（p = .001）。ADHD 的治疗发病率也从 2000 年的每 100,000 人 44.67 例增加到 2005 年的每 100,000 人 81.20 例（p = .013）。然而，ADHD 的治疗患病率仍低于台湾的社区数据。男性和女性 ADHD 的治疗患病率峰值均出现在 7-12 岁，女性 ADHD 的治疗发病率峰值出现在 0-6 岁，男性 ADHD 的治疗发病率峰值出现在 7-12 岁。总体而言，男性和女性 ADHD 的治疗发病率和患病率在 13-18 岁（均 p<.001）后急剧下降（均 p<.001）。在 25-30 岁之前，男性和女性的 ADHD 治疗患病率和发病率的比值均高于 1，但此后均低于 1。
尽管在 1999-2005 年期间，台湾寻求 ADHD 治疗的人数有所增加，但 ADHD 的治疗患病率仍低于社区数据。13-18 岁后，ADHD 的治疗发病率和患病率急剧下降。然而，成年后，寻求治疗的女性多于男性。ADHD 的诊断和治疗可能不足，尤其是在女性和成年人中。
