Schlack R, Mauz E, Hebebrand J, Hölling H
Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, General-Pape-Straße 62-66, 12101, Berlin, Deutschland,
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2014 Jul;57(7):820-9. doi: 10.1007/s00103-014-1983-7.
Recent international studies have reported a considerable increase in the diagnosis of attention deficit hyperactivity disorder (ADHD). Data from German statutory health insurance companies suggest a comparable trend for Germany. Based on data from the nationally representative study KiGGS Wave 1 (2009-2012) it was the aim of this study to report on the prevalence rates of parent-reported ADHD diagnoses in children and adolescents aged 3-17 years as well as to report on time trends in comparison with the KiGGS baseline study (2003-2006). ADHD caseness was met if a parent reported that a physician or a psychologist diagnosed their child with ADHD. Participants without a reported ADHD diagnosis but who scored ≥ 7 (clinical range) on the parent-rated hyperactivity subscale of the Strengths and Difficulties Questionnaire (SDQ) were considered as potential ADHD cases. The prevalence of diagnosed ADHD was 5.0% (prevalence of potential ADHD cases 6.0%). An ADHD diagnosis was more than four and a half times more likely to be reported among boys than girls. Children from families with low socioeconomic status (SES) were more than two and a half times more likely to be diagnosed with ADHD than children from families with high SES. Among potential cases, boys were twice as common as girls, and children from families with low SES were approximately three times more common compared with those from high SES families. The proportion of lifetime ADHD diagnoses increased with age and was highest in 11- to 17-year-olds. In every fifth child with ADHD the initial diagnosis was made by the age of 6 years and in 1 out of 11 children with ADHD the initial diagnosis was made by the age of 5 years. In total, we observed no significant changes regarding the frequency of ADHD diagnosis compared to the KiGGS baseline study. Increases reported using data from German statuary health insurance companies were not reflected in the KiGGS data.
近期的国际研究报告称，注意缺陷多动障碍（ADHD）的诊断数量大幅增加。德国法定健康保险公司的数据显示德国也有类似趋势。基于具有全国代表性的KiGGS第一轮研究（2009 - 2012年）的数据，本研究旨在报告3至17岁儿童及青少年中家长报告的ADHD诊断患病率，并与KiGGS基线研究（2003 - 2006年）相比较，报告其时间趋势。如果家长报告医生或心理学家诊断其孩子患有ADHD，则符合ADHD病例标准。未报告有ADHD诊断但在优势与困难问卷（SDQ）家长评定的多动分量表上得分≥7（临床范围）的参与者被视为潜在ADHD病例。确诊ADHD的患病率为5.0%（潜在ADHD病例患病率为6.0%）。男孩被报告患有ADHD的可能性是女孩的四倍半以上。社会经济地位低（SES）家庭的孩子被诊断患有ADHD的可能性是社会经济地位高家庭孩子的两倍半以上。在潜在病例中，男孩的数量是女孩的两倍，社会经济地位低家庭的孩子与社会经济地位高家庭的孩子相比，数量约为其三倍。终生ADHD诊断的比例随年龄增长而增加，在11至17岁的青少年中最高。每五个患有ADHD的儿童中，有一个在6岁时首次被诊断，每十一个患有ADHD的儿童中，有一个在5岁时首次被诊断。总体而言，与KiGGS基线研究相比，我们未观察到ADHD诊断频率有显著变化。使用德国法定健康保险公司数据报告的增加情况未在KiGGS数据中体现。
