Yallop Lauren, Brownell Marni, Chateau Dan, Walker John, Warren Michelle, Bailis Dan, Lebow Michael
Clinical Psychologist, Alberta Health Services, Calgary, Alberta.
Associate Professor, Department of Community Health Sciences (Manitoba Centre for Health Policy), College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba.
Can J Psychiatry. 2015 Oct;60(10):432-40. doi: 10.1177/070674371506001004.
It has only recently been accepted that attention-deficit hyperactivity disorder (ADHD) persists into adulthood. Accordingly, less is known about adult diagnostic and treatment prevalence. We aimed to determine the lifetime prevalence of ADHD diagnosis and psychostimulant prescriptions for young adults in the province of Manitoba and to explore how diagnosis differs according to sociodemographic characteristics and age at diagnosis; and to investigate whether a socioeconomic gradient exists within young adults with a lifetime ADHD diagnosis, as well as the variables that moderate the gradient.
Using the Manitoba Population Health Research Data Repository, our cross-sectional analysis used 24 fiscal years of data (1984/85 to 2008/09) and included all adults aged 18 to 29 during 2007/08 to 2008/09 in Manitoba (n = 207 544) who had a lifetime diagnosis of ADHD (n = 14 762). Regression analyses tested for differences in rates by sex, region, age, age at diagnosis, and socioeconomic status.
Lifetime prevalence for ADHD diagnosis (7.11%) and psychostimulant prescriptions (3.09%) differed according to sex, region, and age. In contrast to previous Manitoban research on childhood ADHD, the socioeconomic gradient for ADHD diagnosis was not found in young adulthood. When region was accounted for, a small negative gradient in the urban population and a positive gradient in the rural population were evident. People from the highest income quintile were significantly less likely to be diagnosed before age 18, compared with other income quintiles.
Given the high lifetime prevalence of ADHD in Manitoban young adults and significant socioeconomic correlates for diagnosis, further investigation into the trajectory of this relatively unexplored population is recommended.
注意缺陷多动障碍（ADHD）会持续至成年期，这一观点直到最近才被人们所接受。因此，对于成人ADHD的诊断及治疗患病率的了解还比较少。我们旨在确定曼尼托巴省年轻成年人ADHD诊断及精神兴奋剂处方的终生患病率，并探讨诊断如何因社会人口学特征及诊断时的年龄而有所不同；同时调查在终生诊断为ADHD的年轻成年人中是否存在社会经济梯度，以及调节该梯度的变量。
利用曼尼托巴省人口健康研究数据储存库，我们的横断面分析使用了24个财政年度的数据（1984/85至2008/09），纳入了2007/08至2008/09年期间曼尼托巴省所有年龄在18至29岁的成年人（n = 207544），其中终生诊断为ADHD的有14762人。回归分析检验了性别、地区、年龄、诊断时的年龄及社会经济状况在患病率上的差异。
ADHD诊断的终生患病率（7.11%）及精神兴奋剂处方的终生患病率（3.09%）因性别、地区和年龄而有所不同。与曼尼托巴省之前关于儿童ADHD的研究不同，在年轻成年人中未发现ADHD诊断的社会经济梯度。在考虑地区因素后，城市人口中存在小的负梯度，农村人口中存在正梯度。与其他收入五分位数相比，最高收入五分位数的人群在18岁之前被诊断的可能性显著更低。
鉴于曼尼托巴省年轻成年人中ADHD的终生患病率较高，且诊断存在显著的社会经济相关性，建议对这一相对未被充分研究的人群的病程进行进一步调查。
