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台湾地区成人注意力缺陷多动障碍患者的患病趋势、特征及药物治疗:一项全国性调查

Trend, characteristics, and pharmacotherapy of adults diagnosed with attention-deficit/hyperactivity disorder: a nationwide survey in Taiwan.

作者信息

Cheng Yu-Shian, Shyu Yu-Chiau, Lee Sheng-Yu, Yuan Shin-Sheng, Yang Chun-Ju, Yang Kang-Chung, Lee Tung-Liang, Wang Liang-Jen

机构信息

Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung.

Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung; Institute of Molecular Biology, Academia Sinica, Nankang, Taipei.

出版信息

Neuropsychiatr Dis Treat. 2017 Mar 1;13:643-651. doi: 10.2147/NDT.S126438. eCollection 2017.

Abstract

OBJECTIVE

Attention-deficit/hyperactivity disorder (ADHD) in adults may result in functional impairment warranting clinical interventions. However, few studies have investigated the diagnosis and treatment rates of adult ADHD in non-Caucasian ethnic groups. This study used nationwide population-based data to investigate the rate of diagnosis, associated characteristics, and pharmacological treatment for adult ADHD in Taiwan.

METHODS

Adults (age ≥18 years) newly diagnosed with ADHD (n=5,397) between January 2000 and December 2011 were enrolled from the National Health Insurance database in Taiwan. All patients were monitored until December 31, 2011. Patients who received treatment with immediate-release methylphenidate (IR-MPH), osmotic release oral system-methylphenidate (OROS-MPH), and atomoxetine (ATX) were analyzed.

RESULTS

The cumulative prevalence of adult ADHD was 0.028%, and the incidence increased 10.9-fold from 2000 to 2011. The male to female ratio was 1.16, and 74.9% of the patients had the inattentive type. Overall, 55% of the patients received drug therapy for ADHD, and the average treatment duration was 478.3 days. Of the total patients, 50.4%, 13.3%, and 1.7% were prescribed with IR-MPH, OROS-MPH, and ATX, for a mean duration of 453.9, 327.7, and 161.4 days, respectively.

CONCLUSION

This population-based study showed an increasing trend in the diagnosis rate of adult ADHD; however, this rate is still low compared with Western countries. Approximately 45% of the adult patients with ADHD never received medication for their ADHD. Continuous efforts are needed to increase public awareness of adult ADHD.

摘要

目的

成人注意力缺陷多动障碍(ADHD)可能导致功能损害,需要临床干预。然而,很少有研究调查非白种人种族群体中成人ADHD的诊断和治疗率。本研究使用全国基于人群的数据来调查台湾成人ADHD的诊断率、相关特征和药物治疗情况。

方法

从台湾国民健康保险数据库中纳入2000年1月至2011年12月期间新诊断为ADHD的成人(年龄≥18岁,n = 5397)。所有患者均监测至2011年12月31日。对接受速释哌甲酯(IR-MPH)、渗透泵控释哌甲酯(OROS-MPH)和托莫西汀(ATX)治疗的患者进行分析。

结果

成人ADHD的累积患病率为0.028%,2000年至2011年发病率增加了10.9倍。男女比例为1.16,74.9%的患者为注意力不集中型。总体而言,55%的患者接受了ADHD药物治疗,平均治疗时长为478.3天。在所有患者中,50.4%、13.3%和1.7%的患者分别被处方使用IR-MPH、OROS-MPH和ATX,平均用药时长分别为453.9天、327.7天和161.4天。

结论

这项基于人群的研究显示成人ADHD的诊断率呈上升趋势;然而,与西方国家相比,这一比率仍然较低。约45%的成人ADHD患者从未接受过ADHD药物治疗。需要持续努力提高公众对成人ADHD的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3cb7/5338966/d8357458dd12/ndt-13-643Fig1.jpg

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