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定义注意力缺陷多动障碍(ADHD)诊断和治疗率的挑战:过去十年的趋势

Challenges in defining the rates of ADHD diagnosis and treatment: trends over the last decade.

作者信息

Davidovitch Michael, Koren Gideon, Fund Naama, Shrem Maayan, Porath Avi

机构信息

Department of Child Development, Medical Division, Maccabi Healthcare Services, 27 Hamered St., 6812509, Tel Aviv, Israel.

Research Institute, Maccabi Healthcare Services, Tel Aviv, Israel.

出版信息

BMC Pediatr. 2017 Dec 29;17(1):218. doi: 10.1186/s12887-017-0971-0.

Abstract

BACKGROUND

There is a global trend of large increases in the prevalence and incidence of Attention Deficit Hyperactivity Disorder (ADHD). This study aimed to address potential causes of these major changes.

METHODS

The authors used a large cohort to analyze data employing patients' electronic medical records, with physicians' diagnosis of ADHD, including records of medication purchases.

RESULTS

The prevalence of ADHD diagnoses rose twofold from 6.8% to 14.4% between 2005 and 2014 (p < 0.001), while the ratio of males to females with ADHD decreased from 2.94 in 2005 to 1.86 in 2014 (p < 0.001). The incidence increased, peaking in 2011 before declining in 2014. ADHD medication usage by children and adolescents was 3.57% in 2005 and 8.51% by 2014 (p < 0.001).

CONCLUSIONS

We report a dramatic increase in the rate of ADHD diagnoses. One of the leading factors to which we attribute this increase is the physicians' and parents' changed attitude towards diagnosing attention/hyperactivity problems, with more parents appear to consider ADHD diagnosis and treatment as a means to improve their child's academic achievements, commonly with the aid of medications. This change in attitude may also be associated with the dramatic increase in female ADHD diagnosis prevalence.

摘要

背景

注意缺陷多动障碍(ADHD)的患病率和发病率在全球范围内呈大幅上升趋势。本研究旨在探讨这些重大变化的潜在原因。

方法

作者使用一个大型队列,利用患者的电子病历分析数据,这些病历包含医生对ADHD的诊断,包括药物购买记录。

结果

2005年至2014年间,ADHD诊断的患病率从6.8%上升了两倍至14.4%(p < 0.001),而患有ADHD的男性与女性比例从2005年的2.94降至2014年的1.86(p < 0.001)。发病率上升,在2011年达到峰值,随后在2014年下降。2005年儿童和青少年的ADHD药物使用率为3.57%,到2014年为8.51%(p < 0.001)。

结论

我们报告了ADHD诊断率的急剧上升。我们认为导致这种上升的主要因素之一是医生和家长对注意力/多动问题诊断的态度发生了变化,越来越多的家长似乎将ADHD诊断和治疗视为提高孩子学业成绩的一种手段,通常借助药物。这种态度的变化也可能与女性ADHD诊断患病率的急剧上升有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b985/5747128/09e471bba152/12887_2017_971_Fig1_HTML.jpg

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