Psychiatry Department, Hospital Universitario Infanta Leonor and Psychiatry and Medical Psychology Department, Complutense University, Madrid, Spain.
Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; and Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain.
BMC Psychiatry. 2018 Feb 8;18(1):40. doi: 10.1186/s12888-017-1581-y.
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in childhood (5.3% to 7.1% worldwide prevalence), with substantial overall financial burden to children/adolescents, their families, and society. The aims of this study were to describe the clinical characteristics of children and adolescents with ADHD in Spain, estimate the associated direct/indirect costs of the disorder, and assess whether the characteristics and financial costs differed between children/adolescents adequately responding to currently available pharmacotherapies compared with children/adolescents for whom pharmacotherapies failed.
This was a multicenter, cross-sectional, descriptive analysis conducted in 15 health units representative of the overall Spanish population. Data on demographic characteristics, socio-occupational status, social relationships, clinical variables of the disease, and pharmacological and non-pharmacological treatments received were collected in 321 children and adolescents with ADHD. Direct and indirect costs were estimated over one year from both a health care system and a societal perspective.
The estimated average cost of ADHD per year per child/adolescent was €5733 in 2012 prices; direct costs accounted for 60.2% of the total costs (€3450). Support from a psychologist/educational psychologist represented 45.2% of direct costs and 27.2% of total costs. Pharmacotherapy accounted for 25.8% of direct costs and 15.5% of total costs. Among indirect costs (€2283), 65.2% was due to caregiver expenses. The total annual costs were significantly higher for children/adolescents who responded poorly to pharmacological treatment (€7654 versus €5517; P = 0.024), the difference being mainly due to significantly higher direct costs, particularly with larger expenses for non-pharmacological treatment (P = 0.012).
ADHD has a significant personal, familial, and financial impact on the Spanish health system and society. Successful pharmacological intervention was associated with lower overall expenses in the management of the disorder.
注意力缺陷多动障碍（ADHD）是一种常见的儿童神经发育障碍（全球患病率为 5.3%至 7.1%），对儿童/青少年、他们的家庭和社会都带来了巨大的经济负担。本研究的目的是描述西班牙儿童和青少年 ADHD 的临床特征，估计该疾病的直接/间接相关成本，并评估与药物治疗失败的儿童/青少年相比，对现有药物治疗有充分反应的儿童/青少年的特征和经济成本是否存在差异。
这是一项多中心、横断面、描述性分析，在代表西班牙整体人口的 15 个卫生单位进行。共收集了 321 名 ADHD 儿童和青少年的人口统计学特征、社会职业状况、社会关系、疾病临床变量以及接受的药物和非药物治疗的数据。从医疗保健系统和社会两个角度估计了一年的直接和间接成本。
2012 年，每个儿童/青少年 ADHD 的年平均估计费用为 5733 欧元；直接费用占总费用的 60.2%（3450 欧元）。来自心理学家/教育心理学家的支持占直接费用的 45.2%，占总费用的 27.2%。药物治疗占直接费用的 25.8%，占总费用的 15.5%。间接费用（2283 欧元）中，65.2%是看护人费用。对药物治疗反应不佳的儿童/青少年的总年度费用明显更高（7654 欧元比 5517 欧元；P=0.024），差异主要是由于直接费用显著增加，特别是非药物治疗的费用更大（P=0.012）。
ADHD 对西班牙的医疗保健系统和社会造成了重大的个人、家庭和经济影响。成功的药物干预与该疾病管理的总体费用降低有关。
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