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注意缺陷多动障碍(ADHD)儿童的精神和非精神共病情况:德国全国性索赔数据的探索性分析。

Psychiatric and Nonpsychiatric Comorbidities Among Children With ADHD: An Exploratory Analysis of Nationwide Claims Data in Germany.

机构信息

Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany.

出版信息

J Atten Disord. 2021 Apr;25(6):874-884. doi: 10.1177/1087054719865779. Epub 2019 Jul 31.

DOI:10.1177/1087054719865779
PMID:31364481
Abstract

This study examined the full spectrum of comorbid disorders in all statutory-health-insured children aged 5 to 14 years with ADHD in 2017 by using nationwide claims data in Germany. Children with ADHD ( = 258,662) were compared for the presence of 864 comorbid diseases with a control group matched by gender, age, and region of residence ( = 2,327,958). Among others, metabolic disorders (odds ratio [OR] = 9.18; 95% confidence interval [CI] = [8.43, 9.99]), viral pneumonia (OR = 4.95; 95% CI = [2.37, 10.33]), disorders of white blood cells (OR = 4.55; 95% CI = [3.83, 5.40]), kidney failure (OR = 3.33; 95% CI = [2.65, 4.18]), hypertension (OR = 3.26; 95% CI = [3.00, 3.55]), obesity (OR = 2.85; 95% CI = [2.80, 2.91]), type 2 diabetes (OR = 2.61; 95% CI = [2.11, 3.23]), migraine (OR = 2.49; 95% CI = [2.37, 2.61]), asthma (OR = 2.19; 95% CI = [2.16, 2.22]), atopic dermatitis (OR = 2.10; 95% CI = [2.16, 2.23]), juvenile arthritis (OR = 1.56; 95% CI = [1.39, 1.76]), glaucoma (OR = 1.51; 95% CI = [1.30, 1.75]), and type 1 diabetes (OR = 1.30; 95% CI = [1.20, 1.40]) were more likely to be diagnosed in ADHD children. Along with psychiatric diseases, various somatic diseases were more common in ADHD children. The results have direct implications for patient care, including fine-grained diagnostics and personalized therapy.

摘要

本研究利用德国全国性索赔数据,对 2017 年所有年龄在 5 至 14 岁、患有 ADHD 的法定医疗保险儿童进行了全面的共病障碍研究。将患有 ADHD 的儿童(n=258662)与性别、年龄和居住地相匹配的对照组(n=2327958)进行比较,以确定 864 种共病疾病的存在。其他疾病包括代谢紊乱(比值比[OR] = 9.18;95%置信区间[CI] = [8.43, 9.99])、病毒性肺炎(OR = 4.95;95% CI = [2.37, 10.33])、白细胞疾病(OR = 4.55;95% CI = [3.83, 5.40])、肾衰竭(OR = 3.33;95% CI = [2.65, 4.18])、高血压(OR = 3.26;95% CI = [3.00, 3.55])、肥胖症(OR = 2.85;95% CI = [2.80, 2.91])、2 型糖尿病(OR = 2.61;95% CI = [2.11, 3.23])、偏头痛(OR = 2.49;95% CI = [2.37, 2.61])、哮喘(OR = 2.19;95% CI = [2.16, 2.22])、特应性皮炎(OR = 2.10;95% CI = [2.16, 2.23])、青少年关节炎(OR = 1.56;95% CI = [1.39, 1.76])、青光眼(OR = 1.51;95% CI = [1.30, 1.75])和 1 型糖尿病(OR = 1.30;95% CI = [1.20, 1.40])更有可能被诊断为 ADHD 儿童。除了精神疾病,ADHD 儿童还更常见各种躯体疾病。这些结果对包括精细化诊断和个性化治疗在内的患者护理具有直接影响。

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