Unit of Innovation and Organization, Navarre Health Service, 31003 Pamplona, Navarre, Spain.
NNBi, 31191 Pamplona, Navarre, Spain.
Int J Environ Res Public Health. 2021 Aug 31;18(17):9208. doi: 10.3390/ijerph18179208.
(1) Background: Attention deficit hyperactivity disorder (ADHD) constitutes one of the leading mental health and behavioral disorders in childhood and adolescence. The main objective of this study was to analyze the time trend in the incidence of ADHD diagnoses in Navarre (Spain) from 2003 to 2019 in children and adolescents from 5 to 19 years old. Additionally, the seasonal trends of ADHD incidence and ADHD prevalence were determined. (2) Methods: A population-based observational retrospective study, which included people born between 1991 and 2011 and who attended compulsory education between 2007 and 2017 in Navarre (Spain), was carried out with data from both the Education and Health Department databases. (3) Results: The incidence rate increased from 4.18 cases per 1000 person-years in 2003 to 7.43 cases per 1000 person-years in 2009, before decreasing progressively to 2.1 cases per 1000 person-years in 2019. A peak incidence rate at 7-8 years of age was observed, which is consistent across the study period and for both genders. Males were more than twice as likely to be diagnosed with ADHD than females, with similar time trends in both. A seasonal pattern in ADHD diagnosis was found, with peaks in February-March and the lowest rates in the summer months. Inattentive cases were much more frequent than hyperactive cases, whereas combined cases remained low across the study period. (4) Conclusions: In this age-period-cohort analysis, a clear period and age effect was observed. We found a decreasing trend in the ADHD incidence rate since 2015. Further research is needed to confirm whether a change of trend is occurring globally.
（1）背景：注意力缺陷多动障碍（ADHD）是儿童和青少年时期主要的精神健康和行为障碍之一。本研究的主要目的是分析西班牙纳瓦拉地区（Navarre）2003 年至 2019 年 5 至 19 岁儿童和青少年 ADHD 诊断的发病率趋势，并确定 ADHD 发病率和 ADHD 患病率的季节性趋势。（2）方法：本研究采用基于人群的回顾性观察研究，纳入了 1991 年至 2011 年出生并于 2007 年至 2017 年在纳瓦拉（西班牙）接受义务教育的人群，数据来源于教育和卫生部门的数据库。（3）结果：2003 年至 2009 年，发病率从 4.18 例/1000 人年增加到 7.43 例/1000 人年，随后逐渐下降至 2019 年的 2.1 例/1000 人年。在整个研究期间和两性中，都观察到 7-8 岁时发病率达到高峰。男性被诊断为 ADHD 的可能性是女性的两倍多，且两性的发病率趋势相似。ADHD 诊断存在季节性模式，2 月至 3 月和夏季的发病率最高，夏季的发病率最低。在这段时间里，注意力不集中的病例比多动的病例更为常见，而混合病例则一直较少。（4）结论：在这项年龄-时期-队列分析中，我们观察到了明显的时期和年龄效应。自 2015 年以来，ADHD 的发病率呈下降趋势。需要进一步的研究来证实全球是否正在发生趋势变化。
