Institut national de santé publique du Québec (Quebec public health institute), Quebec, Quebec, Canada.
Department of Community Health Science, University of Sherbrooke, Sherbrooke, Quebec, Canada.
Int J Methods Psychiatr Res. 2022 Mar;31(1):e1903. doi: 10.1002/mpr.1903. Epub 2021 Dec 24.
To estimate the prevalence of ADHD, and related comorbidities, mortality, and type of health service use among children and young adults, using different case definitions.
We conducted a population-based retrospective cohort study between 2000 and 2018, using the Quebec Integrated Chronic Disease Surveillance System (QICDSS) database. All residents aged less than 25 years eligible for health insurance coverage were included. We compared outcomes of three indicators (morbidity, services use and mortality) according two different algorithms of ADHD definitions, to the general population.
The cumulative prevalence of ADHD has risen steadily over the past decade, reaching 12.6% in 2017-2018. People with ADHD have a higher prevalence of psychiatric comorbidities, make greater use of medical, mental health services, and are hospitalized more often. The comparison of prevalence between the two algorithms and the general population for the three indicators showed that the cohort having one claim was very close to that with two or more, and statistically significant higher to that of people without ADHD.
This finding support that a single claim algorithm for ADHD can be used for case definition. More research is needed on the impact of potentially effective treatments in improving consequences of ADHD.
使用不同的病例定义，估计 ADHD 及相关共病、死亡率和儿童及青年人群的卫生服务使用类型的患病率。
我们于 2000 年至 2018 年期间，利用魁北克综合慢性疾病监测系统（QICDSS）数据库开展了一项基于人群的回顾性队列研究。所有符合医疗保险覆盖条件的 25 岁以下居民均纳入研究。我们将两种 ADHD 定义算法的三个指标（发病率、服务使用和死亡率）的结果与普通人群进行了比较。
过去十年中，ADHD 的累积患病率稳步上升，在 2017-2018 年达到 12.6%。ADHD 患者的精神共病患病率较高，更多地使用医疗和心理健康服务，住院率也更高。两种算法与普通人群在三个指标上的患病率比较表明，一个诊断的队列非常接近两个或更多诊断的队列，与无 ADHD 的人群相比，统计学上显著更高。
这一发现支持使用单一的 ADHD 诊断算法来定义病例。需要进一步研究潜在有效的治疗方法对 ADHD 后果的影响。
