Schlack Robert, Beyer Ann-Kristin, Beck Lilian, Hölling Heike, Pfeifer Stefan, Romanos Marcel, Jans Thomas, Hetzke Leila, Berner Annalena, Weyrich Sophia, Scholz Vanessa, Ravens-Sieberer Ulrike, Kaman Anne, Gilbert Martha, Reiß Franziska, Greiner Wolfgang, Witte Julian, Hasemann Lena, Heuschmann Peter, Fiessler Cornelia, Widmann Jonas, Riederer Cordula
Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Germany.
Klinik und Poliklinik für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Würzburg, Germany.
Gesundheitswesen. 2024 Jul;86(S 03):S231-S237. doi: 10.1055/a-2340-1474. Epub 2024 Jul 29.
As one of the most frequently diagnosed mental disorders in children and adolescents with sometimes serious individual, family and social consequences, attention deficit/hyperactivity disorder (ADHD) is highly relevant to society and health policy. In Germany, data from statutory health insurance companies has reported increasing ADHD diagnosis prevalence rates over years, while epidemiological data has shown constant and recently even decreasing prevalence rates. The clinical validity of diagnoses from either data sources is unknown. In the framework of the consortium project INTEGRATE-ADHD, 5461 parents of children aged 0 to 17 years with a confirmed administrative ADHD diagnosis insured with the third-largest German statutory health insurance provider (DAK-Gesundheit) in at least one quarter of 2020 were surveyed with the questionnaires from the epidemiological German Health Interview and Examination Survey (KiGGS study) and its in-depth module on child mental health (BELLA study) on their child's ADHD diagnosis and symptoms and on other topics, including comorbidity, utilisation of healthcare services, quality of care and satisfaction, psychosocial risk and protective factors and health-related quality of life. In addition, a subsample of 202 children and adolescents with a clinical diagnosis based on the AMWF S3 guideline on ADHD was analysed. An important aim of the project is to use data linkage on person-level to identify possible causes for the often divergent prevalence estimates from epidemiological and administrative data and to integrate and validate the data sources using a guideline-based clinical diagnosis, thereby contributing to a more accurate population-based prevalence estimate of ADHD in children and adolescents and clarifying actual or supposed contradictions between the data sources. The INTEGRATE-ADHD data linkage project combines administrative, epidemiological and clinical ADHD diagnosis data to create a "three-dimensional view" of the ADHD diagnosis. The results will be used to identify fields of action for healthcare policy and self-administration in the German healthcare system and to derive recommendations for the actors and stakeholders in the field of ADHD. The first results will be published in 2024.
注意缺陷多动障碍（ADHD）是儿童和青少年中最常被诊断出的精神障碍之一，有时会给个人、家庭和社会带来严重后果，与社会和卫生政策高度相关。在德国，法定健康保险公司的数据显示，多年来ADHD诊断患病率呈上升趋势，而流行病学数据则显示患病率保持稳定，最近甚至有所下降。来自这两种数据源的诊断的临床有效性尚不清楚。在“整合ADHD”联盟项目的框架内，对2020年至少一个季度在德国第三大法定健康保险公司（DAK-Gesundheit）投保且行政确诊为ADHD的5461名0至17岁儿童的家长进行了调查，使用了德国健康访谈与检查调查（KiGGS研究）及其关于儿童心理健康的深入模块（BELLA研究）的问卷，内容涉及孩子的ADHD诊断和症状以及其他主题，包括共病、医疗服务利用情况、护理质量和满意度、心理社会风险和保护因素以及健康相关生活质量。此外，还对202名根据ADHD的AMWF S3指南进行临床诊断的儿童和青少年进行了子样本分析。该项目的一个重要目标是利用个人层面的数据链接来确定流行病学数据和行政数据中患病率估计值经常存在差异的可能原因，并使用基于指南的临床诊断来整合和验证数据源，从而有助于更准确地估计儿童和青少年中ADHD的人群患病率，并澄清数据源之间实际或假定的矛盾。“整合ADHD”数据链接项目将行政、流行病学和临床ADHD诊断数据结合起来，以创建ADHD诊断的“三维视图”。研究结果将用于确定德国医疗系统中医疗政策和自我管理的行动领域，并为ADHD领域的行为者和利益相关者提供建议。首批结果将于2024年公布。
