Liu Jingran, Jiang Zhongliang, Li Fenghua, Zheng Yi, Cui Yonghua, Xu Hui, Li Ying
Department of Psychiatry, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Key Lab of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
Ann Gen Psychiatry. 2025 Apr 13;24(1):23. doi: 10.1186/s12991-025-00558-w.
Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Despite its significance, no large-scale epidemiological study assessing ADHD, and its associated comorbidities in children and adolescents has been conducted in China.
Within a national epidemiological survey of 73,992 children and adolescents aged between 6 and 16 in China, we used the CBCL, MINI-KID, and DSM-IV to identify ADHD and its comorbid conditions. Chi-square tests were utilized to compare the prevalence estimates across varied age and sex groups.
The overall ADHD prevalence was estimated at 6.4% (95% CI: 6.2-7.0%). Broken down by subtypes, ADHD-I had a prevalence of 3.9%, ADHD-C was at 1.7%, and ADHD-H was at 0.9%. Boys and the younger age bracket recorded higher prevalence rates for ADHD and its subtypes (p < 0.001). Among ADHD-diagnosed individuals, 53% exhibited at least one comorbid psychiatric disorder. Oppositional defiant disorder/conduct disorder (ODD/CD) was the most prevalent comorbidity for ADHD-C and ADHD-H, at 58%, while anxiety disorders, at 17%, were predominant among ADHD-I cases. ODD/CD was notably higher among younger subjects (p < 0.001). In contrast, anxiety disorders were more frequent in older children and in girls (p < 0.001). Tic disorders showed a higher prevalence in younger boys, whereas mood and substance use disorders were more common in older boys (p < 0.001).
ADHD is a common neurodevelopmental disorder with high comorbidity rates that vary substantially across subtypes, age, and sex. These clinical heterogeneities complicate management and highlight the need for tailored interventions.
注意力缺陷多动障碍（ADHD）是一种常见的神经发育障碍。尽管其具有重要性，但中国尚未开展大规模的评估儿童和青少年ADHD及其相关合并症的流行病学研究。
在中国对73992名6至16岁儿童和青少年进行的全国性流行病学调查中，我们使用儿童行为量表（CBCL）、儿童版简明国际神经精神访谈（MINI-KID）和《精神疾病诊断与统计手册》第四版（DSM-IV）来识别ADHD及其合并症。采用卡方检验比较不同年龄和性别组的患病率估计值。
ADHD总体患病率估计为6.4%（95%置信区间：6.2 - 7.0%）。按亚型划分，注意力不集中型ADHD（ADHD-I）患病率为3.9%，多动冲动型ADHD（ADHD-C）为1.7%，混合型ADHD（ADHD-H）为0.9%。男孩和年龄较小的年龄段ADHD及其亚型的患病率较高（p < 0.001）。在被诊断为ADHD的个体中，53%表现出至少一种合并的精神障碍。对立违抗障碍/品行障碍（ODD/CD）是ADHD-C和ADHD-H最常见的合并症，患病率为58%，而在ADHD-I病例中，焦虑障碍占主导，患病率为17%。ODD/CD在较年轻的受试者中明显更高（p < 0.001）。相比之下，焦虑障碍在年龄较大的儿童和女孩中更常见（p < 0.001）。抽动障碍在年龄较小的男孩中患病率较高，而情绪和物质使用障碍在年龄较大的男孩中更常见（p < 0.001）。
ADHD是一种常见的神经发育障碍，合并症发生率高，且在亚型、年龄和性别之间存在很大差异。这些临床异质性使管理变得复杂，并突出了进行针对性干预的必要性。
