Demographic Characteristics and Psychiatric Comorbidity of Children and Adolescents Diagnosed with ADHD in Specialized Healthcare

Abstract

Recent studies have shown an increasing incidence of attention-deficit/hyperactivity disorder (ADHD) among children diagnosed in specialized services. This study aims to describe children with ADHD in Finnish specialized healthcare by reporting the demographic characteristics, time trends in diagnosis, psychiatric comorbidity, and the validity of register-based diagnoses. All the singletons born in Finland between 1991 and 2005 and diagnosed with ADHD by 2011 were identified and their psychiatric comorbidity data was obtained from the Finnish Hospital Discharge Register (FHDR). Parents of 69 patients were interviewed via telephone for a diagnostic validation. A total of 10,409 children were identified with ADHD, with a male: female ratio of 5.3:1 and a psychiatric comorbidity rate of 76.7 %. Of the validation sample 88 % met the diagnostic criteria of ADHD for DSM-IV. There is an increasing trend of ADHD diagnosis among both males and females. Psychiatric comorbidity is common and includes a wide range of disorders among children with ADHD. There was an increase of ADHD diagnoses especially among boys. More attention is needed to detect ADHD among girls in health services. Diagnoses in the FHDR show diagnostic validity and their sociodemographic patterns are in line with previous studies.

Prenatal smoking exposure and neuropsychiatric comorbidity of ADHD: a finnish nationwide population-based cohort study

“…The other most common comorbid diagnoses were : CD / ODD ( 28.1  %), anxiety disorders ( 13.6  %), autism spectrum disorders ( 11.9  %), depression ( 8.9  %,) and mental retardation ( 3.7  %). The psychiatric comorbid patterns of the sample have been reported recently in more detail [25]. These findings were in general consistent with previous studies [5].…”

Relative age within the school year and diagnosis of attention-deficit hyperactivity disorder: a nationwide population-based study

“…The validity of the diagnosis of ADHD in the FHDR has been demonstrated. 19 The Finnish healthcare system uses the ICD-10 classification as the prevailing diagnostic system, which refers to the term 'hyperkinetic disorder', but for convenience in this article we refer to it as 'ADHD'. The term 'ADHD' for 'hyperkinetic disorder' has also been used in previous Nordic studies that use the ICD classification.…”

Demographic trends in ADHD diagnosis in U.S. children using NHANES data between 2004 and 2012

“…In addition, the epidemiology and characteristics of the disease varies between genders [22] and thus different approaches for ADHD are needed for males and females [7]. Boys are known to have a greater prevalence of ADHD and are prescribed more medications than girls [2].…”

“…Boys are known to have a greater prevalence of ADHD and are prescribed more medications than girls [2]. Joelsson et al also noted that sex distribution is different when measured in clinical versus population samples [7]. Based on a community sample, Willcutt reported that ADHD was 2-3 times more prevalent among males than females [23], while a study in a clinical sample by Nussbaum showed 2-9 fold greater diagnosis of ADHD in males [22].…”

“…With an annual estimated societal cost of illness for ADHD in children of approximately $42.5 billion, ADHD constitutes a significant financial burden on the global community [6]. The estimated prevalence of ADHD worldwide is approximately 5% [1,7], with time trends revealing a notable increase in its diagnosis [2,[8][9][10][11].…”