Estimated prevalence and incidence of diagnosed ADHD and health care utilization in adults in Sweden – a longitudinal population-based register study

Abstract

BackgroundAlthough the worldwide prevalence of attention-deficit/hyperactivity disorder (ADHD) in adults is estimated to be between 2% and 5%, it is considered to be underdiagnosed. This register study explored the prevalence of diagnosed ADHD and incidence of newly diagnosed ADHD in Swedish adults over time, and assessed comorbidities and pharmacologic treatment.MethodsNational Patient Register data were used to estimate the overall prevalence of adults (≥18 years) with a registered ADHD diagnosis from 2006 to 2011, and the incidence of newly registered diagnoses from 2007 to 2011. Data from the Prescribed Drug Register were used to estimate the mean dose of the most frequently prescribed ADHD medication.ResultsThe estimated annual prevalence (N=44,364) of diagnosed ADHD increased from 0.58 per 1,000 persons in 2006 to 3.54 per 1,000 persons in 2011. The estimated annual incidence of newly diagnosed ADHD (N=24,921) increased from 0.39 per 1,000 persons to 0.90 per 1,000 persons between 2007 and 2011. At least one comorbidity was diagnosed in 52.6% of adults with ADHD (54.0% of newly diagnosed adults), with anxiety, substance use disorders, and depression being the most common. Among all adults with ADHD, 78.9% (65.7% of newly diagnosed adults) were prescribed ADHD medication and one-third were prescribed more than one add-on medication. Osmotic release oral system methylphenidate was the most commonly used medication. The mean daily dose was 51.5 mg, and was significantly higher in males, patients with substance use disorders, patients with drug holidays, and patients with at least one add-on medication. The most frequent concomitant medications were anxiolytics and hypnotics.ConclusionIn Sweden, the number of adults diagnosed with ADHD increased between 2006 and 2011, and the majority of patients were prescribed ADHD-specific medication. Over one-half of patients had psychiatric comorbidities; one-third were prescribed more than one add-on medication. Consumption of pharmacologic ADHD medication was high in specific patient subpopulations.

Genetic and clinical characteristics of treatment-resistant depression using primary care records in two UK cohorts

“…Therefore, undiagnosed ADHD or a past diagnosis of the disease should be assessed in patients with TRD. In our sample, ADHD diagnosis was difficult to assess, as it could not be reliably assessed in primary care data (prevalence < 0.01%), probably due to the lack of registration of diagnoses received during childhood, lower awareness of the manifestations of ADHD and underdiagnosis in the past as well as underdiagnosis in adults (Ginsberg et al, 2014; Polyzoi et al, 2018). Although not included in our main analyses due to availability in a subset of the UKB only, the OR of self-reported ADHD diagnosis received by a professional was 6.65 (95% CI 2.04-21.07, p=8.12e-04) in TRD compared with non-TRD groups (7 on a total of 581 and 8 on a total of 4373 subjects, respectively).…”

Who Is at Risk of Dying Young from Suicide and Sudden Violent Death? Common and Specific Risk Factors among Children, Adolescents, and Young Adults

“…In a national public health survey, every third woman and every fifth man in the age group 16–29 years report reduced mental well‐being in 2018 (Folkhälsomyndigheten, ). Additionally, an increased occurrence of ADHD diagnoses has been noticed, may be partly due to the diagnosis being a precondition for supportive measures in Swedish schools (Polyzoi, Ahnemark, Medin, & Ginsberg, ; Rydell, Lundström, Gillberg, Lichtenstein, & Larsson, ).…”

Comparison of clinical and cognitive characteristics of a Mexican adult clinical population with and without ADHD

“…In our ADHD group, more than three quarters of the study sample had at least one comorbidity; and a higher average of comorbid disorders than those without ADHD. In this regard, in a study published by Polyzoi, Ahnemark, Medin, and Ginsberg(2018), based on the Swedish national register of patients, 52.6% of adults with ADHD had at least one comorbidity, mainly anxiety disorders, substance use disorders and affective disorders. Our findings support the scientific evidence that having ADHD is related to more severe clinical symptoms than in those who do not have the diagnosis (Barkley & Brown, 2008;Nierenberg et al, 2005).…”