Temporal trends and geographical variability of the prevalence and incidence of attention deficit/hyperactivity disorder diagnoses among children in Catalonia, Spain

Abstract

temporal trends and geographical variability of the prevalence and incidence of attention deficit/ hyperactivity disorder diagnoses among children in catalonia, Spain Laura pérez-crespo 1,2,3 , Josefa canals-Sans 4 , elisabet Suades-González 5 & Mònica Guxens 1,2,3,6* Attention deficit/hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood. According to a recent systematic review, the worldwide estimate of ADHD prevalence is 7.2% in children. This study aims to assess the prevalence of ADHD diagnoses in 2017 and the incidence of ADHD diagnoses in 2009-2017 in children living in Catalonia, Spain, as well as their temporal and geographical variability, and stratifying by sex and age. We used administrative data for all children aged 4 to 17 years who were insured in the public Catalan Health System in 2009-2017. We identified all ADHD cases diagnosed in 2009-2017 (ICD-9 code 314). We estimated the prevalence of ADHD diagnoses in 2017 and the overall annual incidence of ADHD diagnoses in 2009-2017. We used Poisson regression models to assess temporal trends in the incidence. We estimated a prevalence of ADHD diagnoses of 4.06% (95%CI 4.03, 4.10) in 2017, being 5.81% (95%CI 5.75, 5.87) for boys and 2.20% (95%CI 2.16, 2.24) for girls, the highest prevalence being in 13-to-17-year-olds (7.28% (95%CI 7.20, 7.36)). We did not observe a statistically significant increase of the incidence of ADHD diagnoses during the study period. Geographical differences were found across the healthcare areas in both prevalence and annual incidence and constant during the study period. In conclusion, the prevalence of ADHD diagnoses observed in this study was 4.06%, which was lower than the estimates reported in previous systematic reviews, but in line with the prevalence estimates from other recent european studies. the prevalence was higher in boys than girls, with a sex ratio consistent with previous studies. We did not observe an increase in the temporal trend of incidence of ADHD diagnoses in recent years, but we found geographical differences. Attention deficit/hyperactivity disorder (ADHD) is one of the most common behavioral disorders in childhood and adolescence 1. ADHD is commonly characterized by a persistent pattern of inattention, hyperactivity and/or impulsivity. These manifestations can cause a significant impairment in school as well as in the activities of daily life 2. ADHD appears to have a complex etiology including environmental and genetic risk factors 3. In the past decade, several systematic reviews have been conducted to estimate the prevalence of ADHD. According to a recent systematic review conducted with 175 studies across the world, the overall pooled estimate of ADHD prevalence was 7.2% in children 4. Most of the ADHD prevalence studies were conducted in Europe (54 studies, 31%) and within school populations (130 studies, 74%). The studies included in this review have reported highly variable rates worldwide, ranging from 0.2% to 34.5%. Globally, ADHD prevalence estimates are

Incidence of Attention Deficit Hyperactivity Disorder (ADHD) Diagnoses in Navarre (Spain) from 2003 to 2019

“…Most of the studies analyzing the ADHD incidence in the long term reported an increasing trend in the incidence rate over the course of the years studied [21][22][23][24][25]. In contrast, a study including children and adolescents aged 4-17 years from Catalonia (Spain) did not observe a statistically significant increase in the incidence of ADHD diagnoses between 2009 and 2017 [26].…”

l2-Penalized temporal logit-mixed models for the estimation of regional obesity prevalence over time

“…Since population health often varies over regions and time periods, the model must account for geographic and temporal heterogeneity. 11,12 Against this background, the temporal logit-mixed model is a reasonable choice for prevalence estimation. However, the method is likely to encounter technical problems.…”

“…Disease frequencies are often subject to both regional and temporal heterogeneity. 11,12 The statistical methodology must account for these distributional characteristics in order to allow for reliable results. Accordingly, the choice of a suitable model is crucial.…”

Participation in Everyday Activities of Children with and without Neurodevelopmental Disorders: A Cross-Sectional Study in Spain

“…The most prevalent and usually reported NDDs in childhood are attention deficit and hyperactivity disorder (ADHD), developmental coordination disorder (DCD), and autism spectrum disorders (ASDs). In a comprehensive review on ADHD prevalence conducted by Polanczyk et al, it was reported that 9.5% of children had a lifetime diagnosis of ADHD worldwide during the past three decades [ 7 ], while this prevalence ranges between 4.1% and 8.8% among Spanish children and adolescents [ 8 , 9 , 10 ]. Reported estimates of the prevalence of DCD in schoolchildren usually range between 5 and 6% [ 11 , 12 , 13 ] but recent studies have found that up to 12.0% of Spanish children are at risk of DCD [ 14 , 15 ].…”