Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011
Public controversy regarding the potential overdiagnosis and overmedication of children with attention-deficit/hyperactivity disorder (ADHD) has continued for decades. This study used the National Health Insurance Research Database of Taiwan (NHIRD-TW) to explore trends in ADHD diagnosis in youths a...
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| Veröffentlicht in: | Epidemiology and psychiatric sciences 2017-12, Vol.26 (6), p.624-634 |
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| creator | Wang, L.-J. Lee, S.-Y. Yuan, S.-S. Yang, C.-J. Yang, K.-C. Huang, T.-S. Chou, W.-J. Chou, M.-C. Lee, M.-J. Lee, T.-L. Shyu, Y.-C. |
| description | Public controversy regarding the potential overdiagnosis and overmedication of children with attention-deficit/hyperactivity disorder (ADHD) has continued for decades. This study used the National Health Insurance Research Database of Taiwan (NHIRD-TW) to explore trends in ADHD diagnosis in youths and the proportion of those receiving medication, with the aim of determining whether ADHD is overdiagnosed and overmedicated in Taiwan.
Youths (age ≤18 years) who had at least two NHIRD-TW claims records with ADHD diagnosis between January 2000 and December 2011 were selected as the subject cohort. In total, the study sample comprised 145 018 patients with ADHD (mean age at a diagnosis of ADHD: 7.7 ± 3.1 years; 21.4% females). The number of cases of ADHD were calculated annually for each year (from 2000 to 2011), and the number of cases per year who received medication was determined as those with at least one record of pharmacotherapy (immediate-release methylphenidate, osmotic controlled-release formulation of methylphenidate, and atomoxetine) in each year.
The prevalence rates of a diagnosis of ADHD in the youths ranged from 0.11% in 2000 to 1.24% in 2011. Compared with children under 6 years of age, the ADHD diagnosis rates in children aged between 7 and 12 years (ratio of prevalence rates = 4.36) and in those aged between 13 and 18 years (ratio of prevalence rates = 1.42) were significantly higher during the study period. The prevalence in males was higher than that in females (ratio of prevalence rates = 4.09). Among the youths with ADHD, 50.2% received medications in 2000 compared with 61.0% in 2011. The probability of receiving ADHD medication increased with age. More male ADHD patients received medications that females patients (ratio of prevalence rates = 1.16).
The rate of ADHD diagnosis was far lower than the prevalence rate (7.5%) identified in a previous community study using face-to-face interviews. Approximately 40-50% of the youths with ADHD did not receive any medications. These findings are not consistent with a systematic public opinion about overdiagnosis or overmedication of ADHD in Taiwan. |
| doi_str_mv | 10.1017/S2045796016000500 |
| format | Article |
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Youths (age ≤18 years) who had at least two NHIRD-TW claims records with ADHD diagnosis between January 2000 and December 2011 were selected as the subject cohort. In total, the study sample comprised 145 018 patients with ADHD (mean age at a diagnosis of ADHD: 7.7 ± 3.1 years; 21.4% females). The number of cases of ADHD were calculated annually for each year (from 2000 to 2011), and the number of cases per year who received medication was determined as those with at least one record of pharmacotherapy (immediate-release methylphenidate, osmotic controlled-release formulation of methylphenidate, and atomoxetine) in each year.
The prevalence rates of a diagnosis of ADHD in the youths ranged from 0.11% in 2000 to 1.24% in 2011. Compared with children under 6 years of age, the ADHD diagnosis rates in children aged between 7 and 12 years (ratio of prevalence rates = 4.36) and in those aged between 13 and 18 years (ratio of prevalence rates = 1.42) were significantly higher during the study period. The prevalence in males was higher than that in females (ratio of prevalence rates = 4.09). Among the youths with ADHD, 50.2% received medications in 2000 compared with 61.0% in 2011. The probability of receiving ADHD medication increased with age. More male ADHD patients received medications that females patients (ratio of prevalence rates = 1.16).
The rate of ADHD diagnosis was far lower than the prevalence rate (7.5%) identified in a previous community study using face-to-face interviews. Approximately 40-50% of the youths with ADHD did not receive any medications. These findings are not consistent with a systematic public opinion about overdiagnosis or overmedication of ADHD in Taiwan.</description><identifier>ISSN: 2045-7960</identifier><identifier>EISSN: 2045-7979</identifier><identifier>DOI: 10.1017/S2045796016000500</identifier><identifier>PMID: 27435692</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adolescent ; Adrenergic Uptake Inhibitors - therapeutic use ; Atomoxetine Hydrochloride - therapeutic use ; Attention Deficit Disorder with Hyperactivity - diagnosis ; Attention Deficit Disorder with Hyperactivity - drug therapy ; Attention Deficit Disorder with Hyperactivity - epidemiology ; Attention deficit hyperactivity disorder ; Central Nervous System Stimulants - therapeutic use ; Child ; Children ; Cohort Studies ; Controlled release ; Drug therapy ; Epidemiology ; Female ; Females ; Health insurance ; Humans ; Hyperactivity ; Male ; Males ; Medical diagnosis ; Medical Overuse - statistics & numerical data ; Methylphenidate ; Methylphenidate - therapeutic use ; Original ; Original Articles ; Population Surveillance ; Prevalence ; Psychiatry ; Public opinion ; Studies ; Taiwan - epidemiology</subject><ispartof>Epidemiology and psychiatric sciences, 2017-12, Vol.26 (6), p.624-634</ispartof><rights>Copyright © Cambridge University Press 2016</rights><rights>Cambridge University Press 2016 2016 Cambridge University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-b44f6336203975ae40bae74a5e0f74988b780c788049ec3bfa429a9721a884d43</citedby><cites>FETCH-LOGICAL-c471t-b44f6336203975ae40bae74a5e0f74988b780c788049ec3bfa429a9721a884d43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6998980/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S2045796016000500/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,230,314,724,777,781,882,27905,27906,53772,53774,55609</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27435692$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wang, L.-J.</creatorcontrib><creatorcontrib>Lee, S.-Y.</creatorcontrib><creatorcontrib>Yuan, S.-S.</creatorcontrib><creatorcontrib>Yang, C.-J.</creatorcontrib><creatorcontrib>Yang, K.-C.</creatorcontrib><creatorcontrib>Huang, T.-S.</creatorcontrib><creatorcontrib>Chou, W.-J.</creatorcontrib><creatorcontrib>Chou, M.-C.</creatorcontrib><creatorcontrib>Lee, M.-J.</creatorcontrib><creatorcontrib>Lee, T.-L.</creatorcontrib><creatorcontrib>Shyu, Y.-C.</creatorcontrib><title>Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011</title><title>Epidemiology and psychiatric sciences</title><addtitle>Epidemiol Psychiatr Sci</addtitle><description>Public controversy regarding the potential overdiagnosis and overmedication of children with attention-deficit/hyperactivity disorder (ADHD) has continued for decades. This study used the National Health Insurance Research Database of Taiwan (NHIRD-TW) to explore trends in ADHD diagnosis in youths and the proportion of those receiving medication, with the aim of determining whether ADHD is overdiagnosed and overmedicated in Taiwan.
Youths (age ≤18 years) who had at least two NHIRD-TW claims records with ADHD diagnosis between January 2000 and December 2011 were selected as the subject cohort. In total, the study sample comprised 145 018 patients with ADHD (mean age at a diagnosis of ADHD: 7.7 ± 3.1 years; 21.4% females). The number of cases of ADHD were calculated annually for each year (from 2000 to 2011), and the number of cases per year who received medication was determined as those with at least one record of pharmacotherapy (immediate-release methylphenidate, osmotic controlled-release formulation of methylphenidate, and atomoxetine) in each year.
The prevalence rates of a diagnosis of ADHD in the youths ranged from 0.11% in 2000 to 1.24% in 2011. Compared with children under 6 years of age, the ADHD diagnosis rates in children aged between 7 and 12 years (ratio of prevalence rates = 4.36) and in those aged between 13 and 18 years (ratio of prevalence rates = 1.42) were significantly higher during the study period. The prevalence in males was higher than that in females (ratio of prevalence rates = 4.09). Among the youths with ADHD, 50.2% received medications in 2000 compared with 61.0% in 2011. The probability of receiving ADHD medication increased with age. More male ADHD patients received medications that females patients (ratio of prevalence rates = 1.16).
The rate of ADHD diagnosis was far lower than the prevalence rate (7.5%) identified in a previous community study using face-to-face interviews. Approximately 40-50% of the youths with ADHD did not receive any medications. These findings are not consistent with a systematic public opinion about overdiagnosis or overmedication of ADHD in Taiwan.</description><subject>Adolescent</subject><subject>Adrenergic Uptake Inhibitors - therapeutic use</subject><subject>Atomoxetine Hydrochloride - therapeutic use</subject><subject>Attention Deficit Disorder with Hyperactivity - diagnosis</subject><subject>Attention Deficit Disorder with Hyperactivity - drug therapy</subject><subject>Attention Deficit Disorder with Hyperactivity - epidemiology</subject><subject>Attention deficit hyperactivity disorder</subject><subject>Central Nervous System Stimulants - therapeutic use</subject><subject>Child</subject><subject>Children</subject><subject>Cohort Studies</subject><subject>Controlled release</subject><subject>Drug therapy</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Females</subject><subject>Health insurance</subject><subject>Humans</subject><subject>Hyperactivity</subject><subject>Male</subject><subject>Males</subject><subject>Medical diagnosis</subject><subject>Medical Overuse - statistics & numerical data</subject><subject>Methylphenidate</subject><subject>Methylphenidate - therapeutic use</subject><subject>Original</subject><subject>Original Articles</subject><subject>Population Surveillance</subject><subject>Prevalence</subject><subject>Psychiatry</subject><subject>Public opinion</subject><subject>Studies</subject><subject>Taiwan - epidemiology</subject><issn>2045-7960</issn><issn>2045-7979</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kU1r3DAQhk1paEKSH9BLEfTSy7b6sj4uhZCkTSHQQNKzGNvjXQVbSiV7l_331ZLtkrb0NGLmmXdm9FbVW0Y_Msr0p3tOZa2tokxRSmtKX1Unu9RCW21fH96KHlfnOT8WhkpLjVBvqmOupaiV5SdVvku4hgFDiyTBhJnEnmzjPK0y6TwsQ8zYkY2fVgRCR0bsfFuwjvQxkYurmyviAwESYPIxbHyHJM9pjdtd-gH8BgLpUxwJL-PJFEtk7Kw66mHIeL6Pp9WPL9cPlzeL2-9fv11e3C5aqdm0aKTslRCKU2F1DShpA6gl1Eh7La0xjTa01caUu7AVTQ-SW7CaMzBGdlKcVp-fdZ_mpizeYpgSDO4p-RHS1kXw7s9K8Cu3jGunrDXW0CLwYS-Q4s8Z8-RGn1scBggY5-yY4UpzUb6yoO__Qh_jnEI5zzGrhJTFIV4o9ky1KeacsD8sw6jbuer-cbX0vHt5xaHjt4cFEHtRGJvkuyW-mP1f2V_GLanz</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Wang, L.-J.</creator><creator>Lee, S.-Y.</creator><creator>Yuan, S.-S.</creator><creator>Yang, C.-J.</creator><creator>Yang, K.-C.</creator><creator>Huang, T.-S.</creator><creator>Chou, W.-J.</creator><creator>Chou, M.-C.</creator><creator>Lee, M.-J.</creator><creator>Lee, T.-L.</creator><creator>Shyu, Y.-C.</creator><general>Cambridge University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20171201</creationdate><title>Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011</title><author>Wang, L.-J. ; Lee, S.-Y. ; Yuan, S.-S. ; Yang, C.-J. ; Yang, K.-C. ; Huang, T.-S. ; Chou, W.-J. ; Chou, M.-C. ; Lee, M.-J. ; Lee, T.-L. ; Shyu, Y.-C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-b44f6336203975ae40bae74a5e0f74988b780c788049ec3bfa429a9721a884d43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Adrenergic Uptake Inhibitors - therapeutic use</topic><topic>Atomoxetine Hydrochloride - therapeutic use</topic><topic>Attention Deficit Disorder with Hyperactivity - diagnosis</topic><topic>Attention Deficit Disorder with Hyperactivity - drug therapy</topic><topic>Attention Deficit Disorder with Hyperactivity - epidemiology</topic><topic>Attention deficit hyperactivity disorder</topic><topic>Central Nervous System Stimulants - therapeutic use</topic><topic>Child</topic><topic>Children</topic><topic>Cohort Studies</topic><topic>Controlled release</topic><topic>Drug therapy</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Females</topic><topic>Health insurance</topic><topic>Humans</topic><topic>Hyperactivity</topic><topic>Male</topic><topic>Males</topic><topic>Medical diagnosis</topic><topic>Medical Overuse - statistics & numerical data</topic><topic>Methylphenidate</topic><topic>Methylphenidate - therapeutic use</topic><topic>Original</topic><topic>Original Articles</topic><topic>Population Surveillance</topic><topic>Prevalence</topic><topic>Psychiatry</topic><topic>Public opinion</topic><topic>Studies</topic><topic>Taiwan - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wang, L.-J.</creatorcontrib><creatorcontrib>Lee, S.-Y.</creatorcontrib><creatorcontrib>Yuan, S.-S.</creatorcontrib><creatorcontrib>Yang, C.-J.</creatorcontrib><creatorcontrib>Yang, K.-C.</creatorcontrib><creatorcontrib>Huang, T.-S.</creatorcontrib><creatorcontrib>Chou, W.-J.</creatorcontrib><creatorcontrib>Chou, M.-C.</creatorcontrib><creatorcontrib>Lee, M.-J.</creatorcontrib><creatorcontrib>Lee, T.-L.</creatorcontrib><creatorcontrib>Shyu, Y.-C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Epidemiology and psychiatric sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wang, L.-J.</au><au>Lee, S.-Y.</au><au>Yuan, S.-S.</au><au>Yang, C.-J.</au><au>Yang, K.-C.</au><au>Huang, T.-S.</au><au>Chou, W.-J.</au><au>Chou, M.-C.</au><au>Lee, M.-J.</au><au>Lee, T.-L.</au><au>Shyu, Y.-C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011</atitle><jtitle>Epidemiology and psychiatric sciences</jtitle><addtitle>Epidemiol Psychiatr Sci</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>26</volume><issue>6</issue><spage>624</spage><epage>634</epage><pages>624-634</pages><issn>2045-7960</issn><eissn>2045-7979</eissn><abstract>Public controversy regarding the potential overdiagnosis and overmedication of children with attention-deficit/hyperactivity disorder (ADHD) has continued for decades. This study used the National Health Insurance Research Database of Taiwan (NHIRD-TW) to explore trends in ADHD diagnosis in youths and the proportion of those receiving medication, with the aim of determining whether ADHD is overdiagnosed and overmedicated in Taiwan.
Youths (age ≤18 years) who had at least two NHIRD-TW claims records with ADHD diagnosis between January 2000 and December 2011 were selected as the subject cohort. In total, the study sample comprised 145 018 patients with ADHD (mean age at a diagnosis of ADHD: 7.7 ± 3.1 years; 21.4% females). The number of cases of ADHD were calculated annually for each year (from 2000 to 2011), and the number of cases per year who received medication was determined as those with at least one record of pharmacotherapy (immediate-release methylphenidate, osmotic controlled-release formulation of methylphenidate, and atomoxetine) in each year.
The prevalence rates of a diagnosis of ADHD in the youths ranged from 0.11% in 2000 to 1.24% in 2011. Compared with children under 6 years of age, the ADHD diagnosis rates in children aged between 7 and 12 years (ratio of prevalence rates = 4.36) and in those aged between 13 and 18 years (ratio of prevalence rates = 1.42) were significantly higher during the study period. The prevalence in males was higher than that in females (ratio of prevalence rates = 4.09). Among the youths with ADHD, 50.2% received medications in 2000 compared with 61.0% in 2011. The probability of receiving ADHD medication increased with age. More male ADHD patients received medications that females patients (ratio of prevalence rates = 1.16).
The rate of ADHD diagnosis was far lower than the prevalence rate (7.5%) identified in a previous community study using face-to-face interviews. Approximately 40-50% of the youths with ADHD did not receive any medications. These findings are not consistent with a systematic public opinion about overdiagnosis or overmedication of ADHD in Taiwan.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>27435692</pmid><doi>10.1017/S2045796016000500</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Cambridge Journals; PubMed Central |
| subjects | Adolescent Adrenergic Uptake Inhibitors - therapeutic use Atomoxetine Hydrochloride - therapeutic use Attention Deficit Disorder with Hyperactivity - diagnosis Attention Deficit Disorder with Hyperactivity - drug therapy Attention Deficit Disorder with Hyperactivity - epidemiology Attention deficit hyperactivity disorder Central Nervous System Stimulants - therapeutic use Child Children Cohort Studies Controlled release Drug therapy Epidemiology Female Females Health insurance Humans Hyperactivity Male Males Medical diagnosis Medical Overuse - statistics & numerical data Methylphenidate Methylphenidate - therapeutic use Original Original Articles Population Surveillance Prevalence Psychiatry Public opinion Studies Taiwan - epidemiology |
| title | Prevalence rates of youths diagnosed with and medicated for ADHD in a nationwide survey in Taiwan from 2000 to 2011 |
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