ADHD Prevalence Estimates Across Three Decades: an Updated Systematic Review and Meta-regression Analysis

Overview

Journal Int J Epidemiol

Specialty Public Health

Date 2014 Jan 28

PMID 24464188

Citations 596

Authors

Guilherme V Polanczyk

Erik G Willcutt

Giovanni A Salum

Christian Kieling

Luis A Rohde

Affiliations

Soon will be listed here.

Abstract

Background: Previous studies have identified significant variability in attention-deficit / hyperactivity disorder (ADHD) prevalence estimates worldwide, largely explained by methodological procedures. However, increasing rates of ADHD diagnosis and treatment throughout the past few decades have fuelled concerns about whether the true prevalence of the disorder has increased over time.

Methods: We updated the two most comprehensive systematic reviews on ADHD prevalence available in the literature. Meta-regression analyses were conducted to test the effect of year of study in the context of both methodological variables that determined variability in ADHD prevalence (diagnostic criteria, impairment criterion and source of information), and the geographical location of studies.

Results: We identified 154 original studies and included 135 in the multivariate analysis. Methodological procedures investigated were significantly associated with heterogeneity of studies. Geographical location and year of study were not associated with variability in ADHD prevalence estimates.

Conclusions: Confirming previous findings, variability in ADHD prevalence estimates is mostly explained by methodological characteristics of the studies. In the past three decades, there has been no evidence to suggest an increase in the number of children in the community who meet criteria for ADHD when standardized diagnostic procedures are followed.

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References

Winterstein A, Gerhard T, Shuster J, Zito J, Johnson M, Liu H . Utilization of pharmacologic treatment in youths with attention deficit/hyperactivity disorder in Medicaid database. Ann Pharmacother. 2007; 42(1):24-31. DOI: 10.1345/aph.1K143. View

Viechtbauer W, Cheung M . Outlier and influence diagnostics for meta-analysis. Res Synth Methods. 2015; 1(2):112-25. DOI: 10.1002/jrsm.11. View

Elsabbagh M, Divan G, Koh Y, Kim Y, Kauchali S, Marcin C . Global prevalence of autism and other pervasive developmental disorders. Autism Res. 2012; 5(3):160-79. PMC: 3763210. DOI: 10.1002/aur.239. View

Singh I . Beyond polemics: science and ethics of ADHD. Nat Rev Neurosci. 2008; 9(12):957-64. DOI: 10.1038/nrn2514. View

Getahun D, Jacobsen S, Fassett M, Chen W, Demissie K, Rhoads G . Recent trends in childhood attention-deficit/hyperactivity disorder. JAMA Pediatr. 2013; 167(3):282-8. DOI: 10.1001/2013.jamapediatrics.401. View

McCarthy S, Wilton L, Murray M, Hodgkins P, Asherson P, Wong I . The epidemiology of pharmacologically treated attention deficit hyperactivity disorder (ADHD) in children, adolescents and adults in UK primary care. BMC Pediatr. 2012; 12:78. PMC: 3472167. DOI: 10.1186/1471-2431-12-78. View

Willcutt E . The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012; 9(3):490-9. PMC: 3441936. DOI: 10.1007/s13311-012-0135-8. View

Mattos P, Rohde L, Polanczyk G . ADHD is undertreated in Brazil. Braz J Psychiatry. 2013; 34(4):513-6. DOI: 10.1016/j.rbp.2012.04.002. View

Bauermeister J, Canino G, Polanczyk G, Rohde L . ADHD across cultures: is there evidence for a bidimensional organization of symptoms?. J Clin Child Adolesc Psychol. 2010; 39(3):362-72. DOI: 10.1080/15374411003691743. View

10.

Polanczyk G, Jensen P . Epidemiologic considerations in attention deficit hyperactivity disorder: a review and update. Child Adolesc Psychiatr Clin N Am. 2008; 17(2):245-60, vii. DOI: 10.1016/j.chc.2007.11.006. View

11.

Polanczyk G, Silva de Lima M, Horta B, Biederman J, Rohde L . The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007; 164(6):942-8. DOI: 10.1176/ajp.2007.164.6.942. View

12.

Fombonne E . Epidemiology of pervasive developmental disorders. Pediatr Res. 2009; 65(6):591-8. DOI: 10.1203/PDR.0b013e31819e7203. View

13.

Rohde L, Szobot C, Polanczyk G, Schmitz M, Martins S, Tramontina S . Attention-deficit/hyperactivity disorder in a diverse culture: do research and clinical findings support the notion of a cultural construct for the disorder?. Biol Psychiatry. 2005; 57(11):1436-41. DOI: 10.1016/j.biopsych.2005.01.042. View

14.

Burns G, de Moura M, Walsh J, Desmul C, Silpakit C, Sommers-Flanagan J . Invariance and convergent and discriminant validity between mothers' and fathers' ratings of oppositional defiant disorder toward adults, ADHD-HI, ADHD-IN, and academic competence factors within Brazilian, Thai, and American children. Psychol Assess. 2008; 20(2):121-30. DOI: 10.1037/1040-3590.20.2.121. View

15.

Swanson J, Sergeant J, Taylor E, Sonuga-Barke E, Jensen P, Cantwell D . Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet. 1998; 351(9100):429-33. View

16.

Robison L, Sclar D, Skaer T, Galin R . National trends in the prevalence of attention-deficit/hyperactivity disorder and the prescribing of methylphenidate among school-age children: 1990-1995. Clin Pediatr (Phila). 1999; 38(4):209-17. DOI: 10.1177/000992289903800402. View

17.

Timimi S, Taylor E . ADHD is best understood as a cultural construct. Br J Psychiatry. 2004; 184:8-9. DOI: 10.1192/bjp.184.1.8. View

18.

. Increasing prevalence of parent-reported attention-deficit/hyperactivity disorder among children --- United States, 2003 and 2007. MMWR Morb Mortal Wkly Rep. 2010; 59(44):1439-43. View

19.

Biederman J, Faraone S . Attention-deficit hyperactivity disorder. Lancet. 2005; 366(9481):237-48. DOI: 10.1016/S0140-6736(05)66915-2. View

20.

Polanczyk G, Rohde L . Epidemiology of attention-deficit/hyperactivity disorder across the lifespan. Curr Opin Psychiatry. 2007; 20(4):386-92. DOI: 10.1097/YCO.0b013e3281568d7a. View