Recent Trends in Childhood Attention-Deficit/Hyperactivity Disorder | Attention Deficit/Hyperactivity Disorders | JAMA Pediatrics | JAMA Network
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Article
March 2013

Recent Trends in Childhood Attention-Deficit/Hyperactivity Disorder

Author Affiliations

Author Affiliations: Departments of Research and Evaluation (Drs Getahun and Jacobsen and Ms Chen) and Maternal-Fetal Medicine (Dr Fassett), West Los Angeles Medical Center, Kaiser Permanente Southern California Medical Group, Pasadena; and Department of Obstetrics and Gynecology, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey (Dr Getahun), and Department of Epidemiology, University of Medicine and Dentistry of New Jersey–School Public Health (Drs Demissie and Rhoads), Piscataway.

JAMA Pediatr. 2013;167(3):282-288. doi:10.1001/2013.jamapediatrics.401
Abstract

Objective To examine trends in attention-deficit/hyperactivity disorder (ADHD) by race/ethnicity, age, sex, and median household income.

Design An ecologic study of trends in the diagnosis of ADHD using the Kaiser Permanente Southern California (KPSC) health plan medical records. Rates of ADHD diagnosis were derived using Poisson regression analyses after adjustments for potential confounders.

Setting Kaiser Permanente Southern California, Pasadena.

Participants All children who received care at the KPSC from January 1, 2001, through December 31, 2010 (n = 842 830).

Main Exposure Period of ADHD diagnosis (in years).

Main Outcome Measures Incidence of physician-diagnosed ADHD in children aged 5 to 11 years.

Results Rates of ADHD diagnosis were 2.5% in 2001 and 3.1% in 2010, a relative increase of 24%. From 2001 to 2010, the rate increased among whites (4.7%-5.6%; relative risk [RR] = 1.3; 95% CI, 1.2-1.4), blacks (2.6%- 4.1%; RR = 1.7; 95% CI, 1.5-1.9), and Hispanics (1.7%-2.5%; RR = 1.6; 95% CI, 1.5-1.7). Rates for Asian/Pacific Islander and other racial groups remained unchanged over time. The increase in ADHD diagnosis among blacks was largely driven by an increase in females (RR = 1.9; 95% CI, 1.5-2.3). Although boys were more likely to be diagnosed as having ADHD than girls, results suggest the sex gap for blacks may be closing over time. Children living in high-income households were at increased risk of diagnosis.

Conclusions The findings suggest that the rate of ADHD diagnosis among children in the health plan notably has increased over time. We observed disproportionately high ADHD diagnosis rates among white children and notable increases among black girls.

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