[Attention deficit/hyperactivity disorders among three-to-six-year-olds treated in medical practices--a national survey].
OBJECTIVE
The aim of the study is to calculate prevalence rates of symptoms and diagnoses of Attention Deficit-/Hyperactivity Disorders (ADHD) in preschoolers, and to assess functional impairment as well as comorbid symptoms by means of parents and teacher symptom checklists.


METHODS
N = 708 kindergarten- and preschool-children were recruited nationwide by pediatricians or child and adolescent psychiatrists. The U8/U9 sample (n = 521 children) was assessed during a routine pediatric screening. The clinical sample consisted of n = 187 children who were rated as having ADHD problems by the physician. The children were assessed by age-adapted ADHD Symptom-Checklists (Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen im Vorschulalter FBB-ADHS-V) rated by parents and teachers. Additionally, the physicians rated ADHD symptoms and comorbid symptoms.


RESULTS
Based on diagnosis criteria of DSM-IV and the parental ratings in U8/U9, 11.3% of the children fulfilled the criteria for one of the three ADHD diagnoses (ICD 10: 3.8%). The prevalence rate was lower in teacher ratings (6.6%) (ICD 10: 1.5%), and in both the parent and teacher ratings 4.2% of the children fulfilled the DSM-IV criteria for ADHD (ICD 10: 1.2%). Higher prevalence rates and comorbidities were found in the clinical sample. The need for professional help (counseling/treatment) is much higher than the treatment the parents and children actually received.


CONCLUSIONS
International prevalence rates can be applied. Despite methodological restrictions, such as a lack of representativeness and possible pre-selection effects, this study demonstrates the relevance of prevention and intervention programmes.
Breuer
Dieter
D
Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum der Universität zu Köln, Robert-Koch-Strasse 10, DE-50931 KOLN. heinz-dieter.breuer@uk-koeln.de
Döpfner
Manfred
M
D000374:Aggression / Q000523:psychology; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D005858:Germany; D006306:Health Surveys; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D007805:Language Development Disorders / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D010552:Personality Assessment; D011795:Surveys and Questionnaires