Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children.
OBJECTIVE
To determine the US national prevalence of attention-deficit/hyperactivity disorder (ADHD) and whether prevalence, recognition, and treatment vary by socioeconomic group.


METHODS
Cross-sectional survey.


METHODS
Nationally representative sample of the US population from 2001 to 2004.


METHODS
Eight- to 15-year-old children (N = 3082) in the National Health and Nutrition Examination Survey.


METHODS
The Diagnostic Interview Schedule for Children (caregiver module) was used to ascertain the presence of ADHD in the past year based on Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) criteria. Prior diagnosis of ADHD by a health professional and ADHD medication use were assessed by caregiver report.


RESULTS
Of the children, 8.7% met DSM-IV criteria for ADHD. The poorest children (lowest quintile) were more likely than the wealthiest (highest quintile) to fulfill criteria for ADHD (adjusted odds ratio [AOR], 2.3; 95% confidence interval [CI], 1.4-3.9). Among children meeting DSM-IV ADHD criteria, 47.9% had a prior diagnosis of ADHD and 32.0% were treated consistently with ADHD medications during the past year. Girls were less likely than boys to have their disorder identified (AOR, 0.3; 95% CI, 0.1-0.8), and the wealthiest children were more likely than the poorest to receive regular medication treatment (AOR, 3.4; 95% CI, 1.3-9.1).


CONCLUSIONS
Of US children aged 8 to 15 years, 8.7%, an estimated 2.4 million, meet DSM-IV criteria for ADHD. Less than half of children meeting DSM-IV criteria report receiving either a diagnosis of ADHD or regular medication treatment. Poor children are most likely to meet criteria for ADHD yet are least likely to receive consistent pharmacotherapy.
Froehlich
Tanya E
TE
Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. tanya.froehlich@cchmc.org
Lanphear
Bruce P
BP
Epstein
Jeffery N
JN
Barbaresi
William J
WJ
Katusic
Slavica K
SK
Kahn
Robert S
RS
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000628:therapy; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007182:Income; D008297:Male; D017057:Medically Uninsured / Q000706:statistics & numerical data; D008913:Minority Groups / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology