How often are German children and adolescents diagnosed with ADHD? Prevalence based on the judgment of health care professionals: results of the German health and examination survey (KiGGS).
BACKGROUND
Attention deficit-/hyperactivity disorder (ADHD) is a chronic disorder with a substantial lifelong impact on personal and social functioning, academic performance, and the health system in general. Extended knowledge regarding its epidemiology will help to optimise the distribution of health resources and support affected children and adolescents.


OBJECTIVE
To report (1) the lifetime prevalence rates of ADHD in children and adolescents in Germany ages 3-17 years diagnosed by health care professionals, (2) the symptoms of hyperactivity and inattention in children and adolescents, and 3) the distributions and odds ratios for gender, age, socioeconomic status (SES), and history of migration.


METHODS
Data were collected from May 2003 until May 2006 in 167 representatively selected sample points in Germany. A total of 17,461 children and adolescents (7,569 boys and 7,267 girls) were medically and physically examined, and their parents completed a self-administered questionnaire. Parent-reports of a lifetime ADHD diagnosis by a medical doctor or psychologist were taken as case definitions. Additional information was obtained via the parents from the strengths and difficulties questionnaire (SDQ) and also from trained observers.


RESULTS
The overall lifetime prevalence of ADHD diagnosis was 4.8%. As expected, there was a significant gender difference between boys (7.7%) and girls (1.8%). Additionally, 4.9% of subjects had scores above threshold on the Inattention/ Hyperactivity subscale of the SDQ. As expected, a significant age effect was found for ADHD diagnosis (1.5% preschool age; 5.3% primary school; 7.1% secondary school). There were neither German east/west differences nor differences for rural versus urban areas. However, socioeconomic status was significantly associated with the prevalence of diagnosis (low SES: 6.4%, medium SES: 5.0%; high SES: 3.2%).


CONCLUSIONS
The prevalence of diagnosed ADHD and the influence of its mediating factors found in our study are in line with those from other European countries, but our findings reflect a lower band of variation.
Huss
Michael
M
Child and Adolescent Psychiatry, Johannes Gutenberg-University Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany. michael.huss@ukmainz.de
Hölling
Heike
H
Kurth
Bärbel-Maria
BM
Schlack
Robert
R
D000293:Adolescent; D000296:Adolescent Psychiatry / Q000706:statistics & numerical data; D017677:Age Distribution; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology*; D002648:Child; D002665:Child Psychiatry / Q000706:statistics & numerical data; D002675:Child, Preschool; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006282:Health Personnel / Q000523:psychology* / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007600:Judgment / Q000502:physiology*; D008297:Male; D016017:Odds Ratio; D010290:Parents / Q000523:psychology; D015995:Prevalence; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires