title: Trend, characteristics, and pharmacotherapy of adults diagnosed with attention-deficit/hyperactivity disorder: a nationwide survey in Taiwan.
abstract: OBJECTIVE
  Attention-deficit/hyperactivity disorder (ADHD) in adults may result in functional impairment warranting clinical interventions. However, few studies have investigated the diagnosis and treatment rates of adult ADHD in non-Caucasian ethnic groups. This study used nationwide population-based data to investigate the rate of diagnosis, associated characteristics, and pharmacological treatment for adult ADHD in Taiwan.
  
  
  METHODS
  Adults (age ≥18 years) newly diagnosed with ADHD (n=5,397) between January 2000 and December 2011 were enrolled from the National Health Insurance database in Taiwan. All patients were monitored until December 31, 2011. Patients who received treatment with immediate-release methylphenidate (IR-MPH), osmotic release oral system-methylphenidate (OROS-MPH), and atomoxetine (ATX) were analyzed.
  
  
  RESULTS
  The cumulative prevalence of adult ADHD was 0.028%, and the incidence increased 10.9-fold from 2000 to 2011. The male to female ratio was 1.16, and 74.9% of the patients had the inattentive type. Overall, 55% of the patients received drug therapy for ADHD, and the average treatment duration was 478.3 days. Of the total patients, 50.4%, 13.3%, and 1.7% were prescribed with IR-MPH, OROS-MPH, and ATX, for a mean duration of 453.9, 327.7, and 161.4 days, respectively.
  
  
  CONCLUSIONS
  This population-based study showed an increasing trend in the diagnosis rate of adult ADHD; however, this rate is still low compared with Western countries. Approximately 45% of the adult patients with ADHD never received medication for their ADHD. Continuous efforts are needed to increase public awareness of adult ADHD.
authors.affiliation: Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine; Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung.
authors.forename: Yu-Shian
authors.initials: YS
authors.lastname: Cheng
authors.affiliation: Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung; Institute of Molecular Biology, Academia Sinica, Nankang, Taipei.
authors.forename: Yu-Chiau
authors.initials: YC
authors.lastname: Shyu
authors.affiliation: Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung; Department of Psychiatry, College of Medicine and Hospital, National Cheng Kung University, Tainan.
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Institute of Statistical Science, Academia Sinica.
authors.forename: Shin-Sheng
authors.initials: SS
authors.lastname: Yuan
authors.affiliation: Institute of Biopharmaceutical Sciences, National Yang-Ming University.
authors.forename: Chun-Ju
authors.initials: CJ
authors.lastname: Yang
authors.affiliation: Institute of Biopharmaceutical Sciences, National Yang-Ming University; Genome and Systems Biology Degree Program, National Taiwan University, Taipei, Taiwan.
authors.forename: Kang-Chung
authors.initials: KC
authors.lastname: Yang
authors.affiliation: Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Tung-Liang
authors.initials: TL
authors.lastname: Lee
authors.affiliation: Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine.
authors.forename: Liang-Jen
authors.initials: LJ
authors.lastname: Wang
keywords: ADHD; comorbidity; drug adherence; epidemiology; gender difference; non-Caucasian