Autor:innen:
Valentina Wiescholleck, Berlin (Germany)
Tobias Banaschewski, Mannheim (Germany)
William Spalding, Lexington (United States)
Tamara Werner-Kiechle, Zug (Switzerland)
Kathrin Borchert, Hannover (Germany)
Dominic Meise, Hannover (Germany)
Sebastian Braun, Hannover (Germany)
Sepehr Farahbakhshian, Lexington (United States)
Introduction: This study describes characteristics, co-occurring illnesses and treatment of patients (pts) with attention-deficit/hyperactivity disorder (ADHD) in Germany.
Methods: Retrospective, observational analysis from anonymized healthcare claims of ~4 million pts from ~60 German health insurances (InGef research database). Pts had confirmed ADHD diagnosis (ICD-10-GM German Modification, code F90/F90.0/F90.1/F90.8/F90.9) and were observable for ≥ 1 day, 1/1/2015–31/12/2017. Pts were stratified by age (children/adolescents: 6–17 yrs; adults: ≥ 18 yrs) and sex. Co-occurring illnesses were identified by ICD-10-GM codes.
Results: Estimated ADHD administrative prevalence in Germany in 2015/16/17 was 6.2/6.2/6.3% for children/adolescents and 0.3/0.3/0.4% for adults. Of 66,275 pts with ADHD, 7.9% were aged < 6 yrs, 39.8% 6–11 yrs, 26.8% 12–17 yrs, 15.0% 18–29 yrs, and 10.6% ≥ 30 yrs; 71.6% were male (children/adolescents 73.3%; adults 66.6%). 15,368/42,006 (36.6%), 15,603/43,944 (35.5%), 16,071/45,041 (35.7%) pts were receiving ADHD-indicated pharmacotherapy in 2015/16/17. In 2017, co-occurring mental/behavioural disorders of special interest in male/female adults with ADHD included psychoactive substance abuse 19.5/16.6%, depression 32.5/52.3%, other anxiety disorders (generalized anxiety disorder) 11.6/22.2%, eating disorders 1.0/7.3%, and personality disorders 8.8/16.8%; and co-occurring somatic illnesses of special interest were diabetes 3.2/5.3% and obesity 9.2/16.1%.
Conclusion: In this German study, administrative prevalence of ADHD in adults was low vs other research (epidemiological prevalence; Fayyad Atten Defic Hyperact Disord 2017), potentially due to under-diagnosis/treatment. Co-occurring illnesses were commonly comorbid with adult ADHD, as seen in other countries (Fayyad 2017, Ahnemark BMC Psychiatry 2018) and most common illnesses occurred more frequently in females vs males.
Funding: Shire Development LLC, a Takeda company.