Epidemiology

Impact of age on prevalence

ADHD is a chronic condition that may persist over a patient's lifespan.1 In a study of 128 males up to 20 years old, the rate of symptom decline was faster for hyperactivity or impulsivity than for inattention, highlighting the importance of considering symptom clusters separately.2 Accordingly, as children enter adolescence, the boy-to-girl prevalence ratio may equilibrate to 1:1.3

Although prevalence declines with age,2,4 between 1% and 7% of the general adult population have been estimated to have ADHD.1,5

Physicians considered that between 29% and 49% of patients with ADHD under the age of 18 years would progress to the adult form of the disorder.6 When these figures are applied to the perceived prevalence data in children and adolescents shown earlier, they suggest a prevalence of ADHD in adults ranging from 3.1% in the USA to 8.8% in France (Figure).6

This is similar to the adult prevalence of 1–7% reported in the literature.1,5

Perceived prevalence of ADHD in Europe and the USA

Perceived prevalence of ADHD in Europe and the USA – disease progression into adulthood. Reproduced with permission from Datamonitor.6

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References:
1. Wasserstein J. Diagnostic issues for adolescents and adults with ADHD. J Clin Psychol 2005; 61: 535–47.
2. Biederman J, Mick E, Faraone SV. Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 2000; 157: 816–8.
3. Cohen P, Cohen J, Kasen S, Velez CN, Hartmark C, Johnson J, et al. An epidemiological study of disorders in late childhood and adolescence–I. Age- and gender-specific prevalence. J Child Psychol Psychiatry 1993; 34: 851–67.
4. Hill JC, Schoener EP. Age-dependent decline of attention deficit hyperactivity disorder. Am J Psychiatry 1996; 153: 1143–6.
5. AACAP official action. Practice parameters for the assessment and treatment of children, adolescents, and adults with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 1997; 36: 85S–121S.
6. Datamonitor, Stakeholder insight: ADHD. Prescriber attention still held by short acting stimulant drugs. DMHC2008. 2004.

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