Prevalence, Recognition, and Treatment of Attention-Deficit/Hyperactivity Disorder in a National Sample of US Children

Abstract

Objective To determine the US national prevalence of attention-deficit/hyperactivity disorder (ADHD) and whether prevalence, recognition, and treatment vary by socioeconomic group. Design Cross-sectional survey. Setting Nationally representative sample of the US population from 2001 to 2004. Participants Eight- to 15-year-old children (N = 3082) in the National Health and Nutrition Examination Survey. Main Outcome Measures The Diagnostic Interview Schedule for Children (caregiver module) was used to ascertain the presence of ADHD in the past year based onDiagnostic 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% metDSM-IVcriteria 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 meetingDSM-IVADHD 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, meetDSM-IVcriteria for ADHD. Less than half of children meetingDSM-IVcriteria 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.