Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder: The Sunny Perspective

Arns, Martijn; van der Heijden, Kristiaan B.; Arnold, L. Eugene; Kenemans, J. Leon

doi:10.1016/j.biopsych.2013.02.010

Cited by 93Attention Deficit Hyperactivity DisorderAutism Spectrum Disorder ResearchCircadian rhythm and melatonin

Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder: The Sunny Perspective

Arns, Martijn, van der Heijden, Kristiaan B., Arnold, L. Eugene, Kenemans, J. Leon·2013·Biological Psychiatry

DOI 10.1016/j.biopsych.2013.02.010

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Abstract

Background Attention-deficit/hyperactivity disorder (ADHD) is the most common psychiatric disorder of childhood, with average worldwide prevalence of 5.3%, varying by region.Methods We assessed the relationship between the prevalence of ADHD and solar intensity (SI) (kilowatt hours/square meters/day) on the basis of multinational and cross-state studies. Prevalence data for the U.S. were based on self-report of professional diagnoses; prevalence data for the other countries were based on diagnostic assessment. The SI data were obtained from national institutes.Results In three datasets (across 49 U.S. states for 2003 and 2007, and across 9 non-U.S. countries) a relationship between SI and the prevalence of ADHD was found, explaining 34%-57% of the variance in ADHD prevalence, with high SI having an apparent preventative effect. Controlling for low birth weight, infant mortality, average income (socioeconomic status), latitude, and other relevant factors did not change these findings. Furthermore, these findings were specific to ADHD, not found for the prevalence of autism spectrum disorders or major depressive disorder.Conclusions In this study we found a lower prevalence of ADHD in areas with high SI for both U.S. and non-U.S. data. This association has not been reported before in the literature. The preventative effect of high SI might be related to an improvement of circadian clock disturbances, which have recently been associated with ADHD. These findings likely apply to a substantial subgroup of ADHD patients and have major implications in our understanding of the etiology and possibly prevention of ADHD by medical professionals, schools, parents, and manufacturers of mobile devices.

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Higher solar intensity is associated with lower ADHD prevalence.
“An association between solar intensity and ADHD prevalence was described, with higher solar intensity associated with lower prevalence.”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Arns et al. (2013)
Solar intensity predicts 34-57% of variance in ADHD prevalence.
“Solar intensity predicts 34-57% of variance n ADHD prevalence”
From A systematic review of circadian function, chronotype and chronotherapy in attention deficit hyperactivity disorder (2017) · cites this paper as Arns et al. (2013)

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Attention-Deficit/Hyperactivity Disorder and Solar Irradiance: A Cloudy Perspective
Hoffmann, M. S., Polanczyk, G. V., Kieling, C., dos Santos, Í. P., Willcutt, E. G., Rohde, L. A., & Salum, G. A. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.07.044 · Cited by 3 · see citing works
The Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder in the United States Is Likely Due to Geographic Variations of Solar Ultraviolet B Doses and Race
Grant, W. B. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.04.031 · Cited by 2 · see citing works
Reply to: The Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder the United States is Likely Due to Geographical Variations of Solar Ultraviolet B Doses and Race
Arns, M., van der Heijden, K. B., Arnold, L. E., & Kenemans, J. L. (2013) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.05.033 · Cited by 3 · see citing works
Self-citation

Authors: Arns, M., van der Heijden, K. B., Arnold, L. E., & Kenemans, J. L.
Affiliations: Utrecht University (NL)
The Ohio State University (US)
Corresponding author: Arns, Martijn
ORCID: Arns, Martijn
Arnold, L. Eugene
Kenemans, J. Leon
Venue: Biological Psychiatry
Publisher: Elsevier BV
Published: 2013-10
Volume: 74
Issue: 8
Pages: 585-590
ISSN: 0006-3223 (ISSN-L)
DOI: 10.1016/j.biopsych.2013.02.010
OpenAlex: W2101087890
Cited by: 93
References: 38
Citations by year: 2026: 1 · 2025: 5 · 2024: 5 · 2023: 5 · 2022: 5 · 2021: 7 · 2020: 6 · 2019: 8 · 2018: 9 · 2017: 7 · 2016: 7 · 2015: 10 · 2014: 7 · 2013: 10
FWCI: 8.02
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Biological Psychiatry (publishedVersion)
PubMed (publishedVersion)
Research Publications (Maastricht University) (publishedVersion)
Research Publications (Maastricht University) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords: attention deficit hyperactivity disorder, ADHD prevalence, solar irradiance, sun exposure, circadian clock, circadian rhythm disruption, ADHD etiology, ADHD prevention, autism spectrum disorder, major depressive disorder, regional variation
MeSH terms: Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Circadian Rhythm, Cross-Sectional Studies, Female, Humans, Male, Solar Energy, United States, Young Adult

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Geographic Variation in the Prevalence of Attention-Deficit/Hyperactivity Disorder: The Sunny Perspective

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