Estimated prevalence and incidence of diagnosed ADHD and health care utilization in adults in Sweden – a longitudinal population-based register study
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BACKGROUND: Although the worldwide prevalence of attention-deficit/hyperactivity disorder (ADHD) in adults is estimated to be between 2% and 5%, it is considered to be underdiagnosed. This register study explored the prevalence of diagnosed ADHD and incidence of newly diagnosed ADHD in Swedish adults over time, and assessed comorbidities and pharmacologic treatment. METHODS: National Patient Register data were used to estimate the overall prevalence of adults (≥18 years) with a registered ADHD diagnosis from 2006 to 2011, and the incidence of newly registered diagnoses from 2007 to 2011. Data from the Prescribed Drug Register were used to estimate the mean dose of the most frequently prescribed ADHD medication. RESULTS: The estimated annual prevalence (N=44,364) of diagnosed ADHD increased from 0.58 per 1,000 persons in 2006 to 3.54 per 1,000 persons in 2011. The estimated annual incidence of newly diagnosed ADHD (N=24,921) increased from 0.39 per 1,000 persons to 0.90 per 1,000 persons between 2007 and 2011. At least one comorbidity was diagnosed in 52.6% of adults with ADHD (54.0% of newly diagnosed adults), with anxiety, substance use disorders, and depression being the most common. Among all adults with ADHD, 78.9% (65.7% of newly diagnosed adults) were prescribed ADHD medication and one-third were prescribed more than one add-on medication. Osmotic release oral system methylphenidate was the most commonly used medication. The mean daily dose was 51.5 mg, and was significantly higher in males, patients with substance use disorders, patients with drug holidays, and patients with at least one add-on medication. The most frequent concomitant medications were anxiolytics and hypnotics. CONCLUSION: In Sweden, the number of adults diagnosed with ADHD increased between 2006 and 2011, and the majority of patients were prescribed ADHD-specific medication. Over one-half of patients had psychiatric comorbidities; one-third were prescribed more than one add-on medication. Consumption of pharmacologic ADHD medication was high in specific patient subpopulations.
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Previous research is mixed, and the percentage of diagnosed individuals who receive pharmacological treatment varies substantially across studies of adults (25-80%) and of older adults (28-88%).
“Previous research is mixed and the percentage of diagnosed individuals who receive pharmacological treatment varies substantially for studies of adults (25-80 %) (Bernardi et al., 2012;Polyzoi et al., 2018) as well as older adults (28-88 %) Polyzoi et al., 2018;Pollak, 2012).”
From Prevalence of attention-deficit/hyperactivity disorder in older adults: a systematic review and meta-analysis (2020) · cites this paper as Polyzoi et al., 2018
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References 34 · Cited by 69
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- Authors
- Polyzoi, M., Ahnemark, E., Medin, E., & Ginsberg, Y.
- Affiliations
- Shire (Sweden) (SE)
- Karolinska Institutet (SE)
- Corresponding author
- Polyzoi, Maria
- Venue
- Neuropsychiatric Disease and Treatment
- Publisher
- Informa UK Limited
- Published
- 2018-05
- Volume
- Volume 14
- Pages
- 1149-1161
- ISSN
- 1176-6328 (ISSN-L)
- 1178-2021
- PMC
- PMC5944447
- OpenAlex
- W2800539231
- Cited by
- 69
- References
- 34
- Citations by year
- 2026: 4 · 2025: 11 · 2024: 10 · 2023: 16 · 2022: 8 · 2021: 10 · 2020: 5 · 2019: 3 · 2018: 2
- FWCI
- 3.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Neuropsychiatric Disease and Treatment (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- adult ADHD, ADHD prevalence, ADHD incidence, underdiagnosis, comorbidities, anxiety disorders, substance use disorders, depression, ADHD medication, methylphenidate, osmotic-release oral system, drug holidays, prescribing patterns, Sweden
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