ADHD prevalence estimates in Italian children and adolescents: a methodological issue

Laura Reale, Maurizio Bonati

Research output: Contribution to journalReview article

Abstract

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is recognized as the most common, and most studied, developmental age disorder. Basic information, such as the most appropriate case definition and the best way to evaluate the disorder's prevalence rate, however, remains an open issue.

METHODS: A comprehensive meta-analysis on the epidemiology of ADHD in Italy, which was lacking from the literature, was therefore performed to attempt to estimate the actual prevalence rate of ADHD, highlighting conceptual and quantitative differences between clinical-diagnosis and survey-based symptoms studies. The Medline, Embase, and PsycINFO databases, and the grey literature, were searched up to January 2018. The review was laid out in three main sections: an overall prevalence estimate, an epidemiological profile of ADHD symptoms, and an attempt to define the actual rate of ADHD diagnosis, as emerged from Italian studies.

RESULTS: A total of 15 unique studies were included. These contributed to estimating the prevalence of ADHD in 67,838 subjects aged 5-17, representing 9 of the 20 regions (45%) of Italy. Overall, the pooled prevalence of ADHD was 2.9% (range: 1.1-16.7%). When distinguishing studies based on case definition, however, we found an average prevalence estimate, based on symptoms criteria, of 5.9% (range: 1.4 to 16.7%) and a best-estimate prevalence rate of 1.4% (range: 1.1 to 3.1%).

CONCLUSIONS: Following the case definition for epidemiological studies of ADHD, counting only subjects with an ADHD diagnosis performed and confirmed by clinical assessment would reduce the wide variability in prevalence estimates, and, above all, would both describe the real rate of subjects suffering from ADHD disorder and avoid misdiagnosis.

Original languageEnglish
Pages (from-to)108
JournalItalian Journal of Pediatrics
Volume44
Issue number1
DOIs
Publication statusPublished - Sep 5 2018

Fingerprint

Attention Deficit Disorder with Hyperactivity
Italy
Literature
Diagnostic Errors
Meta-Analysis
Epidemiologic Studies
Epidemiology
Databases

Keywords

  • Adolescent
  • Age Distribution
  • Attention Deficit Disorder with Hyperactivity/diagnosis
  • Child
  • Child Welfare
  • Child, Preschool
  • Female
  • Humans
  • Italy/epidemiology
  • Male
  • Mental Health
  • Prevalence
  • Severity of Illness Index
  • Sex Distribution

Cite this

ADHD prevalence estimates in Italian children and adolescents : a methodological issue. / Reale, Laura; Bonati, Maurizio.

In: Italian Journal of Pediatrics, Vol. 44, No. 1, 05.09.2018, p. 108.

Research output: Contribution to journalReview article

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AB - BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is recognized as the most common, and most studied, developmental age disorder. Basic information, such as the most appropriate case definition and the best way to evaluate the disorder's prevalence rate, however, remains an open issue.METHODS: A comprehensive meta-analysis on the epidemiology of ADHD in Italy, which was lacking from the literature, was therefore performed to attempt to estimate the actual prevalence rate of ADHD, highlighting conceptual and quantitative differences between clinical-diagnosis and survey-based symptoms studies. The Medline, Embase, and PsycINFO databases, and the grey literature, were searched up to January 2018. The review was laid out in three main sections: an overall prevalence estimate, an epidemiological profile of ADHD symptoms, and an attempt to define the actual rate of ADHD diagnosis, as emerged from Italian studies.RESULTS: A total of 15 unique studies were included. These contributed to estimating the prevalence of ADHD in 67,838 subjects aged 5-17, representing 9 of the 20 regions (45%) of Italy. Overall, the pooled prevalence of ADHD was 2.9% (range: 1.1-16.7%). When distinguishing studies based on case definition, however, we found an average prevalence estimate, based on symptoms criteria, of 5.9% (range: 1.4 to 16.7%) and a best-estimate prevalence rate of 1.4% (range: 1.1 to 3.1%).CONCLUSIONS: Following the case definition for epidemiological studies of ADHD, counting only subjects with an ADHD diagnosis performed and confirmed by clinical assessment would reduce the wide variability in prevalence estimates, and, above all, would both describe the real rate of subjects suffering from ADHD disorder and avoid misdiagnosis.

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KW - Male

KW - Mental Health

KW - Prevalence

KW - Severity of Illness Index

KW - Sex Distribution

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SN - 1720-8424

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