Trends and regional variations in the administrative prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Germany.
Trends and regional variations in the administrative prevalence of attention-deficit/hyperactivity disorder among children and adolescents in Germany.
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DOI：
10.1038/s41598-018-35048-5
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发表时间：
2018-11-19
影响因子：
4.6
通讯作者：
Bätzing J
中科院分区：
文献类型：
--
作者：
Akmatov MK;Steffen A;Holstiege J;Hering R;Schulz M;Bätzing J
关于注意力缺陷/多动障碍（ADHD）患病率的时间趋势存在争议。使用包含大约 600 万法定健康保险儿童数据的全国索赔数据，我们旨在检查 a) 2009-2016 年 ADHD 管理患病率的趋势； b) 患病率的地区差异，以及 c) 与 ADHD 诊断机会增加相关的因素。 ICD-10 代码“F90-多动症”用于定义 ADHD 病例。使用全局和局部 Moran’s I 检验来检查空间自相关和 k 均值聚类分析，以检查多年来行政区 ADHD 患病率的过程。应用两级逻辑回归来检查与 ADHD 诊断相关的个人和地区层面的因素。 ADHD 的行政患病率为 4.33%（95% CI：4.31–4.34%）。我们观察到地区一级存在明显的小区域差异，患病率在 1.6% 到 9.7% 之间。有证据表明存在很强的空间自相关性（Global Moran’s I：0.46，p< 0.0001）。 k-means-方法识别出六个不同大小的簇；在八年的观察期内，所有这些疾病的患病率均呈停滞趋势。在地区一级，外国公民比例较低、儿科精神科医生和儿科医生密度较高与 ADHD 呈正相关，在城市地区影响更为明显。
There is a controversy regarding temporal trends in prevalence of attention-deficit/hyperactivity disorder (ADHD). Using nationwide claims data containing data for approximately six million statutory health insured children we aimed to examine a) trends of ADHD administrative prevalence during 2009–2016; b) regional variations in prevalence, and c) factors associated with an increased chance of ADHD diagnosis. The ICD-10 code ‘F90-hyperkinetic disorder’ was used to define an ADHD case. Global and Local Moran’s I tests were used to examine the spatial autocorrelation and k-means-cluster analysis to examine the course of ADHD prevalence in administrative districts over years. Two-level logistic regression was applied to examine individual- and district-level factors associated with ADHD diagnosis. The administrative prevalence of ADHD was 4.33% (95% CI: 4.31–4.34%). We observed pronounced small-area differences on the district level with prevalences ranging between 1.6% and 9.7%. There was evidence of strong spatial autocorrelation (Global Moran’s I: 0.46, p < 0.0001). The k-means-method identified six clusters of different size; all with a stagnating trend in the prevalence over the observation period of eight years. On the district level, a lower proportion of foreign citizens, and a higher density of paediatric psychiatrists and paediatricians were positively associated with ADHD with a more pronounced effect in urban districts.
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影响因子：
5.5
作者：
Visser SN;Blumberg SJ;Danielson ML;Bitsko RH;Kogan MD
通讯作者：
Kogan MD
影响因子：
3
作者：
Wolraich, Mark L.;Bard, David E.;O'Connor, Karen G.
通讯作者：
O'Connor, Karen G.
影响因子：
3.6
作者：
ANSELIN, L
通讯作者：
ANSELIN, L
影响因子：
5.9
作者：
Bruchmueller, Katrin;Margraf, Juergen;Schneider, Silvia
通讯作者：
Schneider, Silvia
影响因子：
6.3
作者：
Merlo, J;Chaix, B;Larsen, K
通讯作者：
Larsen, K