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Increasing incidence and diagnostic instability in adult attention-deficit hyperactivity disorder nationwide between 1995 and 2012

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ADHD Attention Deficit and Hyperactivity Disorders

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Abstract

Increasing numbers of adult attention-deficit hyperactivity disorder (ADHD) patients are reported. Co-occurring disorders are reported, and treatment with pharmacological stimulants (PS) increases. The aim of this study was to analyse the incidence of adult ADHD in Denmark between 1995 and 2012 and the diagnostic stability and the diagnoses of patients contraindicating treatment with PS. This was a nationwide register-based study of patients diagnosed with ADHD aged ≥ 18 years between 1995 and 2012. The study included 6,701 patients. Incidence increases exponentially; 40.4 % of all patients had another psychiatric diagnosis before being diagnosed with ADHD. Afterwards, 17.4 % received other diagnoses. Diagnoses contraindicating PS were found in 25.8 % of the patients with other diagnoses before (10.5 % of total) and in 40.0 % (6.9 % of total) after a diagnosis of ADHD. There is an increasing incidence and instability in the diagnosis of ADHD. Patients receive diagnoses contraindicating treatment with PS.

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References

  • Byrne N, Regan C, Howard L (2005) Administrative registers in psychiatric research: a systematic review of validity studies. Acta Pschiatr Scand 112(6):409–414

    Article  CAS  Google Scholar 

  • Davidson MA (2008) ADHD in adults: a review of the literature. J Atten Disord 11:628–641

    Article  PubMed  Google Scholar 

  • Donev R, Gantert D, Alawam J, Edworthy A, Hässler D, Meyer-Lindenberg A et al (2011) Comorbidity of schizophrenia and adult attention deficit hyperactivity disorder. World J Biol Psychiatry 12:52–56

    Article  PubMed  Google Scholar 

  • Faraone SV (2013) Attention-deficit hyperactivity disorder an the shifting sands of psychiatric nosology (editorial). Br J Psychiatry 203:81–83

    Article  PubMed  Google Scholar 

  • Halmøy A, Jalleland H, Dramsdahl M, Bergsholm P, Fasmer OB, Haavik J (2010) Bipolar symptoms in adult attention-deficit/hyperactivity disorder: a cross-sectional study of 510 clinically diagnosed patients and 417 population based controls. J Clin Psychiatry 71:48–57

    Article  PubMed  Google Scholar 

  • Kendell RE, Kemp IW (1989) Maternal influenza in the etiology of schizophrenia. Arch Gen Psychiatry 46:878–882

    Article  CAS  PubMed  Google Scholar 

  • Kessing LV (2005) Diagnostic stability in bipolar disorder in clinical practise as according to ICD-10. J Affect Disord 85:293–299

    Article  PubMed  Google Scholar 

  • Kjeldsen BV, Jensen SOW, Munk-Jørgensen P (2012) Increasing number of incident ADHD cases in psychiatric treatment. Acta Psychiatr Scand 126:151–152

    Article  CAS  PubMed  Google Scholar 

  • Larsson H, Rydén E, Boman M, Långström N, Lichtenstein P, Landén M (2013) Risk of bipolar disorder and schizophrenia in relatives of people with attention-deficit hyperactivity disorder. Br J Psychiatry 203:103–106

    Article  PubMed Central  PubMed  Google Scholar 

  • Lundberg AS, Okkels N, Gustafsson L, Larsen JT, Uhrskov Sørensen L and Munk-Jørgensen P (2014) A nationwide study on delirium in psychiatric patients from 1995 to 2011. Acta Neuropsychiatr. doi:10.1017/neu.2013.65

  • Matte B, Rohde LA, Grevet EH (2012) ADHD in adults: a concept in evolution. Atten Defic Hyperact Disord 4:53–62

    Article  PubMed  Google Scholar 

  • McCarthy S, Wilton L, Murray ML, Hodgkins P, Asherson P, Wong ICK (2012) The epidemiology of pharmacologically treated attention deficit hyperactivity disorder (ADHD) in children, adolescents and adults in UK primary care. BMC Pediatr 12:78

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • McGough JJ, Smalley SL, McCracken JT, Yang M, Del’Home M, Lynn DE et al (2005) Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry 162:1621–1627

    Article  PubMed  Google Scholar 

  • Moncrief J, Timimi S (2011) Critical analysis of the concept of adult attention-deficit hyperactivity disorder. Psychiatrist 35:334–338

    Article  Google Scholar 

  • Mors O, Perto GP, Mortensen PB (2011) The Danish Psychiatric Central Research Register. Scand J Public Health 39:54–57

    Article  PubMed  Google Scholar 

  • Munk-Jørgensen P (1992) Incidence and other aspects of the epidemiology of schizophrenia in Denmark, 1971–87. Br J Psychiatry 161:489–495

    Article  PubMed  Google Scholar 

  • Munk-Jørgensen P, Andersen B (2009) Diagnoses and dropout among patients of danish psychiatrists in private practice. Psychiatr Serv 60:1680–1682

    Article  PubMed  Google Scholar 

  • Munk-Jørgensen P, Østergaard SD (2011) Register based studies of mental disorders. Scand J Public Health 39:170

    Article  PubMed  Google Scholar 

  • Okkels N, Vernal DL, Jensen SOW, McGrath JJ, Nielsen RE (2013) Changes in the diagnosed incidence of early onset schizophrenia over four decades. Acta Psychiatr Scand 127:62–68

    Article  CAS  PubMed  Google Scholar 

  • Parker G (2005) Register now: validity later. Acta Psychiatr Scand 112:407–408

    Article  PubMed  Google Scholar 

  • Premal JS, Morton MS (2013) Adults with attention-deficit hyperactivity disorder—diagnosis or normality? Br J Psychiatry 203:317–319

    Article  Google Scholar 

  • Rydén E, Thase ME, Stråht D, Åberg-Wistedt A, Bejerot S, Landén M (2009) A history of childhood attention-deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD. Acta Psychiatr Scand 120:239–246

    Article  PubMed  Google Scholar 

  • Schomerus G, Schwahn C, Holzinger A, Corrigan PW, Grabe HJ, Carta MG et al (2012) Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand 125:440–452

    Article  CAS  PubMed  Google Scholar 

  • Storebø OJ, Simonsen E (2013) Is ADHD an early stage in the development of borderling personality disorder? Nord J Psychiatry 64:1–7

    Google Scholar 

  • The European Medicines Agency (EMEA) (2007) Methylphenidate article 31 referral—annex I, II, III, IV. http://www.ema.europa.eu/docs/en_GB/document_library/Referrals_document/Methylphenidate_31/WC500011138.pdf. Accesed 1 March 2014

  • Vergne DE, Whitham EA, Barroilhet S, Fradkin Y, Nassir Ghaemi S (2011) Adult ADHD and amphetamines: a new paradigm. Neuropsychiatry 1:591–598

    Article  Google Scholar 

  • Wilens TE, Faraone SV, Biederman J (2004) Attention-deficit/hyperactivity disorder in adults. JAMA 292:619–623

    Article  CAS  PubMed  Google Scholar 

  • Zetterqvist J, Asherson P, Halldner L, Långström N, Larsson H (2013) Stimulant and non-stimulant attention deficit/hyperactivity disorder drug use: total population study of trends and discontinuation patterns 2006–2009. Acta Psychiatr Scand 128:70–77

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Organic Psychiatric Disorders and Emergency Ward (Department M), Aarhus University Hospital, Risskov, Skovagervej 2, 8240, Risskov, Denmark

    Christina Blanner Kristiansen, Jan Walter Dhillon Shanmuganathan, Lea Nørgreen Gustafsson, Knut Peter Løkke & Povl Munk-Jørgensen

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  1. Christina Blanner Kristiansen
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  2. Jan Walter Dhillon Shanmuganathan
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  3. Lea Nørgreen Gustafsson
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  4. Knut Peter Løkke
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  5. Povl Munk-Jørgensen
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Corresponding author

Correspondence to Christina Blanner Kristiansen.

Appendices

Appendix 1

See Table 3.

Table 3 Attention-deficit hyperactivity disorder diagnoses included
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Appendix 2

See Table 4.

Table 4 Psychiatric diagnoses distributed in groups
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Appendix 3

See Table 5.

Table 5 Diagnoses contraindicating treatment with stimulants
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Kristiansen, C.B., Shanmuganathan, J.W.D., Gustafsson, L.N. et al. Increasing incidence and diagnostic instability in adult attention-deficit hyperactivity disorder nationwide between 1995 and 2012. ADHD Atten Def Hyp Disord 7, 151–156 (2015). https://doi.org/10.1007/s12402-014-0155-9

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  • DOI: https://doi.org/10.1007/s12402-014-0155-9

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