ADHD in Children, Adolescents, and Adults: Incidence, Prevalence, and Treatment. An Analysis of Routine Health Insurance Data.

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders in children and adolescents, with symptoms often persisting into adulthood. We studied epidemiology and health care provision for ADHD in Germany by analyzing recent billing data. Anonymized billing data from 2017 to 2023 were examined. Patients with ≥ 2 outpatient or one inpatient ADHD diagnosis were included. Application of the inclusion and exclusion criteria yielded 78 919 ADHD cases for analysis. The administrative prevalence of ADHD in 2023 was 3.6% in children/adolescents and 0.6% in adults. In 2023, 40.9% of children and adolescents with ADHD received no treatment, 47.8% were treated with drugs alone, 4.2% were treated with psychotherapy alone, and 7.1% received multimodal therapy. 44.4% of adults with ADHD received no treatment, 38% were treated with drugs alone, 7.6% were treated with psychotherapy alone, and 10% received multimodal therapy. Over the period of observation, the prevalence of ADHD and the frequency of drug treatment, psychotherapy, and multimodal therapy rose slightly. This secondary data analysis characterizes the care of ADHD in Germany. In 2023, the administrative prevalence was much lower in adults than in children and adolescents. Over the period of observation, there was a continuous rise in the provision of psychotherapeutic services-especially behavioral therapy-while the percentage of patients treated with neither drugs nor psychotherapy fell; yet overall rates of treatment are still low, particularly for psychotherapy.