Prevalence and Psychiatric Comorbidity of Attention-Deficit/Hyperactivity Disorder in an Adolescent Finnish Population

doi:10.1097/chi.0b013e3181573137

Journal of the American Academy of Child & Adolescent Psychiatry

Volume 46, Issue 12, December 2007, Pages 1575-1583

https://doi.org/10.1097/chi.0b013e3181573137 Get rights and content

ABSTRACT

Objective

The purpose of the study was to estimate the prevalence of attention-deficit/hyperactivity disorder (ADHD) and its clinical characteristics in the Northern Finland Birth Cohort 1986.

Method

A general population Northern Finland Birth Cohort 1986 of 9,432 children followed prospectively from the early fetal period was surveyed at adolescence (ages 16-18) for ADHD behaviors. Among 6,622 respondents to the survey, a subset of 457 likely cases and controls were evaluated for ADHD and other psychiatric disorders. Chi-square and descriptive statistics were used to examine clinical characteristics of ADHD in the subset, and logistic regression was used to estimate prevalence by weighted extrapolation in the larger cohort.

Results

The estimated prevalence of ADHD among adolescents in the Northern Finland Birth Cohort 1986 is 8.5% with a male/female ratio of 5.7:1. The distribution of ADHD subtypes among the ADHD adolescents is 28% Combined, 64% Inattentive, and 8% Hyperactive-Impulsive. A lifetime diagnosis of a broadly defined ADHD (probable or definite) had a prevalence of 18.2% with a male/female odds ratio (OR) of 3.2. This lifetime diagnosis of ADHD is significantly associated with anxiety (OR 2.4), mood (OR 2.9), and disruptive behavioral disorders (OR 17.3) in the cohort.

Conclusions

ADHD is a common neurobehavioral disorder among Northern Finnish adolescents and significantly associated with psychiatric comorbidity in adolescence.

Section snippets

Sample and Screening Procedures

All of the subjects and their parents participating in the present follow-up study of NFBC 1986 provided informed consent for the survey and clinical assessment under procedures approved by the University of Oulu and University of California, Los Angeles Institutional Review Boards. A screening instrument for ADHD, the Strengths and Weaknesses of ADHD-Symptoms and Normal-Behavior (SWAN) scale (Swanson et al., 2001), was included in the parents' questionnaire of the 9,215 adolescents whose

SWAN Screening

The 6,622 NFBC adolescents (3,314 male) with SWAN data are depicted in Figure 2a-c for the three SWAN scales: C, I,HI. The 95%cutoffs values were .278 (Combined), .625 (Inattentive), and .125 (Hyperactive-Impulsive) based on the full distribution of respondent's questionnaire scores. Males and females differed in SWAN scores for all of the dimensions (Combined, Inattentive, and Hyperactive-Impulsive) as noted in Figure 2, with males demonstrating higher average SWAN scores.

ADHD Prevalence in the NFBC

The prevalence of

DISCUSSION

Investigation of ADHD in the NFBC adolescent cohort yields several important findings for understanding the prevalence of ADHD and its clinical phenomenology cross-culturally. First, ADHD is a common disorder among adolescents in northern Finland with an estimated prevalence of 8.5%, consistent with rates of ADHD noted in other studies of adolescents. For example, a rate of 9.9% was obtained for female twins ages 13.5 to 19.5 in a U.S. study (Hudziak et al., 1998), a rate of 5.8% was found in

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This research was supported byNational Institute of Mental HealthgrantsMH063706(Drs. Smalley and Järvelin) andMH01966(Dr. McGough), The Juselius Foundation, Finland, and the Academy of Finland.

Disclosure: Dr. McCracken has financial interests/arrangements with Eli Lilly, McNeil, Pfizer, and Shire; is also a consultant to Eli Lilly, Janssen, Johnson & Johnson, McNeil, Noven, Pfizer, and Shire; and is on the speakers' bureaus of Eli Lilly, Janssen, and UCB. Dr. McGough receives grant research support from Eli Lilly, McNeil, New River Pharmaceuticals, Novartis, Shire, and Pfizer; is a consultant to Eli Lilly, Novartis, and Shire; and is on the speakers' bureaus of Eli Lilly, McNeil, Novartis, and Shire. Dr. Moilanen is a member of Lilly Strattera Advisory Board, Finland. Dr. Peltonen is a board member of Orion Corporation. The other authors have no financial relationships to disclose.

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SPECIAL SECTIONPrevalence and Psychiatric Comorbidity of Attention-Deficit/Hyperactivity Disorder in an Adolescent Finnish Population

ABSTRACT

Objective

Method

Results

Conclusions

Section snippets

Sample and Screening Procedures

SWAN Screening

ADHD Prevalence in the NFBC

DISCUSSION

Biol Psychiatry

Am J Hum Genet

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Biol Psychiatry

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Am J Hum Genet

J Am Acad Child Adolesc Psychiatry

J Am Acad Child Adolesc Psychiatry

Curr Opin Genet Dev

Quebec child mental health survey: prevalence of DSM-III-R mental health disorders

J Child Psychol Psychiatry

An epidemiological study of disorders in late childhood and adolescence: I. Age- and gender-specific prevalence

J Child Psychol Psychiatry

SPECIAL SECTION
Prevalence and Psychiatric Comorbidity of Attention-Deficit/Hyperactivity Disorder in an Adolescent Finnish Population