Background
Methods
Site selection and patients
Study design, procedures, and scales
Statistical analysis
Results
Patient disposition and characteristics
Criteria | Positive Screen | Screened Positive But Did Not Complete the DIVA | ADHD Established by the DIVA |
---|---|---|---|
(N = 1079) | (N = 265) | (N = 349) | |
ASRS | 941 (87.2) | 244 (25.9)a | 313 (89.7) |
PDI-4 | 433 (40.1) | 74 (17.1)a | 195 (55.9) |
Prevalence of ADHD in adults
Eligible Patients (N = 2284) | ||
---|---|---|
n (%) | ||
Patients completing screening | 2274/2284 (99.6)a | |
Positive screen for ADHD | 1079/2274 (47.4) | |
Negative screen for ADHD | 1195/2274 (52.6) | |
Patients completing DIVA | 814/1079 (75.4)b | |
DSM-IV-TR Criteria | DSM-5 Criteria | |
n (%) | n (%) | |
N = 2284c | N = 2284c | |
Diagnosed with ADHD based on DIVA | 318 (15.8) | 349 (17.4) |
95 % CI | 14.2-17.4 | 15.7-19.0 |
Diagnosis by category | ||
Combined | 201 (10.0) | 256 (12.7) |
Inattentive | 94 (4.7) | 78 (3.9) |
Hyperactive/impulsive | 23 (1.1) | 15 (0.7) |
Psychiatric diagnoses and neurological symptoms
ADHD Diagnosis Established by the DIVA | |||
---|---|---|---|
Prevalence of ADHD Among Patients with Other Disorders | Prevalence of Other Disorders Among Patients with ADHD | Prevalence of Other Disorders Among Non-ADHD Patients | |
(N = 349), | (N = 349), | (N = 1660), | |
n (%) | n (%) | n (%) | |
Psychiatric disordersa | |||
Depression (n = 1215) | 150 (12.3) | 150 (43.0) | 894 (53.9) |
Dysthymia (n = 253) | 34 (13.4) | 34 (9.7) | 198 (11.9) |
Bipolar disorder (n = 268) | 29 (10.8) | 29 (8.3) | 192 (11.6) |
Obsessive-compulsive disorder (n = 126) | 17 (13.5) | 17 (4.9) | 92 (5.5) |
Anxiety disorders (n = 803) | 127 (15.8) | 127 (36.4) | 575 (34.6) |
Eating disorders (n = 113) | 24 (21.2) | 24 (6.9) | 76 (4.6) |
Substance abuse (n = 104) | 32 (30.8) | 32 (9.2) | 56 (3.4) |
Substance dependence (n = 86) | 21 (24.4) | 21 (6.0) | 50 (3.0) |
Alcohol dependence (n = 109) | 14 (12.8) | 14 (4.0) | 81 (4.9) |
Alcohol abuse (n = 133) | 36 (27.1) | 36 (10.3) | 87 (5.2) |
Non-substance dependence (n = 30) | 4 (13.3) | 4 (1.1) | 20 (1.2) |
Antisocial personality disorders (n = 24) | 4 (16.7) | 4 (1.1) | 14 (0.8) |
Borderline personality disorders (n = 172) | 32 (18.6) | 32 (9.2) | 111 (6.7) |
Autistic spectrum disorder (n = 36) | 9 (25.0) | 9 (2.6) | 22 (1.3) |
Other (n = 273) | 56 (20.5) | 56 (16.0) | 184 (11.1) |
No other psychiatric diagnosis (n = 115) | 40 (34.8) | 40 (11.5) | 56 (3.4) |
Neurological symptoms/diagnoses | |||
Any present | 18 (5.2) | 60 (3.6) | |
Tic disorder | 7 (2.0) | 29 (1.7) | |
Tourette’s syndrome | 3 (0.9) | 15 (0.9) | |
Coordination deficiencies | 9 (2.6) | 25 (1.5) | |
Deficiencies in fine motor skills | 8 (2.3) | 41 (2.5) |
Resource utilization (treatment)
ADHD Diagnosis Established by the DIVA | ADHD Diagnosis Not Established | Odds Ratio (ADHD versus No ADHD) | |
---|---|---|---|
(N = 349) | (N = 1660) | (95 % CI) | |
Antidepressants, n (%) | 199 (57.0) | 1193 (71.9) | 0.66 (0.49-0.89) |
Anxiolytics, sedatives, and hypnotics, n (%) | 105 (30.1) | 625 (37.7) | 0.87 (0.61-1.24) |
Antipsychotics, n (%) | 59 (16.9) | 308 (18.6) | 0.51 (0.25-1.05) |
Mood stabilizers, n (%) | 38 (10.9) | 235 (14.2) | 0.82 (0.51-1.31) |
Psychotherapy, n (%) | 108 (30.9) | 451 (27.2) | 0.72 (0.52-1.00) |
Other therapy, n (%)a | 54 (15.5) | 137 (8.3) | 1.50 (0.91-2.49) |
Visits to psychiatrist, n (%) | 291 (83.4) | 1387 (83.6) | 1.08 (0.74-1.58) |
Visits to psychotherapist, n (%) | 103 (29.5) | 449 (27.0) | N/A |
Visits to mental health worker, n (%) | 62 (17.8) | 181 (10.9) | N/A |
Visits to other, n (%) | 40 (11.5) | 216 (13.0) | N/A |
Patient disability and functioning
N
| ADHD Diagnosis Established by the DIVA (DSM-5) |
N
| ADHD Diagnosis Not Established | |
---|---|---|---|---|
(N = 349) | (N = 1660) | |||
SDS | ||||
Total score, mean (SD) | 348 | 18.9 (6.61) | 1659 | 11.6 (8.55) |
Work/school, mean (SD) | 327 | 6.5 (2.62) | 1466 | 4.1 (3.25) |
Social life, mean (SD) | 348 | 6.1 (2.68) | 1659 | 3.8 (3.13) |
Family life/home duties, mean (SD) | 348 | 6.3 (2.61) | 1659 | 3.8 (3.08) |
Days lost, mean (SD) | 348 | 1.9 (2.39) | 1659 | 1.2 (2.14) |
Underproductive days, mean (SD) | 348 | 3.3 (2.46) | 1659 | 2.0 (2.38) |
EQ-5D | ||||
Problems with mobility, n (%) | 349 | 52 (14.9) | 1660 | 285 (17.2) |
Problems with self-care, n (%) | 349 | 50 (14.3) | 1660 | 141 (8.5) |
Problems performing usual activities, n (%) | 349 | 231 (66.2) | 1660 | 684 (41.2) |
Moderate/extreme pain or discomfort, n (%) | 349 | 164 (47.0) | 1660 | 790 (47.6) |
Moderately/extremely anxious or depressed, n (%) | 349 | 268 (76.8) | 1660 | 1157 (69.7) |
Visual analogue scale, mean (SD) | 348 | 62.0 (22.86) | 1659 | 64.3 (21.65) |
Health state value, mean (SD) | 348 | 0.609 (0.332) | 1659 | 0.687 (0.292) |
N
| ADHD Diagnosis Established by the DIVA |
N
| ADHD Diagnosis Not Established | Odds Ratio or LS Mean Difference | |
---|---|---|---|---|---|
(N = 349) | (N = 1660) | (95 % CI) | |||
Master’s/Bachelor’s degrees, n (%) | 68 (19.4) | 399 (24.0) | |||
ADHD, versus non-ADHD, OR (95 % CI) | 0.60 (0.44-0.82) | ||||
Vocational training, n (%) | 88 (25.2) | 293 (17.7) | N/A | ||
Total amount of formal instruction, years (SD) | 346 | 12.58 (5.049) | 1659 | 12.60 (4.586) | N/A |
Student, n (%) | 52 (14.9) | 90 (5.4) | N/A | ||
Employed full time, n (%) | 106 (30.4) | 580 (34.9) | |||
ADHD, versus non-ADHD (female), OR (95 % CI) | 0.54 (0.36-0.81) | ||||
ADHD, versus non-ADHD (male), OR (95 % CI) | 0.89 (0.62-1.26) | ||||
Number of different employers in last 3 years, mean (SD) | 347 | 1.20 (1.598) | 1659 | 0.90 (0.936) | N/A |
Working at level of qualification, n (%) | 159 (45.6) | 840 (50.6) | N/A | ||
Number of biological children, mean (SD) | 348 | 0.93 (1.230) | 1655 | 1.13 (1.135) | |
ADHD versus non-ADHD (at age 31), LS Mean difference | 0.10 (−0.03-0.23) | ||||
ADHD, yes versus non-ADHD (at age 42), LS Mean difference | 0.20 (0.07-0.33) | ||||
ADHD, yes versus non-ADHD (at age 51), LS Mean difference | 0.28 (0.10-0.47) | ||||
Age when first biological child was born (years), mean (SD) | 159 | 25.50 (5.685) | 998 | 26.70 (5.574) | N/A |
Age when first biological child was born (<18 years), n (%) | 7 (2.0) | 23 (1.4) | N/A | ||
Living with parents, n (%) | 78 (22.3) | 215 (13.0) | |||
ADHD versus non-ADHD, OR (95 % CI) | 1.09 (0.76-1.57) | ||||
Driving license held, n (%) | 239 (68.5) | 1303 (78.5) | N/A | ||
Number of times license revoked in last 3 years, mean (SD) | 239 | 0.07 (0.303) | 1300 | 0.04 (0.222) | N/A |
Number of speeding tickets in last 3 years, mean (SD) | 239 | 1.05 (2.072) | 1299 | 0.55 (1.664) | N/A |
Number of parking tickets in last 3 years, mean (SD) | 239 | 1.12 (3.299) | 1296 | 0.60 (1.818) | N/A |
Number of car accidents in last 3 years, mean (SD) | 239 | 0.31 (0.808) | 1301 | 0.16 (0.555) | N/A |
Frequency of debt, n (%) | 124 (35.5) | 404 (24.3) | N/A | ||
Prosecuted since adulthood, n (%) | 48 (13.8) | 102 (6.1) | N/A | ||
Current tobacco use, n (%) | 165 (47.3) | 612 (36.9) | N/A |