Determinanten für die Diagnosestellung einer ADHS-Eine Analyse anhand von GKV-Routinedaten

authored by

Mike Klora, Jan Zeidler, Roland Linder, Bernhard Kis, Philipp Heβmann, Frank Verheyen, J. Matthias Graf Von Der Schulenburg

Abstract

Background

Up to now, there are only few studies on the influence of the sociodemographic factors on the diagnosis of ADHD in Germany, although the knowledge of these characteristics can be important for the design of prevention programs. Therefore, the aim of this study is to broaden the evidence on the factors influencing the diagnosis of ADHD in Germany. In addition, this study provides information on the influence of the familial predisposition with psychiatric diagnosis and the sociodemographic variables.

Methods

Using a 3:1 control group design including claims data of a large German health insurance fund (Techniker Krankenkasse) psychosocial, regional and demographic factors were analyzed descriptively and by logistic regression models. The study variables consisted of the age, sex, region and comorbidities of the patients, the socioeconomic occupational status and the level of education of the members, the psychiatric diagnoses of the parents and the age of the parents at the birth of the patients (variables of the family background).

Results

9,881 ADHD patients with a mean age of 14.9 [SD: 12.6] years were analyzed. Based on this comprehensive sample, it was confirmed that ADHD risk is higher in male patients than in female patients (OR: 2.3 [95%-CI: 2.2-2.5]). In addition, a moderate or high educational status of the member had a significantly lower risk compared to a low education status (OR: 0.78 [95%-CI: 0.70-0.89] and OR: 0.55 [95%-CI: 0.47-0.63], respectively). In addition, the risk of ADHD increases with the parents' age, as well as with the presence of at least one psychiatric diagnosis (OR 1.02 [95%-CI: 1.01-1.03] and OR: 2.09 [95%-CI: 1.95-2.25], respectively). Regarding the socioeconomic index of occupational status, no clear correlation could be identified.

Conclusion

Knowledge of sociodemographic risk factors facilitates the diagnosis and provides information on the development of individual therapy concepts.

Organisation(s)

Institute of Health Economics
Institute of Insurance Business Administration

External Organisation(s)

University of Göttingen
The TK Scientific Institute of Value and Efficiency in Healthcare (WINEG)

Type

Article

Journal

Fortschritte der Neurologie Psychiatrie

Volume

Pages

47-56

No. of pages

ISSN

0720-4299

Publication date

2019

Publication status

Published

Peer reviewed

Yes

ASJC Scopus subject areas

Neurology, Clinical Neurology, Psychiatry and Mental health

Sustainable Development Goals

SDG 3 - Good Health and Well-being

Electronic version(s)

https://doi.org/10.1055/s-0043-124591 (Access: Closed)