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How common is ADHD?

How common is ADHD?

By Rhonda Rowland
CNN Medical Unit

ROCHESTER, Minnesota (CNN) -- Children have at least a 7 1/2 percent chance of being diagnosed with ADHD some time between age 5 and high-school graduation, according to a new Mayo Clinic study.

ADHD, or attention deficit hyperactivity disorder is a brain disorder characterized by hyperactivity and inattention. ADHD is the medical term for what's widely referred to as ADD.

"That's a large number of kids affected at some point during childhood," said Dr. William Barbaresi, developmental and behavioral pediatric specialist at the Mayo Clinic, who is lead author of the study published in Archives of Pediatrics and Adolescent Medicine. "ADHD is without question a very common condition that affects a large number of children and we have to deal with it in a systematic fashion in school and in the medical system. We can't ignore a problem that affects such a large number of kids."

Mayo Clinic researchers studied the computerized medical records of 8,548 children living in the Rochester area who were born between 1976 and 1982. The scientists combed medical and school records to determine which children met the most current diagnostic criteria for ADHD.

Current estimates suggest 3 percent to 5 percent of school-age children have ADHD at any given time.

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"That's an estimate based on a variety of sources of information," said Barbaresi, "but 3 (percent) to 5 percent is a conservative estimate, it's on the low side and it's reasonable to say a larger number is affected during childhood."

Dr. Joe Biederman, a child psychiatrist at Harvard Medical School and Massachusetts General Hospital agrees the current 3 percent to 5 percent prevalence figure is too low.

"The official figure of 3 (percent) to 5 percent is just an estimate, not a hard number," said Biederman, "this is a very common disorder, some studies have estimated 9 percent to 10 percent of children have ADHD. Not all of them may be on medications, but they're being attended to."

But not all ADHD experts think the current estimate is off-base.

"Given the startling data that 7 1/2-percent of school-age children will at some point be diagnosed with ADHD you have to look at why the numbers are as high as they are," said Dr. Steven Kurtz with the Institute for the Study of ADHD and Related Disorders at the NYU Study Center. "One needs to be extra careful about the criteria used in the new study. A child with ADHD has to be impaired in more than one setting and they didn't have data to show that."

Kurtz also noted symptoms in the medical charts could have been due to other disorders.

"Other disorders that could account for symptoms of ADHD include post traumatic stress disorder, which can make kids inattentive," said Kurtz. "Anxiety, depression and learning disorders can do the same thing."

Almost all specialists who treat ADHD agree that in some instances the disorder is over-diagnosed and in other cases under-diagnosed.

"Parents should be concerned and understand the symptoms of ADHD," said Kurtz. "Getting a report from school is a good starting point, but children need to go to a physician for further evaluation."

Current guidelines recommend at least two or three visits with a physician and behavior reports from parents and teachers before there can be an ADHD diagnosis.

"This is a well-done study and in some ways not terribly surprising," said Steven Hinshaw, child psychologist at University of California, Berkeley, "prevalence data has varied widely from 1 percent - 2 percent to as high as 15 percent plus. The figure of 7 1/2 percent is higher than that stated by the surgeon general but within the ballpark of other important population studies."

But Hinshaw cautions the study may not be representative of the entire U.S. population.

"Rochester is white, fairly affluent middle America so we don't know if the figure would be higher or lower in inner cities or other regions of the country," said Hinshaw.


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