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      Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis

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          Abstract

          Background

          Attention deficit/hyperactivity disorder (ADHD), the most common childhood neurobehavioural disorder, can produce a series of negative effects on children, adolescents, and even adults as well as place a serious economic burden on families and society. However, the prevalence of ADHD is not well understood in China. The goal of this study was to estimate the pooled prevalence of ADHD among children and adolescents in China using a systematic review and meta-analysis.

          Methods

          A systematic literature search was conducted in PubMed, Web of Science, MEDLINE, CNKI, Wanfang, Weipu and CBM databases, and relevant articles published from inception to March 1, 2016, that provided the prevalence of ADHD among children and adolescents in China were reviewed. The risk of bias in individual studies was assessed using the Risk of Bias Tool for prevalence studies. Pooled-prevalence estimates were calculated with a random-effects model. Sources of heterogeneity were explored using subgroup analyses.

          Results

          Sixty-seven studies with a total of 275,502 individuals were included in this study. The overall pooled-prevalence of ADHD among children and adolescents in China was 6.26% (95% CI: 5.36–7.22%) with significant heterogeneity (I 2 = 99.0%, P < 0.001). The subgroup analyses showed that, the variables “geographic location” and “source of information” partially explained of the heterogeneity in this study ( P < 0.05). The prevalence of ADHD-I was the highest of the subtypes, followed by ADHD-HI and ADHD-C.

          Conclusions

          The prevalence of ADHD among children and adolescents in China is generally consistent with the worldwide prevalence and shows that ADHD affects quite a large number of people under 18 years old. However, a nationwide study is needed to provide more accurate estimations.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12888-016-1187-9) contains supplementary material, which is available to authorized users.

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          Most cited references44

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          Diagnostic and Statistical Manual of Mental Disorders

          American Psychiatric Association (2013)
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            The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder.

            Russell A Barkley, Mariellen Fischer, Lori Smallish … (2002)
            This study examined the persistence of attention-deficit/hyperactivity disorder (ADHD) into young adulthood using hyperactive (N = 147) and community control (N = 71) children evaluated at ages 19-25 years. ADHD was rare in both groups (5% vs. 0%) based on self-report but was substantially higher using parent reports (46% vs. 1.4%). Using a developmentally referenced criterion (+2 SD), prevalence remained low for self-reports (12% vs. 10%) but rose further for parent reports (66% vs. 8%). Parent reports were more strongly associated with major life activities than were self-reports. Recollections of childhood ADHD showed moderate correlations with actual parent ratings collected in childd hood, which suggests some validity for such recollections. The authors conclude that previous follow-up studies that relied on self-reports might have substantially underestimated the persistence of ADHD into adulthood.
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              Young adult outcome of hyperactive children: adaptive functioning in major life activities.

              Sarah Fischer, Laura R. Barkley, Lori Smallish … (2006)
              The authors report the adaptive functioning of hyperactive and control children in southeastern Wisconsin (Milwaukee) followed to young adulthood. Interviews with participants concerning major life activities were collected between 1992 and 1996 and used along with employer ratings and high school records at the young adult follow-up (mean = 20 years, range 19-25) for this large sample of hyperactive (H; n = 149) and community control (CC; n = 72) children initially seen in 1978-1980 and studied for at least 13 years. Age, duration of follow-up, and IQ were statistically controlled as needed. The H group had significantly lower educational performance and attainment, with 32% failing to complete high school. H group members had been fired from more jobs and manifested greater employer-rated attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms and lower job performance than the CC group. Socially, the H group had fewer close friends, more trouble keeping friends, and more social problems as rated by parents. Far more H than CC group members had become parents (38% versus 4%) and had been treated for sexually transmitted disease (16% versus 4%). Severity of lifetime conduct disorder was predictive of several of the most salient outcomes (failure to graduate, earlier sexual intercourse, early parenthood) whereas attention-deficit/hyperactivity disorder and oppositional defiant disorder at work were predictive of job performance and risk of being fired. These findings corroborate prior research and go further in identifying sexual activity and early parenthood as additional problematic domains of adaptive functioning at adulthood.
              Article 0 comments Cited 177 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Lizhang Chen: +86-0731-88836996 , liche4005@126.com
                Journal
                Journal ID (nlm-ta): BMC Psychiatry
                Journal ID (iso-abbrev): BMC Psychiatry
                Title: BMC Psychiatry
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-244X
                Publication date (Electronic): 19 January 2017
                Publication date PMC-release: 19 January 2017
                Publication date Collection: 2017
                Volume: 17
                Electronic Location Identifier: 32
                Affiliations
                [1 ]ISNI 0000 0001 0379 7164, GRID grid.216417.7, Department of Epidemiology and Health Statistics, , Xiangya School of Public Health, Central South University, ; NO. 238 Shang Ma Yuan Ling Xiang Xiangya Road, Kaifu District, Changsha, Hunan Province China
                [2 ]ISNI 0000 0001 0379 7164, GRID grid.216417.7, Department of Toxicology, , Xiangya School of Public Health, Central South University, ; Changsha, Hunan Province China
                [3 ]GRID grid.431010.7, Department of Oncology, , Xiangya Hospital, Central South University, ; Changsha, Hunan Province China
                [4 ]Deyang Center for Disease Control and Prevention, Sichuan Province, China
                Article
                Publisher ID: 1187
                DOI: 10.1186/s12888-016-1187-9
                PMC ID: 5244567
                PubMed ID: 28103833
                SO-VID: 772aaac1-bb69-450f-a03d-0a98853bf9e7
                Copyright © © The Author(s). 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                Date received : 6 June 2016
                Date accepted : 31 December 2016
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2017

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: attention deficit/hyperactivity disorder,prevalence,china,meta-analysis
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: attention deficit/hyperactivity disorder, prevalence, china, meta-analysis

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