Marzo 2015 - Volume XXXIV - numero 3
Focus
1Laboratorio per la Salute Materno-Infantile, Dipartimento di Salute Pubblica, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milano; 2UOC di Pediatria e Neonatologia, Presidio Ospedaliero di Ravenna, AUSL della Romagna
Indirizzo per corrispondenza: maurizio.bonati@marionegri.it
Key words: Attention deficit disorder, Prevalence, Disease registry, Treatment planning, Epidemiology
Background - Despite a pooled, worldwide ADHD prevalence of 5.29% in children and
adolescents, the rates vary widely between and within countries. Such variability in
prevalence rates often corresponds to heterogeneous methodologies used for diagnostic
evaluation in the studies. The aim was to estimate the prevalence of ADHD and define
the socio-demographic, clinical, and prescription profiles of the subjects enrolled in
Italy’s Lombardy Region’s ADHD Register.
Method - Data on patients evaluated by the 18 regional ADHD reference centres in the
2012-2013 period were analysed.
Results - 753 of 1.150 (65%) suspected patients received a diagnosis of ADHD
(M:F=6:1; range:5-17 yrs). In 24% of cases there was a family history of ADHD. 483
(64%) patients had at least one psychopathological disorder, the more common of
which were learning disorders (35%), sleep disturbances (14%), and oppositional defiant
disorder (13%), while 68 (9%) patients had other chronic medical conditions. 84%
of patients received a prescription for psychoeducational interventions (most commonly
parent training, n=428, 82%, child training, n=308, 59%, and teacher training,
n=173, 33%), 2% received only pharmacological treatment, and 14% a combination of
both. Of the 115 patients receiving drug therapy, 95 (83%) were treated with
methylphenidate, 7% (n=8) with atomoxetine, and 10% (n=12) with another drug, especially
risperidone. Compared to subjects treated with a psychoeducational intervention
alone, patients with drug prescriptions more commonly presented values of CGI-S of 5
or higher (p< .0001), lower cognitive levels (p= .0019), and associated disorders, such
as oppositional defiant disorder (p< .0001) and sleep disturbances (p=.0007).
Conclusions - The registry has revealed to be an essential tool for a continuous, systematic
monitoring of patterns of care, and allows resources to be invested appropriately,
based on documented needs, thus promoting progressive, significant improvements in
clinical practice and ensuring an efficient and homogeneous quality of care.
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