How common is attention-deficit/hyperactivity disorder? Incidence in a population-based birth cohort in Rochester, Minn

William J. Barbaresi, Slavica K. Katusic, Robert C. Colligan, V. Shane Pankratz, Amy L. Weaver, Kevin J. Weber, David A. Mrazek, Steven J. Jacobsen

Research output: Contribution to journalArticlepeer-review

217 Scopus citations


Context: The frequency of occurrence of attention-deficit/hyperactivity disorder (AD/HD) is in dispute. This uncertainty has contributed to the concern that too many children in the United States are being treated with stimulant medication. Objectives: To determine the cumulative incidence of AD/HD in a population-based birth cohort and to estimate the prevalence of pharmacologic treatment for children who fulfill research criteria for AD/HD. Design: Population-based birth cohort study. Setting and Subjects: All children born between 1976 and 1982 in Rochester, Minn, who remained in the community after age 5 years (N = 5718). Main Outcome Measures: Medical and school records were reviewed for clinical diagnoses of AD/HD and supporting documentation (symptoms consistent with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and positive results for AD/HD-related questionnaires). Research-identified cases were defined as: (1) "definite" AD/HD (clinical diagnosis and at least one type of supporting documentation); (2) "probable" AD/HD (clinical diagnosis but no supporting documentation or no clinical diagnosis but both types of supporting documentation); (3) "questionable" AD/HD (no clinical diagnosis, but at least one type of supporting documentation); and (4) "not AD/HD" (all other subjects). Information about pharmacologic treatment for AD/HD was abstracted for all subjects. Results: The highest estimate of the cumulative incidence at age 19 years (with 95% confidence interval) of AD/HD (definite plus probable plus questionable AD/HD) was 16.0% (14.7-17.3). The lowest estimate (definite AD/HD only) was 7.4% (6.5-8.4). Prevalence of treatment with stimulant medication was 86.5% for definite AD/HD, 40.0% for probable AD/HD, 6.6% for questionable AD/HD, and 0.2% for not AD/HD. Conclusions: These results provide insight into the apparent discrepancies in estimates of the occurrence of AD/HD, with less stringent criteria resulting in higher cumulative incidence. Children who met the most stringent criteria for AD/HD were most likely to receive pharmacologic treatment.

Original languageEnglish (US)
Pages (from-to)217-224
Number of pages8
JournalArchives of Pediatrics and Adolescent Medicine
Issue number3
StatePublished - 2002

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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