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Leshno D, Lev Shalem L, Perlove Gavze R, Leshno M. Diabetes Glycemic Control in Adults With Type 2 Diabetes Mellitus and ADHD. J Atten Disord 2024:10870547241288720. [PMID: 39390799 DOI: 10.1177/10870547241288720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2024]
Abstract
INTRODUCTION Persistence in treatment is important in balancing diabetes and preventing complications. ADHD impairs quality of life and functioning in many areas of life. The aim of this study is to evaluate the possible association of ADHD and diabetes glycemic control among adults with type 2 diabetes mellitus (T2DM). METHODS All data were obtained from Maccabi Healthcare Services (MHS) automated databases. This retrospective cross-sectional study uses electronic medical records from the Maccabi Healthcare Services database during the years 2010 to 2020. Using a propensity score with the variables of age, gender, and duration of diabetes, we compared a group of 1,582 patients with T2DM and ADHD to 1,582 patients with T2DM and without ADHD. We used a t-test to compare continuous variables and a Mann-Whitney U test for non-parametric testing. In addition, we used multivariate logistic regression with a cutoff of several HbA1c values in T2DM patients with and without ADHD during 2019 to 2020. The proportion of patients with HbA1c values above 10%, 9%, and 8% in the group of patients with ADHD was 4.7 to 5.9 times higher than in patients without ADHD. In addition, the OR in the multivariate logistic regression was 4.2 (95% CI [2.5, 6.8]), 4.3 (95% CI [3.1, 6.1]), and 2.7 (95% CI [2.2, 3.4]) for cutoff of HbA1c of 10%, 9%, and 8%, respectively. CONCLUSION Patients with co-morbid ADHD and T2DM have a higher incidence of poor glycemic control. The findings extend the knowledge on the relationship between ADHD and diabetes and highlight the need for further research to improve treatment.
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Affiliation(s)
- Dahlia Leshno
- Maccabi Healthcare Services, Tel Aviv, Israel
- Tel Aviv University, Israel
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Ward J, McBride A, Gudka R, Becker K, Newlove-Delgado T, Price A. Wider health needs in attention deficit hyperactivity disorder from lived and professional experience: a qualitative framework analysis. BMJ Open 2024; 14:e083539. [PMID: 39153774 PMCID: PMC11331868 DOI: 10.1136/bmjopen-2023-083539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/26/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVES This study aimed to explore the perspectives of people with attention deficit hyperactivity disorder (ADHD), their supporters and primary care professionals (PCPs), on the wider physical and mental health needs of people with ADHD and the support currently available. DESIGN Qualitative semi-structured interviews, analysed using reflexive thematic analysis. SETTING Five general practice surgeries across England. PARTICIPANTS Participants with lived experience (people with ADHD and their supporters (n=11)) and PCPs (n=9) (eg, general practitioners and practice managers), recruited via clinical academic networks and previous work packages of this study. RESULTS We generated three major themes in relation to ADHD, using reflexive thematic analysis: understanding health, barriers to health and addressing health. Within these, participants reflected on mental and physical health challenges, as well as wider social difficulties and variability in support offered/accessed. CONCLUSIONS This study highlights that health problems in ADHD are complex and rooted both in individual factors (eg, mental health) and social factors (eg, support). This study also highlights the differences in expectations and fulfilment of healthcare.
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Affiliation(s)
- John Ward
- University of Exeter Medical School, Exeter, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | | | | | | | - Anna Price
- University of Exeter Medical School, Exeter, UK
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Lee YS, Sprong ME, Shrestha J, Smeltzer MP, Hollender H. Trajectory Analysis for Identifying Classes of Attention Deficit Hyperactivity Disorder (ADHD) in Children of the United States. Clin Pract Epidemiol Ment Health 2024; 20:e17450179298863. [PMID: 39130191 PMCID: PMC11311732 DOI: 10.2174/0117450179298863240516070510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/12/2024] [Accepted: 04/30/2024] [Indexed: 08/13/2024]
Abstract
Background Attention Deficit Hyperactivity Disorder (ADHD) is a mental health disorder that affects attention and behavior. People with ADHD frequently encounter challenges in social interactions, facing issues, like social rejection and difficulties in interpersonal relationships, due to their inattention, impulsivity, and hyperactivity. Methods A National Longitudinal Survey of Youth (NLSY) database was employed to identify patterns of ADHD symptoms. The children who were born to women in the NLSY study between 1986 and 2014 were included. A total of 1,847 children in the NLSY 1979 cohort whose hyperactivity/inattention score was calculated when they were four years old were eligible for this study. A trajectory modeling method was used to evaluate the trajectory classes. Sex, baseline antisocial score, baseline anxiety score, and baseline depression score were adjusted to build the trajectory model. We used stepwise multivariate logistic regression models to select the risk factors for the identified trajectories. Results The trajectory analysis identified six classes for ADHD, including (1) no sign class, (2) few signs since preschool being persistent class, (3) few signs in preschool but no signs later class, (4) few signs in preschool that magnified in elementary school class, (5) few signs in preschool that diminished later class, and (6) many signs since preschool being persistent class. The sensitivity analysis resulted in a similar trajectory pattern, except for the few signs since preschool that magnified later class. Children's race, breastfeeding status, headstrong score, immature dependent score, peer conflict score, educational level of the mother, baseline antisocial score, baseline anxious/depressed score, and smoking status 12 months prior to the birth of the child were found to be risk factors in the ADHD trajectory classes. Conclusion The trajectory classes findings obtained in the current study can (a) assist a researcher in evaluating an intervention (or combination of interventions) that best decreases the long-term impact of ADHD symptoms and (b) allow clinicians to better assess as to which class a child with ADHD belongs so that appropriate intervention can be employed.
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Affiliation(s)
- Yu-Sheng Lee
- School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois at Springfield, Illinois, United States
| | - Matthew Evan Sprong
- School of Public Management and Policy, College of Public Affairs and Education, University of Illinois at Springfield, llinois, United States
| | - Junu Shrestha
- School of Integrated Sciences, Sustainability, and Public Health, College of Health, Science, and Technology, University of Illinois at Springfield, Illinois, United States
| | - Matthew P. Smeltzer
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, Tennessee, United States
| | - Heaven Hollender
- School of Health and Human Sciences, Indiana University Indianapolis, Indiana, United States
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Rattay K, Robinson LR. Identifying Risk Factors for Attention-Deficit/Hyperactivity Disorder (ADHD): a Public Health Concern and Opportunity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:195-202. [PMID: 38598041 PMCID: PMC11315233 DOI: 10.1007/s11121-024-01667-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders with significant individual and societal negative impacts of the disorder continuing into adulthood (Danielson et al. in Journal of Clinical Child and Adolescent Psychology, in press; Landes and London in Journal of Attention Disorders 25:3-13, 2021). Genetic and environmental risk (e.g., modifiable exposures such as prenatal tobacco exposure and child maltreatment) for ADHD is likely multifactorial (Faraone et al. in Neuroscience & Biobehavioral Reviews 128:789-818, 2021). However, the evidence for potentially modifiable contextual risks is spread across studies with different methodologies and ADHD criteria limiting understanding of the relationship between early risk factors and later childhood ADHD. Using common methodology across six meta-analyses (Bitsko et al. in Prevention Science, 2022; Claussen et al. in Prevention Science 1-23, 2022; Dimitrov et al. in Prevention Science, 2023; Maher et al. in Prevention Science, 2023; Robinson, Bitsko et al. in Prevention Science, 2022; So et al. in Prevention Science, 2022) examining 59 risk factors for childhood ADHD, the papers in this special issue use a public health approach to address prior gaps in the literature. This introductory paper provides examples of comprehensive public health approaches focusing on policy, systems, and environmental changes across socio-ecological contexts to improve health and wellbeing through prevention, early intervention, and support across development using findings from these meta-analyses. Together, the findings from these studies and a commentary by an author independent from the risk studies have the potential to minimize risk conditions, prioritize prevention efforts, and improve the long-term health and wellbeing of children and adults with ADHD.
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Affiliation(s)
- Karyl Rattay
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Lara R Robinson
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and Prevention, Atlanta, GA, USA
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Do D, Lee T, Bably M, Inneh IA, Patel U. Prevalence and Predictors of Multimodal Treatment Among U.S. Adults Newly Diagnosed With ADHD. Am J Prev Med 2024; 66:707-716. [PMID: 38000483 DOI: 10.1016/j.amepre.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/17/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
INTRODUCTION Although a combined treatment of prescription medication and psychotherapy provides long-term benefits for adults with attention deficit/hyperactivity disorder (ADHD), little is known about the prevalence of receiving such multimodal treatment. This study investigated trends in the prevalence and correlates of multimodal treatment among U.S.-insured adults newly diagnosed with ADHD. METHODS 495,180 U.S. adults from the Komodo Healthcare Map with newly diagnosed ADHD in 2017-2021 were included. Descriptive statistics were used to estimate trends in the prevalence of treatment (no treatment, prescription-only, psychotherapy-only, or both) within 3 months from the index ADHD diagnosis. Multinomial logistic regression was used to examine patient and provider characteristics associated with ADHD treatment. Analysis was conducted in May 2023. RESULTS From 2017 to 2021, the prevalence of newly diagnosed ADHD adults receiving multimodal, prescription-only, and psychotherapy-only treatment within 3 months following their first diagnosis increased from 12.9% to 21.4%, 30.2% to 33.3%, and 18.4% to 20.4%, respectively. Over the same period, the prevalence of newly diagnosed ADHD adults receiving no treatment declined from 38.5% to 25%. Relative to their counterparts, the odds of receiving multimodal ADHD treatment were significantly lower (p<0.05) for men, older adults, adults with multiple co-existing conditions, Medicaid and Medicare beneficiaries, and those living in socially disadvantaged areas. Furthermore, the odds of receiving multimodal treatment were higher (p<0.05) for adults who saw a nurse practitioner, physician assistant, or behavioral care (non-physician) provider on their first visit with an ADHD diagnosis, compared to those who saw a physician. CONCLUSIONS 25% of newly diagnosed ADHD adults received no treatment in 2021 and 53.7% only received a single-modality treatment-raising concerns about the potential implications of untreated ADHD or insufficient treatment on the persistence of ADHD-related impairments, morbidity, productivity, and downstream healthcare cost. The study also highlighted potential sociodemographic, clinical, and provider disparities in ADHD treatment.
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Affiliation(s)
- Duy Do
- Evernorth Research Institute, Saint Louis, MO.
| | - Tiffany Lee
- Evernorth Research Institute, Saint Louis, MO
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Curzon MM, Dick AS, Coccia C, Graziano PA. Exploring Differences in Physical Health in Young Children With and Without ADHD. J Pediatr Psychol 2024; 49:120-130. [PMID: 38078865 PMCID: PMC10874215 DOI: 10.1093/jpepsy/jsad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/14/2023] [Accepted: 11/17/2023] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVE To assess differences in child physical health outcomes and metrices associated with obesity in a sample of predominantly Hispanic/Latinx young children with and without attention-deficit/hyperactivity disorder (ADHD). METHODS Participants included 127 children diagnosed with ADHD and 96 typically developing (TD) children between 4 and 7 years of age. Objective measures of children's body composition, fitness, and physical activity were conducted. Parents of children completed food recalls to assess their child's dietary intake, diet quality was calculated based on the Healthy Eating Index-2015, and parents completed a survey about their family's health habits. RESULTS Logistic regression revealed that those with ADHD were more likely to be classified as having an overweight or obese (Ov/O) body mass index (BMI). Linear regression analyses indicated that children with ADHD performed worse on a fitness test and consumed more calories relative to TD children. Moderation analyses indicated that sex differences in steps were prominent in our TD sample, but not among those with ADHD. CONCLUSIONS Young children with ADHD are at greater risk for having an Ov/O BMI, being less fit, and eating a greater intake of calories compared to TD children.
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Affiliation(s)
- Madeline M Curzon
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Anthony S Dick
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Catherine Coccia
- Department of Psychology, Center for Children and Families, Florida International University, USA
| | - Paulo A Graziano
- Department of Psychology, Center for Children and Families, Florida International University, USA
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Luk JW, Ramchandani VA, Diazgranados N, Schwandt ML, Gunawan T, George DT, Goldman D. Multidimensional Quality of Life Across the Spectrum of Alcohol Use Behavior. PSYCHIATRIC RESEARCH AND CLINICAL PRACTICE 2022; 4:92-101. [PMID: 36545505 PMCID: PMC9757500 DOI: 10.1176/appi.prcp.20220023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Quality of life (QoL) is inversely associated with alcohol misuse and is a key measure by which recovery from alcohol use disorder (AUD) might be assessed. Yet, the determinants of QoL are scarcely known. The authors examined three ways through which demographic characteristics, familial and early life factors, and psychopathology conferred risks for QoL, including unique direct effects, developmental pathways, and clinical risk Profiles. Methods Cross-sectional data from 1095 adults (50.4% without AUD; 49.6% with AUD) who participated in the NIAAA Natural History Protocol from January 2015 to March 2022 were analyzed. Multivariable regressions, path analysis, and latent Profile analysis were conducted. Results AUD was uniquely associated with lower QoL, and adverse effects of child maltreatment history and psychopathology symptoms on QoL were of similar or larger magnitudes. Mediation analysis indicated family history of AUD and child maltreatment history were indirectly associated with lower QoL through higher attention-deficit/hyperactivity disorder symptoms, higher depressive symptoms, and positive AUD diagnosis. Latent Profile analysis of an enriched set of clinical characteristics identified four latent Profiles capturing the full range of alcohol use behavior. Latent Profiles with greater severity of familial and early life factors, psychopathology, and problematic drinking showed dose-response associations with lower levels of physical, psychological, social, and environment QoL. Conclusions A constellation of developmental and clinical characteristics disproportionately affects individuals with AUD and is negatively associated with QoL domains. To improve QoL, prevention and intervention need to target multiple factors, including history of child maltreatment, comorbid psychopathology, and problematic drinking itself.
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Affiliation(s)
- Jeremy W. Luk
- Office of the Clinical DirectorNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA
| | - Vijay A. Ramchandani
- Human Psychopharmacology LaboratoryNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA
| | - Nancy Diazgranados
- Office of the Clinical DirectorNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA
| | - Melanie L. Schwandt
- Office of the Clinical DirectorNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA
| | - Tommy Gunawan
- Office of the Clinical DirectorNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA,Human Psychopharmacology LaboratoryNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA
| | - David T. George
- Office of the Clinical DirectorNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA
| | - David Goldman
- Office of the Clinical DirectorNational Institute on Alcohol Abuse and AlcoholismBethesdaMDUSA,Laboratory of NeurogeneticsNational Institute on Alcohol Abuse and AlcoholismRockvilleMDUSA
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Kameg B. Viloxazine ER (Qelbree
®
): A New Non-Stimulant Option in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder. J Psychosoc Nurs Ment Health Serv 2022; 60:7-9. [DOI: 10.3928/02793695-20220610-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wong AWWA, Landes SD. Expanding Understanding of Racial-Ethnic Differences in ADHD Prevalence Rates among Children to Include Asians and Alaskan Natives/American Indians. J Atten Disord 2022; 26:747-754. [PMID: 34189983 DOI: 10.1177/10870547211027932] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prior studies show that ADHD prevalence rates vary by race-ethnicity, but these studies do not include a full range of racial-ethnic minority groups. OBJECTIVE This study aimed to understand differences in ADHD prevalence among children across a wider range of racial-ethnic groups, overall and stratified by biological sex. METHOD Data on children aged 5 to 17 from the 2004 to 2018 National Health Interview Survey Sample Child Files were used in analyses (N = 120,129). RESULTS Compared to Non-Hispanic White children, ADHD prevalence was lower among Hispanic and Non-Hispanic Asian children. This difference was present for both males and females. Across all racial-ethnic groups, males had higher ADHD prevalence than females. CONCLUSION Results from this study provide further evidence that racial-ethnic disparities in ADHD prevalence rates persist across sex and provide initial evidence of substantially lower ADHD prevalence among Non-Hispanic Asians. Implications, limitations, and future research directions derived from the results are discussed.
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London AS, Landes SD. Attention deficit hyperactivity disorder and the age pattern of adult mortality. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2022; 67:28-39. [PMID: 34984945 PMCID: PMC9038627 DOI: 10.1080/19485565.2021.2020618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
We draw upon the life-course perspective and examine whether Attention Deficit Hyperactivity Disorder (ADHD) moderates the age pattern of adult mortality using data from the 2007 and 2012 National Health Interview Survey Sample Adult File linked to National Death Index data through 2015. Overall, 7.0% of respondents died by 2015. Discrete-time hazard analysis indicates that the log odds of mortality were significantly lower among 18 and 19 year old adults ever diagnosed with ADHD and significantly higher among 46 to 64 year old adults ever diagnosed with ADHD, with a crossover occurring at age 33. Results were similar among men and women. It is not known specifically which risks drive changes in the risk of mortality documented among persons with ADHD during the transition to adulthood, the increased risk of mortality in midlife, or whether some risks operate more or less at particular ages. Additional research can lead to targeted, age- and life-course stage-focused interventions for specific risks and contribute to the reduction of ADHD-related mortality.
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Affiliation(s)
- Andrew S London
- Sociology, Aging Studies Institute Associate, and Lerner Center for Public Health Promotion, Syracuse University, Maxwell School of Citizenship and Public Affairs, Syracuse, New York, USA
| | - Scott D Landes
- Sociology, Aging Studies Institute Associate, and Lerner Center for Public Health Promotion, Syracuse University, Maxwell School of Citizenship and Public Affairs, Syracuse, New York, USA
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London AS, Landes SD. Cohort Change in the Prevalence of ADHD Among U.S. Adults: Evidence of a Gender-Specific Historical Period Effect. J Atten Disord 2021; 25:771-782. [PMID: 31189421 DOI: 10.1177/1087054719855689] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: To document inter- and intra-cohort changes in adult ADHD and examine whether changes vary by gender. Method: We analyze data from the 2007 and 2012 U.S. National Health Interview Survey. Results: The prevalence of ADHD among adults aged 18 to 64 years increased from 3.41% in 2007 to 4.25% in 2012. As expected, patterns of inter- and intra-cohort change varied by gender. At younger ages, inter-cohort gender differences are more distinct due to a spike in prevalence among boys/men born in or after 1980. Consistent with a gender-specific historical period effect, recent intra-cohort increases among women have narrowed the gender gap. Conclusion: The gender gap in the prevalence of ADHD among adults decreased by 31.1% from 2007 to 2012 due to increased prevalence among adult women of all ages. We discuss these results in relation to diagnostic practice, adult health and well-being, data limitations and needs, and directions for future research.
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