中国儿童青少年1990—2019年注意缺陷多动障碍疾病负担及预测

杨晓蕾; 李洪杰; 多永胜; 葛杰; 张艳; 孙惠昕

doi:10.16835/j.cnki.1000-9817.2023.07.034

中国儿童青少年1990—2019年注意缺陷多动障碍疾病负担及预测

doi: 10.16835/j.cnki.1000-9817.2023.07.034

1.
齐齐哈尔医学院公共卫生学院, 黑龙江 161006
2.
齐齐哈尔医学院附属第三医院血管烧伤外科
3.
齐齐哈尔医学院护理学院
4.
哈尔滨医科大学肿瘤防治研究所

基金项目:

国家自然科学基金项目 82103869

黑龙江省自然科学基金项目 LH2020H131

详细信息

作者简介:
杨晓蕾(1985-), 女, 黑龙江人, 博士, 副教授, 主要研究方向为儿童行为障碍问题

通讯作者:
孙惠昕, E-mail: sunhx@hrbmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R748 G444 R179
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- 被引次数: 0
出版历程
- 收稿日期: 2023-02-02
- 修回日期: 2023-05-08
- 网络出版日期: 2023-07-25
- 刊出日期: 2023-07-25

Disease burden and prediction of attention deficit hyperactivity disorder in Chinese children and adolescents from 1990 to 2019

1.
School of Public Health, Qiqihar Medical University, Qiqihar(161006), Heilongjiang Province, China

摘要

摘要: 目的了解1990—2019年中国儿童青少年注意缺陷多动障碍(ADHD)疾病负担情况及发展趋势，为卫生行政部门制定政策提供基础理论依据。方法利用2019年全球疾病负担数据库，分析不同性别及年龄组ADHD的发病率、患病率及伤残调整寿命年(DALY)率，并对ADHD疾病趋势进行预测。结果 2019年中国的ADHD发病率、患病率和DALY率分别为70.41/10万、1 546.15/10万和18.87/10万，与1990年相比分别降低27.30%，25.35%和55.80%，并且女性均低于男性。2019年5~9岁年龄组ADHD发病率最高，为837.76/10万，而患病率和DALY率最高的年龄组均为10~14岁组，分别为5 740.47/10万和70.49/10万。Joinpoint回归模型结果显示，1990—2019年ADHD发病率、患病率和DALY率均有降低趋势，平均年度变化百分比(AAPC)分别为-1.35%，-1.16%和-1.16%，差异均有统计学意义(P值均＜0.05)。灰色预测模型GM(1, 1)预测结果显示，2020—2030年中国ADHD的发病率和患病率均呈下降趋势。结论 1990—2019年中国ADHD疾病负担呈降低趋势，中国对儿童青少年ADHD的防治效果有效。应继续采取积极的预防措施以减轻儿童青少年人群ADHD的疾病负担。
- 注意力缺陷障碍伴多动 /
- 患病代价 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To analyze the disease burden and trend of attention deficit hyperactivity disorder (ADHD) in China from 1990 to 2019, so as to provide the basic theoretical basis for the health administrative departments to formulate policies. Methods Using the 2019 Global Burden of Disease Database, the incidence, prevalence and disability adjusted life year (DALY) rates of ADHD were analyzed for both sex and different age groups, and the trends of ADHD were predicted. Results In 2019, the incidence, prevalence and DALY rate of ADHD in China were 70.41/100 000, 1 546.15/100 000 and 18.87/100 000 respectively. Compared with 1990, the rates decreased by 27.30%, 25.35% and 55.80% respectively, and these rates of females were lower than those of males. In 2019, the incidence rate of ADHD was the highest in the age group 5-9 years old (837.76/100 000), while the highest prevalence and DALY rates were found in ages groups of 10-14 years old (5 740.47/100 000 and 70.49/100 000). The results of the Joinpoint regression model showed that the incidence, prevalence and DALY rate had a downward trend from 1990 to 2019. The AAPC was -1.35%, -1.16% and -1.16%, respectively, with a statistically significant difference (P < 0.05). The prediction results of grey prediction model GM (1, 1) indicated that the incidence and prevalence rate of ADHD in China would decline from 2020 to 2030. Conclusion The burden of ADHD in China showed a decreasing trend from 1990 to 2019, indicating that the prevention and treatment effect of ADHD in children and adolescents of China was effective. China should take active preventive measures to reduce the burden of ADHD in children and adolescents.
- Attention deficit disorder with hyperactivity /
- Cost of illness /
- Regression /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 预测2020—2030年ADHD发病率和标化发病率

Figure 1. Prediction of ADHD incidence rate and standardized incidence rate during 2020-2030

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图 2 预测2020—2030年ADHD患病率和标化患病率

Figure 2. Prediction of ADHD prevalence rate and standardized prevalence rate during 2020-2030

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表 1 中国1990和2019年儿童青少年ADHD疾病负担情况/10^-5

Table 1. Disease burden of ADHD in Chinese children and adolescents in 1990 and 2019/10^-5

组别	年份	发病率	标化发病率	患病率	标化患病率	DALY率	标化DALY率
男	1990	142.15	148.55	2 955.79	2 717.48	36.13	33.21
	2019	105.55	180.32	2 227.29	2 900.36	27.21	35.51
女	1990	48.68	52.30	1 129.99	1 039.44	13.74	12.63
	2019	33.89	65.45	835.35	1 134.77	10.20	13.86
合计	1990	96.86	102.57	2 071.19	1 906.92	42.70	23.27
	2019	70.41	127.47	1 546.15	2 070.84	18.87	25.34

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表 2 不同年龄组儿童青少年1990和2019年ADHD疾病负担情况/10^-5

Table 2. Burden of ADHD in different age groups in Chinese adolescents and children in 1990 and 2019/10^-5

年龄组/岁	年份	发病率			患病率			DALY率
年龄组/岁	年份	男性	女性	合计	男性	女性	合计	男性	女性	合计
＜5	1990	476.76	164.45	329.36	495.84	171.21	342.62	6.10	2.11	4.21
	2019	596.79	211.00	418.70	620.48	219.65	435.44	7.63	2.72	5.36
5~9	1990	976.44	347.09	674.38	5 213.21	1 828.88	3 588.87	64.05	22.46	44.09
	2019	1 181.18	433.62	837.76	6 289.08	2 275.25	4 445.16	77.33	28.02	54.68
10~14	1990	84.82	30.44	58.51	6 922.91	2 486.42	4 776.49	84.92	30.47	58.57
	2019	102.86	38.24	73.29	8 038.79	3 015.30	5 740.47	98.72	37.03	70.49
15~19	1990	0	0	0	5 515.09	2 087.21	3 847.60	67.58	25.46	47.09
	2019	0	0	0	5 821.74	2 312.50	4 185.18	71.39	28.27	51.29

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表 3 中国1990—2019年儿童青少年ADHD疾病负担趋势分析/10^-5

Table 3. Analysis of disease burden trend of ADHD in Chinese children and adolescents from 1990 to 2019/10^-5

指标	趋势1		趋势2		趋势3		整体趋势
指标	年份	APC(95%CI)	年份	APC(95%CI)	年份	APC(95%CI)	年份	AAPC(95%CI)
发病率	1990—1995	3.72(2.62~4.74)^*	1995—2004	-4.74(-5.14~-4.20)^*	2004—2019	-0.94(-1.15~-0.74)^*	1990—2019	-1.35(-1.55~-1.14)^*
患病率	1990—1994	1.93(1.35~2.45)^*	1994—1999	-0.53(-1.03~-0.02)	1999—2019	-1.83(-1.89~-1.78)^*	1990—2019	-1.16(-1.25~-0.90)^*
DALY率	1990—1994	1.95(1.45~2.43)^*	1994—1999	-0.56(-1.04~0.05)	1999—2019	-1.82(-1.87~-1.78)^*	1990—2019	-1.16(-1.24~-0.93)^*
注：*P＜0.05。

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表 4 ADHD发病率和患病率灰色模型拟合结果/10^-5

Table 4. Grey model fitting results of incidence and prevalence rate of ADHD/10^-5

年份	发病率			患病率			标化发病率			标化患病率
年份	原始值	预测值	相对误差	原始值	预测值	相对误差	原始值	预测值	相对误差	原始值	预测值	相对误差
1990	96.86	96.86	0	2 071.19	2 071.19	0	102.57	102.57	0	1 906.92	1 906.92	0
1991	102.75	114.60	11.53	2 119.33	2 328.65	9.87	108.65	119.77	10.23	1 973.43	2 087.02	10.23
1992	108.15	112.08	3.63	2 162.59	2 296.92	6.21	114.15	120.22	5.31	2 032.57	2 086.58	5.31
1993	112.46	109.61	2.52	2 197.98	2 265.63	3.07	118.73	120.67	1.63	2 080.95	2 086.15	1.63
1994	114.98	107.20	6.76	2 221.32	2 234.77	0.60	122.05	121.12	0.76	2 115.14	2 085.71	0.76
1995	115.00	104.85	8.82	2 229.13	2 204.33	1.11	123.78	121.57	1.79	2 131.59	2 085.27	1.79
1996	112.53	102.54	8.87	2 223.52	2 174.30	2.21	124.40	122.02	1.91	2 133.98	2 084.84	1.91
1997	108.50	100.29	7.56	2 211.71	2 144.68	3.03	124.64	122.48	1.74	2 130.06	2 084.40	1.74
1998	103.43	98.08	5.16	2 194.78	2 115.46	3.61	124.66	122.94	1.38	2 122.16	2 083.96	1.38
1999	97.95	95.92	2.06	2 173.49	2 086.64	3.99	124.60	123.40	0.96	2 112.62	2 083.53	0.96
2000	92.73	93.81	1.17	2 149.48	2 058.22	4.24	124.60	123.86	0.59	2 103.88	2 083.09	0.59
2001	88.32	91.75	3.88	2 117.06	2 030.18	4.10	124.77	124.32	0.36	2 092.78	2 082.66	0.36
2002	84.61	89.73	6.06	2 074.99	2 002.52	3.49	125.13	124.79	0.28	2 077.47	2 082.22	0.28
2003	81.47	87.76	7.72	2 028.63	1 975.24	2.63	125.66	125.25	0.32	2 062.19	2 081.78	0.32
2004	78.88	85.83	8.81	1 983.24	1 948.33	1.70	126.33	125.72	0.48	2 051.10	2 081.35	0.48
2005	76.82	83.94	9.27	1 944.89	1 921.79	1.18	127.11	126.19	0.72	2 048.34	2 080.91	0.72
2006	75.49	82.10	8.76	1 914.58	1 895.61	0.99	128.30	126.66	1.28	2 055.67	2 080.48	1.28
2007	74.79	80.29	7.35	1 888.16	1 869.79	0.97	129.94	127.14	2.16	2 069.37	2 080.04	2.16
2008	74.44	78.53	5.49	1 862.53	1 844.32	0.97	131.63	127.61	3.05	2 085.08	2 079.61	3.05
2009	74.13	76.80	3.60	1 835.05	1 819.19	0.86	132.96	128.09	3.66	2 098.42	2 079.17	3.66
2010	73.54	75.11	2.13	1 804.41	1 794.41	0.55	133.52	128.57	3.71	2 104.92	2 078.73	3.71
2011	72.38	73.46	1.49	1 768.58	1 769.96	0.07	133.12	129.05	3.05	2 101.49	2 078.30	3.05
2012	70.93	71.84	1.29	1 729.23	1 745.85	0.96	132.04	129.53	1.90	2 091.06	2 077.86	1.90
2013	69.68	70.26	0.84	1 690.17	1 722.07	1.88	130.67	130.02	0.50	2 078.05	2 077.43	0.50
2014	68.78	68.72	0.09	1 654.77	1 698.61	2.64	129.42	130.50	0.84	2 066.79	2 076.99	0.84
2015	68.14	67.21	1.35	1 624.09	1 675.47	3.16	128.66	130.99	1.81	2 061.59	2 076.56	1.81
2016	68.10	65.73	3.47	1 598.02	1 652.65	3.41	128.34	131.48	2.45	2 062.64	2 076.12	2.45
2017	68.99	64.28	6.81	1 577.04	1 630.13	3.36	128.12	131.97	3.01	2 064.94	2 075.69	3.01
2018	69.98	62.87	10.16	1 560.50	1 607.93	3.03	127.85	132.47	3.00	2 067.41	2 075.25	3.61
2019	70.41	61.49	12.66	1 546.15	1 586.02	2.57	127.47	132.96	4.31	2 070.84	2 074.82	4.31

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