注意力不足過動症的流行病學

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注意力不足過動症各子類型的比例分布(紫色為混合型;藍色為注意力缺陷為主型;粉紅色為過動—衝動為主型)[1][2][3]

注意力不足過動症(ADHD)是童年階段最常見的發展障礙[4]。根據2015年發表的流行病學研究,依照DSM-III, DSM-III-R及DSM-IV的標準,國際注意力不足過動症的流行率中位數,兒童為6-8%[5][6]。若使用ICD-10的標準,同年齡兒童的流行率則為1–2% [7]。美國的成人注意力不足過動症的流行率為4-5%[8][9]。根據《找回專注力:成人ADHD全方位自助手冊》,成人ADHD在台灣的流行率推估為3-4%[10]:24-25。ADHD是全球性的[11][12][13][14]。世界各地ADHD流行率的差異主要是因為世界各地使用的ADHD診斷方法不同。[15] 若使用相同的診斷方法,則世界各地所得出的ADHD流行率將介於伯仲之間。[16]

英國和美國的ADHD診斷率和治療率自1970年代起逐年增加至今[17]。學界的共識認為這個現象是因為診斷方法的變遷[17]以及人們逐漸願意利用藥物來治療ADHD所致[7],並非ADHD的流行率真的增加了。[17][7][18]:134 [18]

學界共識認為,2013年起,DSM的版本從DSM 4TR 推進到 DSM 5 會使得ADHD的診斷數增加(特別是成人注意力不足過動症的診斷數) [19]

美洲[编辑]

美國 4–17 歲的ADHD診斷率(2007)[20]
  14%–15.9%
  11%–13.9%
  9.6%–10.9%
  8.0%–9.5%
  5.6%–7.9%
美國的數據

截至2011年底,大約11%的4-17歲的兒童與青少年被診斷出注意力不足過動症[21]。11%換算後約為640萬的兒童與青少年。[21]診斷出有ADHD的男童在比例上比女童約高出兩倍。對於這個性別上差異的成因,目前仍然未知確切原因。不過,有專家指有可能由於女童的病症普遍與男童不同,因此在診斷時亦同時較男童難於察覺,所以較少讓家長及老師發現而作出轉介。[22] [23]

研究顯示美國一年因注意力不足過動症損失高達近40億美金,其中即包括父母的工作損失[24]

亞洲[编辑]

台灣的數據

ADHD在台灣兒童暨青少年的盛行率約為7%至7.5%。依據衛生福利部中央健保署之健保資料庫[25]的資料顯示,兒童就醫者大約是2.3%至2.5%左右[26]。兒童及青少年ADHD的就醫比率不到一半,也就是有超過三分之二患有注意力不足過動症的兒童及青少年沒有接受診斷。[10]:24ADHD在台灣成人的盛行率推估為一百個成人中大約有四位(4%)左右的ADHD成人患者。根據2012年健保資料庫的資料顯示:18歲至50歲成人,曾診斷為ADHD的比率為0.057%。[10]:25 [27]

韓國的數據

注意力不足過動症在南韓成人族群(18歲以上)的盛行率大約為 4.4%。而此症在南韓的兒童及青少年族群的盛行率與西方國家的數據大致相同。[28]

日本的數據

日本的學齡族群中(6-18歲)中,注意力不足過動症的盛行率約為7%。[29]

中國大陸的數據

根据最新2016年中國大陸的流行病学调研(調查研究),中國大陸儿童與青少年的ADHD患病率是6.26% (95% 信賴區間: 5.36–7.22%),这意味着中國大陸有數千万小於十八歲的未成年患有注意力缺陷/多动症。[30]

ADHD在香港兒童與青少年的流行率約落在5%至7%之間。[31][32] ADHD在澳門的流行率與國際盛行率相仿。[33]

越南的數據

越南國小學生族群中,ADHD的流行率約為7.7%。其中「注意力缺失型」約佔1.7%;「過動-衝動型」約佔5%;「混合型」約佔1%。[34]

各子類型中的個案性別平均分布。越南的研究指出,7.7%的流行率與鄰近的亞洲國家和世界其他國家的ADHD兒童流行率相仿,呼籲提升越南境內對ADHD的意識。[34]

大洋洲[编辑]

澳洲的數據

澳洲官方數據顯示,在18歲以下的兒童與青少年族群中,有大約11.2%的人患有ADHD。ADHD是澳洲未成年族群中最常見的心理疾患。[35]其中男性患者的比例為女性患者的將近三倍。[35]

歐洲[编辑]

西班牙的數據

ADHD在西班牙未成年族群中的盛行率約為6.8%。[36]

法國的數據

ADHD在法國大學生(平均年齡:20.6歲)中的盛行率約為5.6%。[37]

研究發現,有ADHD的大學生和沒有ADHD的大學生相較之下,有ADHD的大學生有顯著更高的機率需要重修課程以及顯著較低的學業成就。有ADHD的大學生相較之下也有顯著較多的物質或特定行為成癮的個案數,這些成癮的具體事例有:酒精成癮大麻成癮菸癮賭博成癮衝動購物症飲食障礙、和网络成瘾症等。[37]研究也點出「ADHD個別化醫療」的重要性。[37]

非洲[编辑]

非洲的數據

ADHD影響了大概5.4-8.7%的非洲兒童[38],然而此數據的品質並不高。[38]

文獻來源[编辑]

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