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Open Access 01-12-2019 | Attention Deficit Hyperactivity Disorder | Protocol

Prevalence and comorbidity of attention deficit hyperactivity disorder in Spain: study protocol for extending a systematic review with updated meta-analysis of observational studies

Authors: Ferrán Catalá-López, Manuel Ridao, Amparo Núñez-Beltrán, Ricard Gènova-Maleras, Adolfo Alonso-Arroyo, Rafael Aleixandre-Benavent, Miguel A. Catalá, Rafael Tabarés-Seisdedos

Published in: Systematic Reviews | Issue 1/2019

Abstract

Background

Attention deficit hyperactivity disorder (ADHD) is a childhood-onset disorder characterized by a persistent pattern of symptoms of developmentally inappropriate and impaired inattention and/or hyperactivity/impulsivity, with difficulties often continuing into adulthood. ADHD can come with other comorbid conditions. The aim of this study will be to quantify the prevalence and comorbidity of ADHD among children, adolescent, and adult population in Spain.

Methods/design

We designed and registered a study protocol for an update and expansion of a systematic review and meta-analysis of pooled prevalence data. We will include cross-sectional observational studies reporting prevalence of ADHD in Spain and conducted in the general population, outpatient, and/or school settings. The primary outcome will be the prevalence of ADHD. Secondary outcomes will be the prevalence of any physical or mental comorbidity in association with ADHD. No limitations will be imposed on publication status, study conduct period, and language of dissemination. Comprehensive literature searches will be conducted in multiple electronic databases, including PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO, IME – Spanish Medical Index, and IBECS – Spanish Bibliographic Index of Health Sciences. We will also search Google Scholar, dissertation databases, and conference abstracts. Two team members will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis. Prevalence estimates will be stratified according to gender, age, and geographical location. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., methodological quality, sample size, diagnostic criteria).

Discussion

This systematic review and meta-analysis of observational data will provide an updated synthesis of the prevalence and comorbidity of ADHD in Spain. This study will also examine factors that may explain potential variations in prevalence data. The findings of this study will be published in a peer-reviewed journal.

Systematic review registration

PROSPERO CRD42018106082.

Available only for authorised users

Thapar A, Cooper M. Attention deficit hyperactivity disorder. Lancet. 2016;387(10024):1240–50. https://doi.org/10.1016/S0140-6736(15)00238-X.CrossRefPubMed

Verkuijl N, Perkins M, Fazel M. Childhood attention-deficit/hyperactivity disorder. BMJ. 2015;350:h2168. https://doi.org/10.1136/bmj.h2168.CrossRefPubMed

Feldman HM, Reiff MI. Clinical practice. Attention deficit-hyperactivity disorder in children and adolescents. N Engl J Med. 2014;370(9):838–46. https://doi.org/10.1056/NEJMcp1307215.CrossRefPubMed

Biederman J, Kwon A, Aleardi M, Chouinard VA, Marino T, Cole H, et al. Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects. Am J Psychiatry. 2005;162(6):1083–9. https://doi.org/10.1176/appi.ajp.162.6.1083.CrossRefPubMed

Muskens JB, Velders FP, Staal WG. Medical comorbidities in children and adolescents with autism spectrum disorders and attention deficit hyperactivity disorders: a systematic review. Eur Child Adolesc Psychiatry. 2017;26(9):1093–103. https://doi.org/10.1007/s00787-017-1020-0.CrossRefPubMedPubMedCentral

Tung I, Li JJ, Meza JI, Jezior KL, Kianmahd JS, Hentschel PG, O'Neil PM, Lee SS. Patterns of comorbidity among girls with ADHD: a meta-analysis. Pediatrics. 2016;138(4):e20160430.

Catalá-López F, Alonso-Arroyo A, Page MJ, Hutton B, Tabarés-Seisdedos R, Aleixandre-Benavent R. Mapping of global scientific research in comorbidity and multimorbidity: a cross-sectional analysis. PLoS One. 2018;13(1):e0189091. https://doi.org/10.1371/journal.pone.0189091.CrossRefPubMedPubMedCentral

Brodersen J, Schwartz LM, Heneghan C, O'Sullivan JW, Aronson JK, Woloshin S. Overdiagnosis: what it is and what it isn't. BMJ Evid Based Med. 2018;23(1):1–3. https://doi.org/10.1136/ebmed-2017-110886.CrossRefPubMed

Bowers S. Why are we failing young patients with ADHD? BMJ. 2014;349:g6082. https://doi.org/10.1136/bmj.g6082.CrossRefPubMed

10.

Thomas R, Mitchell GK, Batstra L. Attention-deficit/hyperactivity disorder: are we helping or harming? BMJ. 2013;347:f6172. https://doi.org/10.1136/bmj.f6172.CrossRefPubMed

11.

Taylor E. Attention deficit hyperactivity disorder: overdiagnosed or diagnoses missed? Arch Dis Child. 2017;102(4):376–9. https://doi.org/10.1136/archdischild-2016-310487.CrossRefPubMed

12.

Coon ER, Quinonez RA, Moyer VA, Schroeder AR. Overdiagnosis: how our compulsion for diagnosis may be harming children. Pediatrics. 2014;134(5):1013–23. https://doi.org/10.1542/peds.2014-1778.CrossRefPubMed

13.

Morrow RL, Garland EJ, Wright JM, Maclure M, Taylor S, Dormuth CR. Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children. CMAJ. 2012;184(7):755–62. https://doi.org/10.1503/cmaj.111619.CrossRefPubMedPubMedCentral

14.

Hoekstra PJ, Buitelaar JK. Is the evidence base of methylphenidate for children and adolescents with attention-deficit/hyperactivity disorder flawed? Eur Child Adolesc Psychiatry. 2016 Apr;25(4):339–40. https://doi.org/10.1007/s00787-016-0845-2.CrossRefPubMed

15.

Storebø OJ, Simonsen E, Gluud C. The evidence base of methylphenidate for children and adolescents with attention-deficit hyperactivity disorder is in fact flawed. Eur Child Adolesc Psychiatry. 2016;25(9):1037–8. https://doi.org/10.1007/s00787-016-0855-0.CrossRefPubMed

16.

The Lancet. The realities and needs of children living with ADHD. Lancet. 2014;384(9938):104. https://doi.org/10.1016/S0140-6736(14)61146-6.CrossRef

17.

McGough JJ. Treatment controversies in adult ADHD. Am J Psychiatry. 2016;173(10):960–6. https://doi.org/10.1176/appi.ajp.2016.15091207.CrossRefPubMed

18.

GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390(10100):1211–59. https://doi.org/10.1016/S0140-6736(17)32154-2.CrossRef

19.

Thomas R, Sanders S, Doust J, Beller E, Glasziou P. Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics. 2015;135(4):e994–1001. https://doi.org/10.1542/peds.2014-3482.CrossRefPubMed

20.

Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434–42. https://doi.org/10.1093/ije/dyt261.CrossRefPubMedPubMedCentral

21.

Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics. 2012;9(3):490–9. https://doi.org/10.1007/s13311-012-0135-8.CrossRefPubMedPubMedCentral

22.

Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry. 2007;164(6):942–8. https://doi.org/10.1176/ajp.2007.164.6.942.CrossRefPubMed

23.

Erskine HE, Ferrari AJ, Nelson P, Polanczyk GV, Flaxman AD, Vos T, et al. Epidemiological modelling of attention-deficit/hyperactivity disorder and conduct disorder for the global burden of disease study 2010. J Child Psychol Psychiatry. 2013;54(12):1263–74. https://doi.org/10.1111/jcpp.12144.CrossRefPubMed

24.

Erskine HE, Ferrari AJ, Polanczyk GV, Moffitt TE, Murray CJ, Vos T, et al. The global burden of conduct disorder and attention-deficit/hyperactivity disorder in 2010. J Child Psychol Psychiatry. 2014;55(4):328–36. https://doi.org/10.1111/jcpp.12186.CrossRefPubMed

25.

Global Burden of Disease Child and Adolescent Health Collaboration, Kassebaum N, Kyu HH, Zoeckler L, Olsen HE, Thomas K, et al. Child and adolescent health from 1990 to 2015: findings from the Global Burden Diseases, Injuries, and Risk Factors 2015 Study. JAMA Pediatr. 2017;171(6):573–92. https://doi.org/10.1001/jamapediatrics.2017.0250.CrossRef

26.

Erskine HE, Baxter AJ, Patton G, Moffitt TE, Patel V, Whiteford HA, et al. The global coverage of prevalence data for mental disorders in children and adolescents. Epidemiol Psychiatr Sci. 2017;26(4):395–402. https://doi.org/10.1017/S2045796015001158.CrossRefPubMed

27.

Wang T, Liu K, Li Z, Xu Y, Liu Y, Shi W, Chen L. Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis. BMC Psychiatry. 2017;17(1):32. https://doi.org/10.1186/s12888-016-1187-9.CrossRefPubMedPubMedCentral

28.

Alhraiwil NJ, Ali A, Househ MS, Al-Shehri AM, El-Metwally AA. Systematic review of the epidemiology of attention deficit hyperactivity disorder in Arab countries. Neurosciences. 2015;20(2):137–44. https://doi.org/10.17712/nsj.2015.2.20140678.CrossRefPubMedPubMedCentral

29.

Catalá-López F, Peiró S, Ridao M, Sanfélix-Gimeno G, Gènova-Maleras R, Catalá MA. Prevalence of attention deficit hyperactivity disorder among children and adolescents in Spain: a systematic review and meta-analysis of epidemiological studies. BMC Psychiatry. 2012;12:168. https://doi.org/10.1186/1471-244X-12-168.CrossRefPubMedPubMedCentral

30.

Program of Activities for the Early Detection of Health Problems between 0 and 14 years-old: Effectiveness, safety and economic evaluation of the existing alternatives for the early detection of Attention Deficit Hyperactivity Disorder (ADHD). Reports of Health Technology Assessment. Health Sciences Institute in Aragón (IACS). Madrid: Ministry of Health, Social Services and Equality; 2016. http://www.iacs.es/wp-content/uploads/2017/05/758-IACS-TDAH.pdf. Accessed 1 Feb 2019.

31.

ABC [News]. El 6,8% de los niños españoles padecería trastorno por déficit de atención e hiperactividad. December 12, 2013. http://www.abc.es/salud/noticias/20131111/abci-ninos-espanoles-padeceria-trastorno-201311291110.html. Accessed 22 June 2018.

32.

Carballal Mariño M, Gago Ageitos A, Ares Alvarez J, Del Rio Garma M, García Cendón C, Goicoechea Castaño A, et al. Prevalence of neurodevelopmental, behavioural and learning disorders in Pediatric Primary Care. An Pediatr (Barc). 2017 doi: https://doi.org/10.1016/j.anpedi.2017.10.007.

33.

Canals J, Morales-Hidalgo P, Jané MC, Domènech E. ADHD prevalence in Spanish preschoolers: comorbidity, socio-demographic factors, and functional consequences. J Atten Disord. 2018;22(2):143–53. https://doi.org/10.1177/1087054716638511.CrossRefPubMed

34.

Cerrillo-Urbina AJ, García-Hermoso A, Martínez-Vizcaíno V, Pardo-Guijarro MJ, Ruiz-Hermosa A, Sánchez-López M. Prevalence of probable attention-deficit/hyperactivity disorder symptoms: result from a Spanish sample of children. BMC Pediatr. 2018;18(1):111. https://doi.org/10.1186/s12887-018-1083-1.CrossRefPubMedPubMedCentral

35.

An integrative metaregression framework for descriptive epidemiology. Flaxman AD, Vos T, Murray CJL (Editors). Seattle: University of Washington Press; 2015. http://www.washington.edu/uwpress/search/books/FLAINT.html.

36.

Barendregt JJ, Doi SA, Lee YY, Norman RE, Vos T. Meta-analysis of prevalence. J Epidemiol Community Health. 2013;67(11):974–8. https://doi.org/10.1136/jech-2013-203104.CrossRefPubMed

37.

Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Chapter 5: Systematic reviews of prevalence and incidence. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer's Manual. The Joanna Briggs Institute; 2017. https://wiki.joannabriggs.org/. Accessed 22 June 2018.

38.

Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Methodological guidance for systematic reviews of observational epidemiological studies reporting prevalence and cumulative incidence data. Int J Evid Based Healthc. 2015;13(3):147–53. https://doi.org/10.1097/XEB.0000000000000054.CrossRefPubMed

39.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1. https://doi.org/10.1186/2046-4053-4-1.CrossRefPubMedPubMedCentral

40.

Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;350:g7647. https://doi.org/10.1136/bmj.g7647.CrossRefPubMed

41.

McGowan J, Sampson M, Salzwedel DM, Cogo E, Foerster V, Lefebvre C. PRESS peer review of electronic search strategies: 2015 guideline statement. J Clin Epidemiol. 2016;75:40–6. https://doi.org/10.1016/j.jclinepi.2016.01.021.CrossRefPubMed

42.

Catalá-López F, Ridao M, Hurtado I, Núñez-Beltrán A, Gènova-Maleras R, Alonso-Arroyo A, et al. Prevalence and comorbidity of autism spectrum disorder in Spain: study protocol for a systematic review and meta-analysis of observational studies. PROSPERO 2018 CRD42018090372. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018090372. Accessed 1 Feb 2019.

43.

Valderas JM, Mendivil J, Parada A, Losada-Yáñez M, Alonso J. Development of a geographic filter for PubMed to identify studies performed in Spain. Rev Esp Cardiol. 2006;59(12):1244–51. https://doi.org/10.1016/S1885-5857(07)60080-2.CrossRefPubMed

44.

Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. https://doi.org/10.1371/journal.pmed.1000097.CrossRefPubMedPubMedCentral

45.

Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–60. https://doi.org/10.1136/bmj.327.7414.557.CrossRefPubMedPubMedCentral

46.

Deeks JJ, Higgins JPT, Altman DG. Chapter 9: Analysing data and undertaking meta-analyses. In: JPT H, Green S, editors. Cochrane handbook for systematic reviews of interventions. Chichester (UK): Wiley; 2008.

47.

Cochran WG. The combination of estimates from different experiments. Biometrics. 1954;10:101–29. https://doi.org/10.2307/3001666.CrossRef

48.

Harbord RM, Higgins JPT. Meta-regression in Stata. Stata J. 2008;8(4):493–519.CrossRef

49.

Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315(7109):629–34. https://doi.org/10.1136/bmj.315.7109.629.CrossRefPubMedPubMedCentral

50.

Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics. 1994;50(4):1088–101. https://doi.org/10.2307/2533446.CrossRefPubMed

51.

StataCorp: Stata Statistical Software: Release 15. College Station, TX: StataCorp LP; 2017.

52.

Palmer TM, Sterne JAC, Newton HJ, Cox NJ (Editors). Meta-analysis in Stata: an updated collection from the Stata journal. Second ed. College Station, TX: StataCorp LP; 2016.

53.

Staniszewska S, Brett J, Simera I, Seers K, Mockford C, Goodlad S, et al. GRIPP2 reporting checklists: tools to improve reporting of patient and public involvement in research. BMJ. 2017;358:j3453. https://doi.org/10.1136/bmj.j3453.CrossRefPubMedPubMedCentral

54.

Brett J, Staniszewska S, Simera I, Seers K, Mockford C, Goodlad S, et al. Reaching consensus on reporting patient and public involvement (PPI) in research: methods and lessons learned from the development of reporting guidelines. BMJ Open. 2017;7(10):e016948. https://doi.org/10.1136/bmjopen-2017-016948.CrossRefPubMedPubMedCentral

55.

Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA. 2000;283(15):2008–12. https://doi.org/10.1001/jama.283.15.2008.CrossRefPubMed

56.

Catalá-López F, Hutton B, Núñez-Beltrán A, Page MJ, Ridao M, Macías Saint-Gerons D, et al. The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: a systematic review with network meta-analyses of randomised trials. PLoS One. 2017;12(7):e0180355. https://doi.org/10.1371/journal.pone.0180355.CrossRefPubMedPubMedCentral

57.

Catalá-López F, Hutton B, Page MJ, Ridao M, Driver JA, Alonso-Arroyo A, et al. Risk of mortality among children, adolescents, and adults with autism spectrum disorder or attention deficit hyperactivity disorder and their first-degree relatives: a protocol for a systematic review and meta-analysis of observational studies. Syst Rev. 2017;6(1):189. https://doi.org/10.1186/s13643-017-0581-9.CrossRefPubMedPubMedCentral

Title: Prevalence and comorbidity of attention deficit hyperactivity disorder in Spain: study protocol for extending a systematic review with updated meta-analysis of observational studies
Authors: Ferrán Catalá-López
Manuel Ridao
Amparo Núñez-Beltrán
Ricard Gènova-Maleras
Adolfo Alonso-Arroyo
Rafael Aleixandre-Benavent
Miguel A. Catalá
Rafael Tabarés-Seisdedos
Publication date: 01-12-2019
Publisher: BioMed Central
Keywords: Attention Deficit Hyperactivity Disorder
Attention Deficit Hyperactivity Disorder
Published in: Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-019-0967-y

ACC 2024 Congress

Springer Medicine

Prevalence and comorbidity of attention deficit hyperactivity disorder in Spain: study protocol for extending a systematic review with updated meta-analysis of observational studies

Abstract

Background

Methods/design

Discussion

Systematic review registration

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods/design

Discussion

Systematic review registration

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