OBJECTIVES : Give a descriptive overview of attention-deficit/hyperactivity disorder (ADHD) in Germany by examining characteristics of, and treatment patterns in, patients with ADHD.

METHODS : Retrospective, observational analysis using the InGef research database containing anonymized healthcare claims of ~4 million individuals from ~60 German health insurances. Patients had a confirmed diagnosis of ADHD (International Classification of Diseases, 10^th Revision, German Modification [ICD-10-GM] code F90/F90.0/F90.1/F90.8/F90.9) and were observable for ≥1 day between 1 January 2015 and 31 December 2017. Analyses included stratification by age groups of special interest (children/adolescents: 6–17 years; adults: ≥18 years) and sex. Co-occurring illnesses were identified by ICD-10-GM codes.

RESULTS : ADHD administrative prevalence in Germany in 2015/2016/2017 was estimated as 6.23%/6.19%/6.25% for children/adolescents and 0.30%/0.34%/0.37% for adults, respectively. The analysis included 66,275 patients with ADHD (7.85% <6 years, 39.79% 6–11 years, 26.81% 12–17 years, 14.96% 18–29 years, 10.59% ≥30 years); 71.57% were male (73.30% of children/adolescents; 66.56% adults). The total numbers of patients receiving ADHD-indicated pharmacotherapy in 2015/2016/2017 were 15,368/42,006 (36.59%), 15,603/43,944 (35.51%) and 16,071/45,041 (35.68%), respectively. Co-occurring mental/behavioural disorders of special interest were common in adult (male/female) patients with ADHD in 2017: psychoactive substance abuse 19.49%/16.64%, depression 32.48%/52.27%, other anxiety disorders (including generalized anxiety disorder) 11.58%/22.17%, eating disorders 1.03%/7.28% and personality disorders 8.77%/16.83%. Rates of co-occurring somatic illnesses of special interest in 2017 for adult males/females were: diabetes 3.19%/5.30% and obesity 9.18%/16.12%.

CONCLUSIONS : In this German study, the administrative prevalence of ADHD among adults was lower than estimates of epidemiological prevalence,¹ suggesting potential under-diagnosis/treatment. Co-occurring illnesses (mental/behavioural and somatic) were commonly comorbid with ADHD in adults, reflective of patterns seen in other countries,^1,2 and most common illnesses occurred more frequently in females than males.

1. Fayyad J, et al. Atten Defic Hyperact Disord 2017;9:47–65.
2. Ahnemark E, et al. BMC Psychiatry 2018;18:223.