The Prevalence of Attention Deficit Hyperactivity Disorder in Iran: A Systematic Review

Article excerpt

Objectives: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder of childhood. Children with ADHD may experience significant functional problems. Our objective was to examine the prevalence of ADHD and its subtypes in Iran.

Methods: Pubmed, ISI web of science, psychinfo, Iranpsych, Iranmedex, Irandoc were searched. Irandoc, Iranmedex and Iranpsych are Iranian databases of which the last one is especially for psychiatry and psychology literature.

Inclusion criteria were: conducting studies by random sampling, using valid instruments to assess ADHD diagnosis or symptoms ,and presenting a prevalence of ADHD or attention deficit and / or hyperactivity symptoms.

Results: after quality assessment, 16 studies were accepted. Their estimation of prevalence was different as different scales were used. Hyperactive type was more prevalent in boys, and inattentive type was more prevalent in girls.

Conclusion: Being aware of the epidemiology of ADHD in Iran helps us to make improvements in planning the allocation of funds for mental health services. Using one instrument in studying the prevalence of ADHD in a population may lead to more precise estimations.

Keywords: Attention deficit disorder with hyperactivity, Iran, Prevalence, Review

Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in children. ADHD is also among the most prevalent chronic health conditions affecting school-aged children. The core symptoms of ADHD include inattention, hyperactivity, and impulsivity (1, 2). Children with ADHD may experience significant functional problems such as school difficulties, academic underachievement (3), troublesome interpersonal relationships with family members (4, 5) and peers, and low self-esteem. Children with ADHD may continue to show symptoms as they enter adolescence and adulthood (6, 7).

Children with ADHD might have serious social problems not only caused by the disorder, but also due to co morbidity with other disorders, leading to serious social withdrawal. Early diagnostic and treatment of ADHD might improve educational and psychosocial development of these children.

The prevalence rate of attention deficit hyperactivity disorder (ADHD) is a controversial matter. Although the DSM-IV gives an interval of between 3% to 5%, possibly the value most widely accepted by the scientific community, there is in fact a very high degree of variability.

Several literature reviews have reported highly variable rates worldwide, ranging from as low as 1% to as high as nearly 20% among school-age children (8, 9).

There is concern that ADHD/HD may be a product of cultural factors and this has promoted an enduring debate in the medical literature (9-11). Other experts have argued that the variability of ADHD/HD prevalence estimates may be best explained by the use of different case definitions and that no variability of the actual prevalence across geographical sites should be found when case definitions are the same (4, 9, 12). Some studies have been conducted in our country to determine the prevalence of ADHD in Iran.

Awareness of the epidemiology of ADHD in Iran helps us to plan the allocation of funds for mental health services in a more effective manner. Further knowledge on this issue would be valuable for the development of policies in the education sector.

The main purpose of this study was to conduct a review of literature on the prevalence of ADHD in Iran.

Materials and Method

A systematic review of literature was performed to identify the prevalence of ADHD in Iranian children and adolescents (up to 18 years old) from 1977. Inclusion criteria were: 1) conducting a study by generalizability of the produced data to the population of the same age; 2) using valid instruments to assess ADHD diagnosis or symptoms; and 3) presenting a prevalence of ADHD or attention deficit and / or hyperactivity symptoms. …