What is it about?
Background: Attention deficit hyperactive disorder (ADHD) is a leading mental disorder among adolescents globally and is associated with premature mortality. Knowing the trends and key determinants of ADHD in youth are critical for earlier diagnosis and interventions. Methods: We retrospectively examined all hospitalizations in patients aged 11 to 18 years with ADHD in Spain, using data from the Spanish National Registry of Hospital Discharges spanning 2000 to 2021. We compared our data with available literature. Results: Over the 22-year study period, there were 2,015,589 hospitalizations among adolescents in Spain, with 118,609 (5.9%) cases involving mental disorders. There were 10,292 admissions with ADHD, representing 8.7% of all hospitalizations among youth with mental disorders. Median age was of 14 years. Boys represented 72.6%. Admissions with ADHD experienced a 17-fold increase during the last decade (p < .001). The in-hospital mortality rate for adolescents with ADHD was 0.1%, lower than for other mental disorders. During the first year of the COVID-19 pandemic, admissions decreased but resumed its rising trend thereafter. Conclusion: Hospital admissions for ADHD among adolescents have significantly increased in Spain during the last two decades. This increase outpaced the mild upward trend in ADHD diagnoses over the same period, which is not due to actual increases in the incidence of ADHD, which has remained stable at 5% worldwide. Factors beyond increased awareness, improved identification, and changes in diagnostic criteria must be considered. Boys represented 72.6% of these admissions. In-hospital mortality in adolescents with ADHD was lower than for admissions with other mental disorders.
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Why is it important?
The importance of this study lies in its demonstration of a significant increase in hospital admissions for ADHD among adolescents in Spain over the last two decades, revealing trends beyond just rising ADHD prevalence or improved diagnosis. Understanding these trends is critical to identifying key determinants and developing earlier diagnosis and targeted interventions to address ADHD effectively during adolescence. Additionally, highlighting the demographic profile (majority boys, median age 14) and the comparison of mortality rates with other mental disorders informs healthcare planning and resource allocation. The findings stress the need to explore factors other than diagnosis increases—such as healthcare access, comorbidities, or societal changes—that may contribute to this rise in hospitalizations.
Perspectives
As an author, I believe this article provides a critical and necessary perspective on the evolution of ADHD in adolescents from a hospital-based approach, highlighting that the increase in hospitalizations cannot be explained solely by greater recognition or diagnosis of the disorder. I find it relevant that the discrepancy between the stable worldwide incidence of ADHD and the sharp rise in hospital admissions is emphasized, suggesting the influence of additional factors such as possible changes in case severity, associated comorbidities, or variations in mental health policies and practices. I also consider that the low mortality rate compared to other mental disorders reflects advances in care, although it should not lead to underestimating ADHD as a significant clinical problem. In summary, this work encourages deeper understanding of the causes behind these trends and improving early detection and intervention to minimize the impact of ADHD in adolescence.
Octavio Corral Pazos de Provens
Universidad Internacional de La Rioja
Read the Original
This page is a summary of: Rising Rate of Hospitalizations in Adolescents with Attention Deficit Hyperactive Disorder in Spain, Journal of Attention Disorders, February 2025, SAGE Publications,
DOI: 10.1177/10870547251320210.
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