Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national survey

Abstract Background Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Despite its significance, no large-scale epidemiological study assessing ADHD, and its associated comorbidities in children and adolescents has been conducted in China. Methods Within a na...

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Main Authors: Jingran Liu, Zhongliang Jiang, Fenghua Li, Yi Zheng, Yonghua Cui, Hui Xu, Ying Li
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Annals of General Psychiatry
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Online Access:https://doi.org/10.1186/s12991-025-00558-w
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author Jingran Liu
Zhongliang Jiang
Fenghua Li
Yi Zheng
Yonghua Cui
Hui Xu
Ying Li
author_facet Jingran Liu
Zhongliang Jiang
Fenghua Li
Yi Zheng
Yonghua Cui
Hui Xu
Ying Li
author_sort Jingran Liu
collection DOAJ
description Abstract Background Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Despite its significance, no large-scale epidemiological study assessing ADHD, and its associated comorbidities in children and adolescents has been conducted in China. Methods Within a national epidemiological survey of 73,992 children and adolescents aged between 6 and 16 in China, we used the CBCL, MINI-KID, and DSM-IV to identify ADHD and its comorbid conditions. Chi-square tests were utilized to compare the prevalence estimates across varied age and sex groups. Results The overall ADHD prevalence was estimated at 6.4% (95% CI: 6.2–7.0%). Broken down by subtypes, ADHD-I had a prevalence of 3.9%, ADHD-C was at 1.7%, and ADHD-H was at 0.9%. Boys and the younger age bracket recorded higher prevalence rates for ADHD and its subtypes (p < 0.001). Among ADHD-diagnosed individuals, 53% exhibited at least one comorbid psychiatric disorder. Oppositional defiant disorder/conduct disorder (ODD/CD) was the most prevalent comorbidity for ADHD-C and ADHD-H, at 58%, while anxiety disorders, at 17%, were predominant among ADHD-I cases. ODD/CD was notably higher among younger subjects (p < 0.001). In contrast, anxiety disorders were more frequent in older children and in girls (p < 0.001). Tic disorders showed a higher prevalence in younger boys, whereas mood and substance use disorders were more common in older boys (p < 0.001). Conclusions ADHD is a common neurodevelopmental disorder with high comorbidity rates that vary substantially across subtypes, age, and sex. These clinical heterogeneities complicate management and highlight the need for tailored interventions.
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spelling doaj-art-aeadce76f53348119ab58a8d283a76b92025-08-20T02:28:10ZengBMCAnnals of General Psychiatry1744-859X2025-04-0124111110.1186/s12991-025-00558-wPrevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national surveyJingran Liu0Zhongliang Jiang1Fenghua Li2Yi Zheng3Yonghua Cui4Hui Xu5Ying Li6Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthKey Lab of Mental Health, Institute of Psychology, Chinese Academy of SciencesDepartment of pediatrics, Beijing Anding Hospital, Capital Medical UniversityDepartment of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthBig Data Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthAbstract Background Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder. Despite its significance, no large-scale epidemiological study assessing ADHD, and its associated comorbidities in children and adolescents has been conducted in China. Methods Within a national epidemiological survey of 73,992 children and adolescents aged between 6 and 16 in China, we used the CBCL, MINI-KID, and DSM-IV to identify ADHD and its comorbid conditions. Chi-square tests were utilized to compare the prevalence estimates across varied age and sex groups. Results The overall ADHD prevalence was estimated at 6.4% (95% CI: 6.2–7.0%). Broken down by subtypes, ADHD-I had a prevalence of 3.9%, ADHD-C was at 1.7%, and ADHD-H was at 0.9%. Boys and the younger age bracket recorded higher prevalence rates for ADHD and its subtypes (p < 0.001). Among ADHD-diagnosed individuals, 53% exhibited at least one comorbid psychiatric disorder. Oppositional defiant disorder/conduct disorder (ODD/CD) was the most prevalent comorbidity for ADHD-C and ADHD-H, at 58%, while anxiety disorders, at 17%, were predominant among ADHD-I cases. ODD/CD was notably higher among younger subjects (p < 0.001). In contrast, anxiety disorders were more frequent in older children and in girls (p < 0.001). Tic disorders showed a higher prevalence in younger boys, whereas mood and substance use disorders were more common in older boys (p < 0.001). Conclusions ADHD is a common neurodevelopmental disorder with high comorbidity rates that vary substantially across subtypes, age, and sex. These clinical heterogeneities complicate management and highlight the need for tailored interventions.https://doi.org/10.1186/s12991-025-00558-wADHDPrevalenceComorbidityChildren and adolescents
spellingShingle Jingran Liu
Zhongliang Jiang
Fenghua Li
Yi Zheng
Yonghua Cui
Hui Xu
Ying Li
Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national survey
Annals of General Psychiatry
ADHD
Prevalence
Comorbidity
Children and adolescents
title Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national survey
title_full Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national survey
title_fullStr Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national survey
title_full_unstemmed Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national survey
title_short Prevalence and comorbidity of attention deficit hyperactivity disorder in Chinese school-attending students aged 6–16: a national survey
title_sort prevalence and comorbidity of attention deficit hyperactivity disorder in chinese school attending students aged 6 16 a national survey
topic ADHD
Prevalence
Comorbidity
Children and adolescents
url https://doi.org/10.1186/s12991-025-00558-w
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