https://doi.org/10.1177/1087054720905664
Journal of Attention Disorders
1–4
© The Author(s) 2020
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DOI: 10.1177/1087054720905664
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Research Brief
Introduction
ADHD diagnosis is based on the assessment of behavioral
symptoms. Prevalence estimates for this disease have there-
fore been at the core of an international debate in the last
two decades (Polanczyk et al., 2007, 2014).
In France, the only available study carried out telephone
inquiries in 2008 from a 7,912 randomly selected sample of
households. The researchers estimated that 3.5% children
suffered from ADHD, while 2.2% other children were
treated with psychostimulants for attention deficit or hyper-
activity symptoms without having formally been diagnosed
(Lecendreux et al., 2011). The use of a rigorous scientific
approach and a strong methodology which had been inter-
nationally duplicated (Lecendreux et al., 2011) let the
authors conclude the prevalence rate of children suffering
from ADHD in France ranged from 3.5% to 5.6%. They
also noted that among the 3.5% of children who were diag-
nosed with ADHD, 36.5% were being treated with methyl-
phenidate (Lecendreux et al., 2011). Therefore, they
estimated that 3.48% of children aged 6 to 12 were effec-
tively treated with psychostimulants: 2.2% + (3.5% ×
0.365) = 3.48%.
Another way of estimating diagnosis and methylpheni-
date prescription rates for ADHD is the analysis of data
belonging to national health care insurance systems
(Yoshida et al., 2020; Zhou et al., 2020). Although these
data are not strictly equivalent to an effective prevalence
rate, a more precise prevalence rate of medication use for
ADHD and/or rate of ADHD diagnosis could only help
researchers, professionals, and parents have access to the
best level of information available on the epidemiology of
the disorder.
In 2017, a report was issued by the National Agency for
Medicines and Health Products Safety
1
using data from the
French National Social Security System (Système National
d’Information Inter-Régimes de l’Assurance Maladie
[SNIIRAM]) concerning methylphenidate consumption
among children aged 6 to 11. This report showed that 19,613
children aged 6 to 11 were effectively treated with methyl-
phenidate in 2014 (Agence nationale de sécurité du médica-
ment et des produits de santé [ANSM], 2017). The study
905664JAD XX X 10.1177/1087054720905664Journal of Attention DisordersPonnou and Haliday
research-article 2020
1
Université de Rouen, Mont-Saint-Aignan, France
2
Paris Nanterre University, France
Corresponding Author:
Sébastien Ponnou, UFR Lettres et Sciences Humaines, Université de
Rouen, Place Emile Blondel, 76821 Mont-Saint-Aignan, France.
Email: sebastien.ponnou-delaffon@univ-rouen.fr
ADHD Diagnosis and Drug Use Estimates
in France: A Case for Using Health Care
Insurance Data
Sébastien Ponnou
1
and Héloïse Haliday
2
Abstract
Objective: Prevalence estimates for ADHD have been debated for decades. In France, the only available study states the
prevalence rate in France ranges from 3.5% to 5.6% of children aged 6 to 12. It also evaluates that 3.48% of children aged
6 to 12 are treated with psychostimulants. The article uses a different method to determine whether these estimates
hold true. Method: Estimating ADHD diagnosis and methylphenidate prescription rates can be done by analyzing national
health care insurance system’s data. We used data from the French Healthcare Insurance as reported by the National
Agency for Medicines and Health Products Safety. Results: We claim that an adequate estimate of the ADHD prevalence
rate in France fluctuates around 0.3% of children aged 6 to 11. Discussion: Methodological biases in ADHD prevalence
studies and factors contributing to the low level of prescription in France need to be assessed. Conclusion: We call for
supplementary investigations in health care insurance databases to conduct contradictory studies. (J. of Att. Dis. XXXX;
XX(X) XX-XX)
Keywords
ADD/ADHD, prevalence, methylphenidate