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Psych Congress  

Comorbidity Burden in Delayed and Non-Delayed ADHD Diagnosis among Commercially Insured Adults in the United States

Regina Grebla, PhD, MPH
Juliana Meyers, MA
Mayank Ajmera, PhD
Keith Davis, MA
Manjiri Pawaskar, PhD
Shire Development, LLC

Objectives: To compare comorbidities, mental health diagnoses (MHDs), and timing of diagnoses among adults with and without a delayed attention-deficit/hyperactivity disorder (ADHD) diagnosis. Methods: Patients with ≥2 ADHD diagnosis claims (ICD-9-CM codes 314.00-314.01) or ≥1 ADHD diagnosis and medication claim between 1/1/2006-12/31/2013 were identified in the PharMetrics database (first ADHD diagnosis defined study index date). Patients aged ≥25 years at index date, with ≥24 months pre- and ≥12 months post-index date enrollment, and no ADHD diagnoses pre-index date (newly observed ADHD) were selected. Patients were considered to have a delayed ADHD diagnosis if they had a MHD pre-index date without the diagnosis post-index date. Non-delayed patients had no MHDs pre-index date. Study measures included: Charlson comorbidity index (CCI) score, MHDs, and timing of ADHD diagnosis. Results: A total of 72,693 patients met the study inclusion criteria with 25,015 (34.4%) having a delayed ADHD-diagnosis. Anxiety (41.3%) and depression (27.8%) were the most common MHDs pre-index date among patients with a delay. CCI score was higher among patients with a delay versus without (mean[SD] 1.6[1.8] versus 0.8[1.4]). Patients with a delay had an average of 13.8 months between their first MHD and first ADHD diagnosis (median 13.0 and 16.8 months for patients with depression and mood disorders, respectively). Time to ADHD diagnosis was longest for patients with multiple MHDs pre-index date (median:18.4 months). Conclusions: Time to ADHD diagnosis increases with increasing number of pre-existing MHDs. Anxiety and depression were common among patients with a delayed ADHD diagnosis.

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