Background: Little is known regarding risk for co-occurring mental health conditions among pediatric patients with congenital adrenal hyperplasia (CAH).The objective of the current study was to investigate the prevalence of medically managed attention-deficit/ hyperactivity disorder (ADHD) in 2 large administrative samples of insured children and adolescents with and without CAH in the United States. Methods: We assessed the prevalence of CAH and of medically managed ADHD using algorithms defined from diagnosis codes and filled prescriptions data using the IBM MarketScan Commercial and Multi-State Medicaid claims databases. We evaluated subjects who were continuously enrolled for ≥ 12 months with a first claim during October 2015 through December 2017 when they were 5 to 18 years old. Results: The administrative prevalence of CAH in the Commercial (N = 3 685 127) and Medicaid (N = 3 434 472) samples was 10.1 per 100 000 (n = 372) and 7.2 per 100 000 (n = 247), respectively.The prevalence of medically managed ADHD in the non-CAH population was 8.4% in the Commercial sample and 15.1% in the Medicaid sample. Among children with CAH, there was no increased prevalence of ADHD in the Commercial (9.2%, prevalence ratio [PR] = 1.1; 95% confidence interval [CI], 0.82-1.54; P = 0.48) or Medicaid (13.8%; PR = 0.91; 95% CI, 0.67–1.24; P = 0.55) samples compared with the general population. Conclusions: Using 2 large samples of insured children and adolescents in the United States, we found similar prevalence of medically managed ADHD among those with CAH and the general population. Future research to assess the validity of our claims algorithm for identifying pediatric CAH cases is warranted.
Bibliographical noteFunding Information:
This research was supported by the National Institutes of Health grants F30 CA223591 to L.A.H. and T32 GM008244 to the University of Minnesota Medical Scientist Training Program. This research was also supported by the National Institutes of Health?s National Center for Advancing Translational Sciences, grant UL1TR002494. K.S. receives research support from the National Institutes of Health National Cancer Institute (R01 CA181024); Office of Orphan Products Development of the Food and Drug Administration (R01FDR0006100); Alexion, Inc.; Spruce Biosciences; and Neurocrine Biosciences. L.A.H. and S.D.G. have no financial disclosures to report.
© The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society.
- Administrative data
- Attention-deficit/hyperactivity disorder
- Behavioral health
- Congenital adrenal hyperplasia
- Health insurance claims