ADHD Prevalence in Spanish Preschoolers: Comorbidity, Socio-Demographic Factors, and Functional Consequences

J Atten Disord. 2018 Jan;22(2):143-153. doi: 10.1177/1087054716638511. Epub 2016 Mar 23.


Objective: The object was to examine the prevalence of ADHD among preschoolers, analyzing comorbidity, and the association with socio-demographic factors.

Method: We conducted a two-phase epidemiological study of 1,104 preschoolers aged 3 to 6 years in Catalonia, Spain. The Early Childhood Inventory-4 (ECI-4) was administered to parents and teachers. Children at risk of ADHD were assessed using open-ended face-to-face interviews and were observed in a school setting. ADHD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) criteria.

Results: The prevalence of ADHD diagnosis was 5.4%. Male sex and first-born status were risk factors for ADHD. Parents reported more symptoms (12.9%) than teachers (8.7%). Behavioral problems (odds ratio [OR] = 12, p = .001), autism spectrum disorder problems (OR = 9.5, p = .001), and obsessive-compulsive problems and tics (OR = 5.9, p = .001) were specifically related to ADHD diagnosis. Mother's health status and school achievement were lower in ADHD children.

Conclusion: Even at early stages of development, ADHD has high rates of comorbidity and a significant impact on school performance and family health.

Keywords: ADHD; comorbidity; epidemiology; preschool; prevalence.

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / complications*
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Autism Spectrum Disorder / complications
  • Autism Spectrum Disorder / epidemiology
  • Child
  • Child, Preschool
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Family Health
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / complications
  • Obsessive-Compulsive Disorder / epidemiology
  • Prevalence
  • Risk Factors
  • Spain / epidemiology
  • Tic Disorders / complications
  • Tic Disorders / epidemiology