Prevalence of ADHD diagnoses among children and young people

Quality report

Data description

Description of statistic

The Prevalence of ADHD diagnoses among children and young people statistics describe the proportion of children aged between 7 and 12 and young people aged between 13 and 17 who have been diagnosed with ADHD in primary health care and specialised medical care within the population of the same age in various years. The statistics describe data by gender and wellbeing services county, and the statistics cover the whole of Finland.

The statistics are based on the Finnish Institute for Health and Welfare’s (THL) Care Register for Health Care (Hilmo) and the Dispensed medicines reimbursable under the National Health Insurance scheme (formerly known as the Kela Prescription Register). The latest data, reported here, concerns the year 2023.

The statistics are aimed at professionals in the welfare of children and young people, especially social welfare and health care professionals, administrative authorities, researchers in the field and other people who need information on the subject in their work.

Relevance

The aim of the statistics is to provide an overview of the prevalence of ADHD diagnoses and ADHD medication use among children and young people.

The statistics are part of the Finnish Institute for Health and Welfare’s (THL) monitoring of the health and well-being of children, young people and families (FinChildren). The aim of the monitoring is to produce comparable, topical and nationally and regionally representative data on the health and welfare of children, young people and families, related factors and changes that have occurred over time. Reliable, comparable and up-to-date data is necessary for monitoring the health and welfare of children, young people and families, developing and evaluating services as well as for decision-making at the national and regional levels. Nationally uniform data also enables the monitoring and evaluation of the outcomes of the work of service providers and health care professionals.

The collection of data for the statistics is based on the Act on the National Institute for Health and Welfare (668/2008) and the Act on the Electronic Processing of Client Data in Healthcare and Social Welfare and Health Care (159/2007).

Data content of the statistics

The statistics describe the numbers and proportions of children aged 7–12 and young people aged 13–17 who have used primary health care and specialised medical care services with an ADHD diagnosis recorded at least once during the calendar year as the reason for an appointment or as a primary, secondary, or long-term diagnosis.

The statistics also describe the prevalence of ADHD medication use among children and young people aged 7–17. An ADHD medication user is defined as someone to whom at least one purchase of ADHD medication reimbursable under the health insurance scheme has been registered during the statistical period.

The statistics contain information on the prevalence of ADHD diagnoses among children and young people in Finland in the period 2015–2023 (so-called annual prevalence) and illustrate the trend in ADHD diagnoses in Finland by age and gender group. The report also compares the prevalence of ADHD diagnoses and the use of ADHD medications in different wellbeing services counties in 2023. The population of the statistics is formed by the cohort of children and young people aged 7–17. The wellbeing services counties of mainland Finland and the City of Helsinki were included in the examination of regional differences.

Statistical process

Source data

The following register data serve as the source material for the statistic:

  • Prevalence of ADHD diagnoses: Care Register for Health Care administered by THL (Hilmo). Hilmo is a national health care data collection and reporting system. This statistical report uses the data from the Care Register for Primary Health Care (Avohilmo) and Register for Specialist Medical Care (TerveysHilmo). This data is transferred electronically from the patient record systems to the care notification system. The majority of data is transferred using an automatic solution.
  • Prevalence of the use of ADHD medication: Dispensed medicines reimbursable under the National Health Insurance scheme (formerly known as the Kela Prescription Register). All persons permanently resident in Finland are covered by health insurance. As far as is known, the register contains complete information on all purchases of ADHD medications from pharmacies for children and young people. The person who has been delivered the reimbursed medications is recorded as the recipient.
  • The information on the children’s and young people’s ages is based on the age of the persons at the end of the calendar year. The information on the county is based on the person’s permanent municipality of residence at the end of the calendar year. With regard to ADHD diagnoses, it has been noted that if a person has moved from one county to another during the year and has used health care services in both counties, they are included in the figures for both counties. The person is only included once in the data for the whole country.
  • Population data is based on the population of the entire country and wellbeing services counties at the end of the calendar year. Kela’s population data has been used in the statistics. These may differ slightly from the official population data of Statistics Finland, as at Kela, sampling takes place on 31 December and correction on 27 January. Statistics Finland only publishes its statistics later in the spring. However, the deviations are small and do not affect the presented proportions of population with ADHD.

Data collection

Care Register for Health Care (Hilmo, THL): Data from the patient records systems of the wellbeing services counties is mainly extracted automatically and transferred to the Care Register for Health Care through a technical interface. Hilmo data is submitted to THL daily. However, data can be submitted less frequently throughout the year if this is justified based on the nature of the service provider’s activities or for other reasons. In this case, Hilmo data concerning an individual calendar year must be submitted by the end of February of the following year (28 February). Any corrections and additions to previously submitted Hilmo data must also be made by 28 February.

These statistics take into account data recorded in the Hilmo registers by 3 February 2025. Data were extracted from these registers and finally, this individual-level data was aggregated into statistics presented in a table.

Dispensed medicines reimbursable under the National Health Insurance scheme (Kela): The data in the statistics was extracted from the person-based data on dispensed medicines formed based on a pharmacy accounting benefit system. The population of the statistics consists of persons who have made at least one purchase of ADHD medications reimbursed through a pharmacy. For medications used for treating ADHD in children and adolescents, the following medicinal products were taken into account: methylphenidate (ATC code N06BA04), lisdexamfetamine (N06BA12), dexamfetamine (N06BA2), atomoxetine (N06BA09) and guanfacine (C02AC02). The data is completed by the end of February of the year following the statistical year.

Data validation

Care Register for Health Care (Hilmo, THL): The Finnish Institute for Health and Welfare validates the data of the wellbeing services county mainly in relation to the county’s data from previous monitoring periods. The aim of validation is to detect possible errors in the delivery of data. The validation is not based on precise threshold values. THL only requests validation from wellbeing services counties if the possible error is significant or there are ambiguities or illogicalities in the data as a whole. Indeed, some of the possible errors turn out to be correct data explained by some change in approaches.

Dispensed medicines reimbursable under the National Health Insurance scheme (Kela): Any errors detected in the data are corrected immediately. Statistics on dispensed medicines reimbursable under health insurance have been available since 1993. Annually, Kela and the Finnish Medicines Agency Fimea produce the Finnish Statistics on Medicines publication together.

Data compilation

For statistical purposes, the individual-level Hilmo and Kela data have been aggregated by age and gender. The data has been reported as the number of cases and percentages relative to the population of the same age and gender. The possibilities for the further processing of aggregated data presented in a table are limited.

Data revision

Data from previous statistical years is updated retroactively, if necessary, in connection with the next statistical publication. The impact of retrospective corrections on the figures has been mainly seen to be minor.

Quality assessment of the statistics

Accuracy and reliability

The accuracy of data on diagnoses depends on the quality and accuracy of the data provided by informants and ultimately recorded in the patient record systems by professionals. The data is transferred from the patient record systems to THL’s Care Register for Health Care electronically and mainly automatically. THL, service providers and information system suppliers monitor the quality and coverage of data using quick reports and database reports. If shortcomings are detected in the quality or comprehensiveness of the data, the data producer will make the necessary corrections and resubmit the updated data to THL.

The quality descriptions of the Care Register for Primary Health Care (Avohilmo) and Register for Specialist Medical Care (TerveysHilmo)  assess the reliability and suitability of the register data for various purposes (see Avohilmo quality description; TerveysHilmo quality description).

Data on appointments in specialised medical care has been comprehensively available since 1998. In primary health care, all outpatient service providers in public health care have participated in the data transfer since 2012. Due to changes in the patient record system, problems were detected in the Hilmo data transfer in Vantaa, Kerava and Helsinki in the period 2019–2023. For private service providers, the Hilmo data transfer has been implemented more comprehensively since the end of 2020. For the reasons listed above, the key figures describing the prevalence of ADHD diagnoses presented in the report may slightly underestimate the situation.

THL compiles data on missing Avohilmo data and retroactive corrections made to the data system on a separate website (see Missing Avohilmo data).

As health insurance only covers pharmacotherapy in outpatient care, the Dispensed medicines reimbursable under the National Health Insurance scheme register managed by Kela does not contain information on pharmacotherapy administered in public hospitals or institutional care.

A recent Finnish study utilised individual-level data from the Finnish Institute for Health and Welfare’s Hilmo register combined with data from the Dispensed medicines reimbursable under the National Health Insurance scheme register. The study extended to 2020. In this study, the prevalence of ADHD diagnoses was slightly less than 7% among boys and about 2% among girls of primary school age (6–12-year-olds) in 2020. The corresponding proportions of adolescents (aged 13–17) were 6.7% and 2.6%. These proportions are approximately 0.5 to 1.5 percentage points higher than those of the corresponding year in this statistic. This supports the interpretation that figures in the statistics are slightly underestimated at least at the level of the entire population (Westman et al. 2025).

In addition to the Finnish Institute for Health and Welfare’s Hilmo register, the most comprehensive overall picture of the prevalence of ADHD would be obtained by extracting ADHD diagnosis data from certain Kela benefit registers (rehabilitation, disability allowance for persons under the age of 16 and eligibility for special reimbursement of medicines) and by combining these with person-based data on ADHD medication purchases.

Timeliness and punctuality

The data in the Care Register for Health Care is always extracted for statistical purposes with a delay of approximately one year, which aims to ensure that no further changes are made to the data. The Hilmo data for these statistics were first extracted in December 2024. For Helsinki and the Wellbeing Services County of Vantaa-Kerava, the Avohilmo data for 2023 was supplemented in January 2025, and as a result, the extraction was redone in February 2025. The data in the Dispensed medicines reimbursable under the National Health Insurance scheme register concerning the use of ADHD medications was extracted in May 2024. Kela’s data are completed in February of the following calendar year.

Coherence and comparability

THL’s open database report produces open data separately based on the Care Register for Primary Health Care (Avohilmo) and for Specialist Medical Care (TerveysHilmo) and the data is updated regularly. Meanwhile, the Prevalence of ADHD diagnoses among children and young people statistics utilise individual-level Avohilmo and TerveysHilmo data content and provide a statistical overall picture of the prevalence of ADHD diagnoses based on data from the entire Hilmo register.

Data on the prevalence of ADHD diagnoses in children and young people in the care registers managed by THL is compared to Kela’s register data on the prevalence of ADHD medication used by children and young people. For the population aged 0–17, Kela has reported this data for the period 2021–2023 (see Data package on the wellbeing services counties (in Finnish)). This review also covers wellbeing services counties, but the statistics are not broken down by legal gender. For the purposes of this statistical report, a separate statistical extraction from the Dispensed medicines reimbursable under the National Health Insurance scheme register was used.  Based on this, the diagnosis data extracted from THL’s Hilmo registers could be compared with the data on the prevalence of ADHD medications extracted from Kela’s registers.

Institutional mandate

The production of the statistics is based on the Act on the Finnish Institute for Health and Welfare (688/2008) and the Act on Statistics (280/2004). One of the official tasks of the Finnish Institute for Health and Welfare is to produce statistical data on the health and welfare of the population, the factors affecting them, and the use and functioning of healthcare and social welfare services to support decision-making, development and research. THL’s statistical production practices are guided by the instructions, recommendations and regulations of Eurostat and the Official Statistics of Finland as well as the principles of statistical ethics.

Data sharing and publishing

The statistics are published on the home page of the statistics at thl.fi at a time indicated in the publication calendar. The data is made public to all users at the same time. See here for the statistics publication calendar.

The publication of the statistical report is accompanied by a database report on the THL website. A database report, or data cube, enables users to make their own selections and retrieve information from register data. The data in the data cube can be viewed by gender, age group, region and year.

Confidentiality

As an authority, the Finnish Institute for Health and Welfare is tasked with reporting collected data regarding national health and welfare. The data used to draw up THL’s statistics is primarily confidential, and personal data may not be published. The protection of processed data is based on the Act on the National Institute for Health and Welfare (688/2008), the Statistics Act (280/2004), the Act on the Openness of Government Activities (621/1999), the EU General Data Protection Regulation (EU) 2016/679 and the Data Protection Act (1050/2018) as well as other regulations guiding the activities of the Institute. THL’s datasets are secured at all stages of processing. Data and information systems can only be accessed by persons who have a permit to access certain data for clearly defined purposes. Others do not have the ability to view, process, change or delete data. Written instructions have been drawn up to ensure the data protection of completed statistics. All THL personnel are bound by a confidentiality obligation.

The data in the statistics are obtained in a summarised form without direct personal identifiers.

Special issues concerning the 2023 statistics

The Prevalence of ADHD diagnoses among children and young people statistics include any persons whose entry in the care register included an ADHD diagnosis (F90 or F98.8). An ADHD diagnosis could be a reason for an appointment or the person’s primary, secondary or long-term diagnosis. Diagnostic code F90.9 may, however, be used when healthcare professionals have only recently begun to suspect ADHD. Code F98.8 mainly refers to the form of inattentive ADHD, but the code may also include other disorders not connected to ADHD. For this reason, the statistical report contains a separate section on the effect of the diagnostic codes F90.9 and F98.8 on the reported number of cases and population shares.

[1]  Westman E, Prami T, Kallio A, … Leppämäki S. Increase in occurrence of attention deficit hyperactivity disorder differs by age group and gender–Finnish nationwide register studyLink to an external websiteAvautuu uudessa välilehdessä. Brain Behav 2025;15(1):e70253.

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