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ADHD in Japan   269 vous and ­ mental disorders from the Ministry of Health, ­ Labor, and Welfare. (In Japa­nese) Scheffler, Richard M., Stephen P. Hinshaw, Sepideh Modrek, and Peter Levine. 2007. “The Global Market for ADHD Medi­ cations.” Health Affairs 26 (2): 450–57. doi:10.1377/hlthaff.26.2.450. Soma, Yukio, Kazutoshi Nakamura, Mari Oyama, Yasuo Tsuchiya, and Masaharu Yamamoto . 2009. “Prevalence of Attention-­Deficit/Hyperactivity Disorder (ADHD) Symptoms in Preschool ­ Children: Discrepancy between Parent and Teacher Evaluations.” Environmental Health and Preventive Medicine 14 (2): 150–54. Takeda, Toshinobu. 2009. “Psychopharmacology for Attention-­ Deficit/Hyperactivity Disorder in Japan.” Current Attention Disorders Reports 1 (1): 21–28. Takeda, Toshinobu, Mizuho Ando, and Keiko Kumagai. 2015. “Attention Deficit and Attention Training in Early Twentieth-­ Century Japan.” Attention Deficit and Hyperactivity Disorders 7 (2): 101–11. doi:10.1007/s12402-014-0157-7. Tamekawa Yuji, Souichi Hashimoto, Akiko Hayashi, and Atsushi Kanno. 2014. Misunderstandings about Developmental Disabilities in Japan. Poster. Tamura, Masayuki. 1992. “The Yakuza and Amphetamine Abuse in Japan.” Drugs, Law and the State, 99–118. Teruyama, Junko. 2014. “Japan’s New Minority: Persons with Hattatsu Shogai.” PhD diss., University of Michigan. Tomita, Naoko. 2009. “The Po­ liti­ cal Economy of Incrementally Separating Prescription from Dispensation in Japan.” In Prescribing Cultures and Phar­ ma­ ceu­ ti­ cal Policy in the Asia-­Pacific, edited by Karen Eggleston. Stanford, CA: Walter H. Shorenstein Asia-­ Pacific Research Center Books. Yamauchi, Yuko, Takeo Fujiwara, and Makiko Okuyama. 2014. “­ Factors Influencing Time Lag between Initial Parental Concern and First Visit to Child Psychiatric Ser­ vices among ADHD ­ Children in Japan.” Community ­ Mental Health Journal. doi:10.1007/ s10597-014-9803-­y. Epidemiology, Treatments, and Cultural Influences Yasuo Murayama Hiroyuki Ito Junko Teruyama Masatsugu Tsujii Attention deficit–­ hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects approximately 5% of ­children and adolescents and 2.5% of adults worldwide (Polanczyk et al. 2007). The core characteristics of ADHD—­ inattention, hyperactivity, and impulsivity—­ can lead ­ children and adolescents to 270   Global Perspectives on ADHD experience difficulties in many aspects of daily life, such as academic per­ for­ mance and relationships with peers. ADHD is acknowledged as being a common and chronic neurodevelopmental disorder in many countries. In Japan, numerous ­children, adolescents, and adults with ADHD, as well as their ­ family members, have some form of distress caused by ADHD symptoms and related prob­ lems. In addition, many suffer from social stigma that is in part related to Japa­ nese values regarding child-­ rearing and discipline . This stigma explains why psychosocial interventions, particularly parent training, are more likely to be used to treat ADHD in Japan. In this section, we describe the epidemiology of this disorder, relevant laws, diagnosis and treatment guidelines, and available types of treatment as well as the specific sociocultural conditions surrounding ADHD in Japan. The Epidemiology of ADHD in Japan Prevalence An epidemiological understanding of ADHD may provide insights into its distribution , etiology, and the risk of psychosocial prob­ lems, as well as information for intervention planning. In the past two de­ cades, many investigations have been conducted around the world to define the prevalence of the disorder. Although estimated prevalence rates have been highly variable across the lit­ er­ a­ ture, meta-­regression analyses have shown that the worldwide pooled prevalence was 5.29% among ­children and adolescents (18 years of age or younger) and 2.5% among adults (Polanczyk et al. 2007; Simon et al. 2009). In Japan, a few studies have looked at the epidemiology of ADHD (­ table 13.1). Nomura et al. (2014) examined the prevalence of ADHD among preschool­ children (5 years of age) and reported that 5.8% of the ­ children ­ were eligible for a diagnosis. The Ministry of Education, Culture, Sports, Science, and Technology (2012) conducted a survey on the prevalence of ADHD among elementary and ju­ nior high school students who ­ were enrolled in regular class (6 to 15 years of age). The survey found that 3.1% of students had noticeable ADHD symptoms , although this study was based on behavioral ratings made by class teachers rather than diagnoses made by a specialized physician. Uchiyama, Ohnishi, and Nakamura (2012) looked at ADHD in adults (18 to 49 years of age) and estimated that its prevalence is 1.65%. The relative dearth of epidemiological studies can be attributed to the fact that widespread public awareness of ADHD grew in Japan only in the past two ADHD in Japan   271 de­ cades (Teruyama 2014). In other words, the diagnosis...


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