Psychiatry Investig.  2018 Feb;15(2):118-123. 10.30773/pi.2017.11.01.

Incidence and Comorbidity of Reactive Attachment Disorder: Based on National Health Insurance Claims Data, 2010–2012 in Korea

  • 1Department of Psychiatry, Seonam University College of Medicine, Myongji Hospital, Goyang, Republic of Korea.
  • 2Department of Psychiatry, Seoul Children's Hospital, Seoul, Republic of Korea.
  • 3School of Business, Kyung Hee University, Seoul, Republic of Korea.
  • 4Department of Psychiatry, Graduate School, Kyung Hee University, Seoul, Republic of Korea.
  • 5Department of Rehabilitation, Hanshin University, Osan, Republic of Korea.
  • 6Sewon Infant and Child Development Center, Seoul, Republic of Korea.
  • 7Department of Psychiatry, Konyang University College of Medicine, Konyang University Hospital, Daejeon, Republic of Korea.
  • 8Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Republic of Korea.


We aimed to investigate the current diagnostic incidence, and medical and psychiatric comorbidities of reactive attachment disorder (RAD) using the National Health Insurance Review and Assessment (HIRA) claims data.
To examine the diagnostic incidence, we selected patients who were under 10-year-old and who had at least one medical claim containing a 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) code for RAD (F94.1 and F94.2) and who had not been diagnosed in the previous 360 days, from 2010 to 2012. In this study, we used the term "˜reactive attachment disorder' representing for both RAD per se and Disinhibited social engagement disorder. Comorbid disorders were categorized according to ICD-10.
Among 14,029,571, the total population under 10-year-old during 2010-2012, incident cases of RAD were 736. The mean diagnostic incidence of RAD was 5.25 per 100,000 annually. Language disorders (F80-84) were the most common psychiatric comorbidities in both boys and girls in age groups 0-3 years and 4-6 years, and attention deficit hyperactivity disorder was the most common in both sex aged 7-9 years. In non-psychiatric comorbidities, diseases of the respiratory system (J00-99) were the commonest in both sex in all age groups, and diseases of the digestive system (K00-99) were the next.
RAD was very rare in practice and would be disguised as other psychiatric disorders. Children with RAD might have more medical comorbidities than typically developed children.


Reactive attachment disorder; Incidence; Comorbidity

MeSH Terms

Attention Deficit Disorder with Hyperactivity
Digestive System
International Classification of Diseases
Language Disorders
National Health Programs*
Reactive Attachment Disorder*
Respiratory System
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