Alarming rise in the diagnosis of ADHD in America

Alarming rise in the diagnosis of ADHD in America

By Margaret Rogers

In the last 10 years the number of children being diagnosed by a doctor as having attention deficit hyperactivity disorder (ADHD) has risen by 66%, according to a new study.

The study was conducted by Northwestern Medicine can be found in the journal Academic Paediatrics.  The study further suggests that, over the same period, the care of children with ADHD has switched from primary care physicians to specialists such as paediatric psychiatrists.

Researchers analysed ADHD trends during the period 2000 to 2010.  The cases which were considered were children under the age of 18 who had been diagnosed and treated by practice-based doctors.  The researchers analysed changes which had occurred in both the diagnosis and treatment of ADHD over this decade.

The first author of the study, Craig Garfield said ‘ADHD is now a common diagnosis among children and teens.  The magnitude and speed of this shift in one decade is likely due to an increased awareness of ADHD, which may have caused more physicians to recognise symptoms and diagnose the disorder.’

Garfield said that the symptoms of ADHD include trouble paying attention and controlling impulsive behaviours and being overly active.  These symptoms, he suggests, can affect children and teens both academically and socially.  Garfield is a paediatrician at Children’s Memorial Hospital and Northwestern Memorial Hospital and also a professor in paediatrics and medical social sciences at Northwestern University.

Garfield added that in the past decade several important regulatory and clinical changes regarding ADHD and the medications used to treat it have occurred, yet it was unknown how these factors have affected ADHD management.

The IMS Health National Disease and Therapeutic Index was used by Garfield and his team to quantify ADHD diagnosis and treatment patterns in young people under the age of 18.  The study suggests that in 2010, 10.4 million children and teens under the age of 18 were diagnosed with ADHD by doctors during outpatient visits.  This compares to 6.2 million in 2000.

Psycho-stimulants remain the most common mediation which is prescribed to young people with ADHD, the study found.  In the year 2000 96% of children treated for ADHD were treated by using psycho-stimulants, this fell to 87% in the year 2010.  Garfield said that the reason for the decrease was unclear, but there was not an increase in treatment with other, substitute medications.

It was found that the majority of children and teens with ADHD are still treated by their primary physicians but there has been a substantial move from primary care doctors to specialists. 

Garfield concluded ‘Recently, there’s been more public health advisories issued about problems or side effects of different AHD medications.  It may be that general paediatricians are shying away from the management of these medications.  Given the short supply of psychiatrists specialising in paediatric ADHD this trend might make it difficult for many children to receive medical treatment of ADHD in the future.’