ADHD diagnoses and prescriptions have increased globally across all age groups, our review shows

Diagnoses of attention-deficit/hyperactivity disorder (ADHD) have increased in many countries across all age groups, according to our latest review. We have also shown that prescriptions for ADHD treatments have seen similar increases across all age groups.

Our latest review, published in the Journal of Psychopharmacology, brought together recently published research on ADHD diagnoses and prescriptions worldwide.

We found that in the UK, increases in recorded ADHD diagnoses and treatment prescriptions occurred across all age groups between 2000 and 2018.

The greatest rise in ADHD diagnoses during this period was among children. However, there was also a distinct increase among adults. For example, among men ages 18–29, there was an approximately 20-fold increase in diagnoses and an almost 50-fold increase in prescriptions.

The sex ratio of ADHD diagnoses in childhood and adolescence was approximately 4:1, male to female. However, the ratio of diagnoses in adulthood was nearly 1:1. This shift may partly reflect increased recognition of how ADHD presents in girls and adults—groups that have historically been underdiagnosed.

Alongside these increases in ADHD diagnoses, there has also been an increase in prescriptions for ADHD treatments.

In England, prescriptions of central nervous system stimulants (the main prescription treatments for ADHD) increased by 32% among adults 18 and older in 2021–22. Among children under 17, prescriptions increased by 12% from 2022–23. This was also the first time more adults than children were prescribed these drugs since records started in 2015.

A retrospective study of more than 154 million people from 13 countries in North America, Europe and Asia demonstrated that use of ADHD medication prescriptions had increased in these regions as well.

Why diagnoses and prescriptions are increasing

A few key factors can largely explain the increase in both ADHD diagnoses and prescriptions that we’ve seen. These include increased public awareness of the condition, better understanding by doctors of how symptoms present and the availability of new and improved medications.

Additionally, there is better awareness of how ADHD manifests in groups that may previously have been missed because their symptoms did not match those typically exhibited in boys and adolescents. This includes women and girls and people with predominantly inattentive symptoms.

However, these factors may tell only part of the story. Our review also revealed that other drivers may deserve careful consideration.

For instance, there has been much debate over whether there is an issue of overdiagnosis and overprescribing. Legitimate questions about whether some attention difficulties might be overmedicalized have also been raised. On the other hand, some authors have argued that there is no evidence to suggest overdiagnosis is occurring in the UK.

Understanding the full picture requires looking beyond the obvious explanations to examine cultural, economic, social and technological pressures in a globally competitive environment that may be influencing both diagnosis rates and treatment choices.

Looking forward

The rising rates of ADHD diagnoses and treatment represent a complex picture. There have been genuine improvements in recognizing a real disorder that was historically overlooked (particularly in adult men and women), better clinical awareness and perhaps some degree of overidentification in certain environments.

What seems clear is that ADHD, long thought of as a children’s disorder, is now being treated as what it truly is: a lifelong neurodevelopmental disorder affecting millions of people around the world.

As awareness continues to grow, the challenge ahead lies in preserving limited NHS resources while ensuring those who genuinely need them have improved access.

The wait time for an ADHD diagnosis in England currently ranges from 2 to 15 years. With increasing rates of diagnoses and prescriptions to manage ADHD, there are concerns that demand will soon outstrip NHS capacity entirely.

One potential solution could be the discovery of ADHD biomarkers—objectively measurable indicators of a biological state or condition that can be detected in brain signatures. Currently, ADHD is diagnosed by a doctor who often has to rely on self-reported symptoms. Having biomarkers could improve the accuracy of diagnoses, ensuring that those who have the condition get the support they need earlier.

Who’s behind this story?

Lisa Lock

BA art history, MA material culture. Former museum editor, paramedic, and transplant coordinator. Editing for Science X since 2021.

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Alexander Pol

PhD nano-engineering from Delft University. Published researcher and journal reviewer. Brings scientific insight to content standards.

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This article is republished from The Conversation under a Creative Commons license. Read the original article.