News — According to a new study conducted by UCL researchers, the diagnoses of ADHD and prescriptions for ADHD medication have witnessed significant growth over the past two decades. The study analyzed data from IQVIA Medical Research Data, a UK primary care database, encompassing 7 million individuals ranging from three to 99 years old between the years 2000 and 2018.
Out of these individuals, 35,877 received an ADHD diagnosis, while 18,518 were prescribed ADHD medication by their GP. Notably, the researchers observed that ADHD was more commonly diagnosed in children than in adults, with a higher prevalence in boys and men compared to girls and women.
The absolute increase in ADHD cases was most prominent among children, particularly among boys aged 10-16 years. In 2000, 1.4% of boys in this age group had an ADHD diagnosis, and 0.6% were prescribed ADHD medication. However, by 2018, these numbers had risen significantly to 3.5% with an ADHD diagnosis and 2.4% with prescriptions for ADHD medication.
On the other hand, the relative increase in ADHD diagnoses and prescriptions was more substantial among adults. For instance, men aged 18-29 experienced an approximately twenty-fold increase in ADHD diagnoses (from 0.01% in 2000 to 0.56% in 2018) and nearly fifty-fold increase in prescriptions for ADHD medication over the same period.
While the overall number of individuals receiving medication for ADHD remains relatively low, the study highlights the notable increase in ADHD diagnoses and prescriptions, particularly in children and young adults. These findings shed light on the changing patterns of ADHD diagnosis and medication use over the past two decades.
In contrast, the study revealed that there was no significant increase in ADHD cases among children under five years old.
Dr. Doug McKechnie, the lead author from UCL Institute of Epidemiology & Health Care, stated that diagnoses of ADHD and prescriptions for ADHD medication have become more prevalent over time. Although ADHD is most commonly diagnosed during childhood, the research also found a rising number of people receiving their first diagnosis in adulthood. The exact reasons behind this trend remain unclear, but it could be attributed to improved recognition and diagnosis of ADHD.
The study also highlighted the challenges faced by the healthcare system, with reports of long waiting lists for ADHD assessments, especially in adults. As more individuals are likely to be diagnosed and treated for ADHD in the future, Dr. McKechnie emphasized the need for specialized services to handle the increasing demand.
ADHD symptoms encompass impulsiveness, disorganization, difficulty with time management, poor focus, and restlessness. While these symptoms typically begin in childhood, the research demonstrates a growing understanding of their persistence into adulthood.
The study revealed that the number of ADHD diagnoses was approximately two times higher in the most deprived areas, both among children and adults, in comparison to the least deprived areas.
Dr. McKechnie emphasized that many individuals in deprived areas are seeking private care for ADHD, which can lead to healthcare disparities since ADHD is more prevalent in these areas. Those living in deprived regions might be unable to afford private healthcare, resulting in undiagnosed and untreated ADHD symptoms for extended periods. As a consequence, the actual prevalence of ADHD in deprived areas may be underestimated since the study only accounted for diagnosed cases.
Additionally, the research highlighted a notable increase in the frequency of ADHD medication prescriptions. In the NHS, such prescriptions usually begin with a specialist's referral and are then transferred to GPs for ongoing management.
The researchers are urging for better support and training for GPs in prescribing and monitoring these medications. With numerous demands on GPs' time, implementing appropriate frameworks and resources will be crucial to ensure they can handle the growing rates and awareness of ADHD effectively. This would enable patients to receive timely, safe, and efficient care for their condition.
Dr. Peter Carpenter, Chair of the Royal College of Psychiatrists' Neurodevelopmental Special Interest Group, expressed that individuals with ADHD can face significant disruptions in their personal and professional lives if the condition remains untreated. He commended the increasing public awareness of the disorder and the growing number of people seeking diagnostic assessments and treatment.
Once a person receives an ADHD diagnosis, they often benefit from necessary adjustments at work or in other aspects of their daily lives. Medication can be particularly helpful in addressing symptoms of inattention, hyperactivity, and impulsivity, especially for those with moderate to severe ADHD. In addition to medication, talking therapies and peer support groups can also offer valuable support.
Dr. Carpenter emphasized the crucial need for NHS mental health and primary care services to receive adequate resources to cope with the unprecedented surge in demand for support. Proper funding is essential to effectively manage the growing waiting lists for assessments and ensure timely and high-quality post-diagnostic care for those who require it.
It is worth noting that Dr. McKechnie, the lead author of the study, is supported by funding from the National Institute of Health and Care Research (NIHR). This support contributes to advancing research and understanding of ADHD and its management.
Study limitations
The study's scope was limited to capturing ADHD medication prescriptions within NHS primary care, excluding data from secondary care. Consequently, this approach may lead to an underestimation of the overall incidence and prevalence of ADHD medication usage.
Furthermore, it's essential to recognize that the study period concluded in 2018, and subsequent events, such as the Covid-19 pandemic, have had a significant impact on mental health services. As a result, it is highly probable that the incidence and prevalence of ADHD in the UK have continued to evolve from the end of the study to the present date. The dynamic nature of these factors underscores the importance of staying vigilant and continually assessing the current state of ADHD diagnosis and treatment in the country.
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