Over the last two decades, the number of people diagnosed with and prescribed medication for ADHD has significantly increased in the UK, a new study has found. Though interestingly, this rise has not included children under five.
ADHD, or Attention Deficit Hyperactivity Disorder, is a neurodevelopmental disorder that is usually identified in childhood but that is changing. Those with ADHD may have trouble paying attention, controlling impulsive behavior, or be overly active. They can also have trouble being organized and often have poor time-management skills.
Researchers from University College London (UCL) reviewed data from 7 million individuals aged from three to 99 for the period between 2000 and 2018, the data for which was drawn from IQVIA Medical Research Data. This massive database offers non-identifiable primary care data for over 18 million patients across the UK.
It should be noted that the data only reflected ADHD medication prescribed in NHS primary care, which means the results may not represent the overall trend and prevalence of ADHD diagnosis and medication usage.
The findings showed that the increase of individuals diagnosed with ADHD was highest in boys aged between 10 and 16 years. In 2000, around 1.4 percent had an ADHD diagnosis and 0.6 percent were prescribed medication. This rose to 3.5 percent and 2.4 percent respectively in 2018.
But it was in adults, especially men, that the most significant relative increase took place. For example, during this period, there was about a 20-fold increase in ADHD diagnoses in men aged between 18-29 years, and a nearly 50-fold increase in prescriptions for them (from 0.01 percent to 0.56 percent).
Although the overall trend indicates that more people are being diagnosed and receiving treatment for ADHD, there was no significant increase in children under five.
“ADHD diagnoses and prescriptions for ADHD medication by a GP have become more common over time”, lead author Dr Doug McKechnie, from the UCL Institute of Epidemiology and Healthcare, said in a statement.
“Whilst ADHD is most likely to be diagnosed in childhood, an increasing number of people are diagnosed for the first time in adulthood. We do not know exactly why this is happening, but it may be that ADHD has become better recognized and diagnosed.”
In recent years, there have been reports of long waiting lists for ADHD assessments on the NHS, especially in adults. Given the rise in the number of diagnoses for this condition, it is likely that more people will be given a positive diagnosis as they seek help and treatment. According to McKechnie, this will require more specialist services to be made available to handle the demand.
Crucially, the number of ADHD diagnoses among both children and adults was around two times higher in the most deprived areas.
“Many people are accessing private care for ADHD. This may create healthcare inequalities given that ADHD is more common in deprived areas”, McKechnie added. “People living in deprived areas may not be able to afford private healthcare, and may suffer with undiagnosed and untreated symptoms of ADHD for longer. If people in deprived areas are struggling to get diagnosed with ADHD, our results may actually under-estimate how many people there have it, as we only counted diagnosed ADHD.”
At the moment, the process for receiving medication is inefficient. In the NHS, prescriptions start with a specialist referring a patient to their GP for ongoing treatment, but more needs to be done to support and monitor prescriptions, the team argues.
McKechnie added: “There are already many demands on GPs’ time. We need to ensure we have the right frameworks in place to support them as rates and awareness of ADHD increase – allowing patients to receive prompt, safe and effective care.”
According to Dr Peter Carpenter, Chair of the Royal College of Psychiatrists’ Neurodevelopmental Special Interest Group, “Once someone has a diagnosis, they usually benefit from adjustments at work or in other areas of their daily lives. Medication can help treat symptoms of inattention, hyperactivity and impulsivity, particularly in those who have a moderate to severe expression of ADHD. Talking therapies and peer support groups can also be beneficial.”
“NHS mental health and primary care services must be provided with the necessary resources to meet this unprecedented rise in demand for support. Only with proper funding will they be able to effectively manage growing waiting lists for assessments and provide timely and high-quality post-diagnostic care to those who need it.”
The study is published in BJPsych Open.