“Unprecedented” Surge – ADHD Diagnoses Skyrocket in UK

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Surge Without Precedent: Significant Increase in ADHD Diagnoses and Prescriptions Observed in the UK

Scholars have observed a marked escalation in ADHD diagnoses as well as in prescriptions for medication treating the condition over the past two decades. Interestingly, the most pronounced proportional upswing was seen among adults. In contrast, there was no discernible alteration in the rate of diagnoses among children below the age of five. Questions have been raised concerning the availability of ADHD evaluation and treatment services, particularly in economically disadvantaged areas where ADHD is often more widespread.

A study led by researchers at University College London points to a significant growth in ADHD diagnoses and prescriptions for ADHD medication over a span of twenty years. Notably, this uptrend did not manifest in children under the age of five.

The data analyzed in the study, published in BJPsych Open, were derived from IQVIA Medical Research Data, a primary care database in the UK. This covered individuals ranging from the ages of three to 99, recorded between the years 2000 and 2018.

Out of these individuals, 35,877 were diagnosed with ADHD, and 18,518 had been prescribed medication for the condition by their General Practitioner (GP).

Even though the percentage of individuals medicated for ADHD remains comparatively low, ADHD was more frequently diagnosed in children than in adults, and more common among males than females.

In absolute terms, the surge was most pronounced among children. For example, in 2000, 1.4% of boys aged 10-16 had an ADHD diagnosis and 0.6% had a medication prescription, compared to 3.5% and 2.4% respectively in 2018.

However, the most striking proportional increase occurred among adults. For instance, there was a roughly twenty-fold rise in ADHD diagnoses and nearly a fifty-fold surge in prescriptions for adult men aged 18-29—from 0.01% to 0.56%—over the studied period. Nevertheless, no substantial change was seen in children under five years of age.

The lead author, Dr. Doug McKechnie of UCL Institute of Epidemiology & Health Care, stated that the diagnoses and medication prescriptions for ADHD by a GP have notably increased over the years. Although ADHD is most commonly identified in childhood, an increasing number of adults are being diagnosed for the first time. He further highlighted that, due to long waiting times for ADHD assessments in NHS, especially among adults, there is a growing need for specialized services to manage this trend.

Symptoms of ADHD, which include impulsiveness, poor organizational skills, difficulties in focusing, and restlessness, often commence in childhood but are increasingly being recognized as persisting into adulthood.

In terms of socioeconomic factors, the study found that ADHD diagnoses were roughly twice as common in the most economically deprived areas among both children and adults, compared to the least deprived areas.

Dr. McKechnie noted that healthcare inequalities may emerge as ADHD is more prevalent in disadvantaged areas, and private healthcare may not be affordable for these residents. He cautioned that the results could potentially underestimate the actual prevalence of ADHD in deprived areas.

The study also emphasized that ADHD medications are increasingly being prescribed, with such prescriptions typically initiated by a specialist and subsequently managed by GPs. Researchers advocate for enhanced support mechanisms for GPs in prescribing and monitoring these medications.

Dr. Peter Carpenter, Chair of the Royal College of Psychiatrists’ Neurodevelopmental Special Interest Group, remarked that untreated ADHD could have disruptive impacts on individuals’ personal and professional lives. Medication and other forms of treatment can significantly ameliorate symptoms, but he stressed that adequate funding is essential for the NHS to manage the growing demand for these services.

Reference

The study, titled “Attention-deficit hyperactivity disorder diagnoses and prescriptions in UK primary care, 2000–2018: population-based cohort study,” was authored by Douglas G. J. McKechnie, Elizabeth O’Nions, Sandra Dunsmuir, and Irene Petersen and was published on 17 July 2023 in BJPsych Open. DOI: 10.1192/bjo.2023.512.

Dr. McKechnie’s research was supported by the National Institute of Health and Care Research (NIHR).

Limitations of the Study

The study was limited to prescriptions within the NHS primary care system and did not include secondary care, which could lead to an underestimation of medication usage rates. Additionally, the study concluded in 2018; subsequent events, such as the Covid-19 pandemic, may have significantly influenced mental health services, potentially altering the incidence and prevalence of ADHD diagnoses and treatments in the UK.

Frequently Asked Questions (FAQs) about ADHD Diagnoses in the UK

What is the primary focus of the University College London study?

The primary focus of the study led by University College London is to examine the trend in ADHD diagnoses and prescriptions for ADHD medication in the UK over a period of twenty years, from 2000 to 2018.

Who was the lead author of this study, and where was the study published?

The lead author of the study was Dr. Doug McKechnie from the UCL Institute of Epidemiology & Health Care. The findings of the study were published in BJPsych Open.

Were any specific age groups more affected than others in terms of ADHD diagnoses?

Yes, the study found that although ADHD is more commonly diagnosed in children, the most significant relative increase in diagnoses was among adults. However, there was no significant increase observed in children under the age of five.

Did the study discuss gender differences in ADHD diagnoses?

Yes, the study found that ADHD is more commonly diagnosed in males than in females, both in children and adults.

What are the implications of the study for healthcare accessibility?

The study raises concerns about healthcare inequalities, especially in economically deprived areas where ADHD is more prevalent. Residents in these areas may not have affordable access to private healthcare and could suffer from undiagnosed and untreated symptoms of ADHD for longer periods.

Does the study talk about treatment options for ADHD?

While the study primarily focuses on diagnoses and prescriptions, it does note that medication for ADHD is increasingly being prescribed. Such prescriptions generally begin with a referral from a specialist and are subsequently managed by General Practitioners (GPs).

Are there any limitations of the study?

Yes, the study has limitations. It only captures ADHD medication prescriptions within the NHS primary care system and not secondary care, potentially underestimating the overall prevalence of medication usage. Additionally, the study concluded in 2018 and did not consider subsequent events like the Covid-19 pandemic that may have impacted mental health services.

What measures are suggested for healthcare providers like GPs?

The study advocates for better support frameworks for GPs in the prescribing and monitoring of ADHD medications as the rate of diagnoses and awareness about the condition increase.

Who supported the research?

The research was supported by funding from the National Institute of Health and Care Research (NIHR).

What are the symptoms of ADHD as identified in the study?

The study identifies symptoms of ADHD to include impulsiveness, disorganization, poor time management skills, difficulty focusing, and restlessness. These symptoms often commence in childhood but are increasingly being recognized in adults as well.