Trends Over 20 Years in ADHD Diagnoses Among U.S. Children, Adolescents

Bottom Line: Diagnosed attention-deficit/hyperactivity disorder (ADHD) in U.S. children and adolescents appears to have become more common over 20 years, with an increase in estimated prevalence from 6.1 percent to 10.2 percent between 1997 and 2016, although the cause of this apparent uptick still needs to be better understood.

Why The Research Is Interesting:  Current estimates of the prevalence of ADHD and details on long-term trends are needed for research, clinical care and policymaking.

Who and When: 186,457 U.S. children and adolescents (ages 4 to 17) with data collected from 1997 to 2016 as part of the National Health Interview Survey

What (Study Measures and Outcomes): ADHD diagnosed by a physician or other health care professional

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors:  Wei Bao, M.D., Ph.D., of the University of Iowa, Iowa City, and coauthors

Results: 

Differences in how common diagnosed ADHD is in U.S. children and adolescents depend on age, sex, race/ethnicity, family income and geographic region, although all these subgroups showed an increase in prevalence from 1997 to 2016.

Reasons behind the increase in prevalence need to be better understood because other factors that could partly explain it include increased physician awareness about ADHD, changes in diagnostic criteria, and increased public awareness and better access to health care services that could lead to a higher likelihood of ADHD diagnosis.

Study Limitations: Parent-reported information about physicians’ diagnoses could result in misreporting; it wasn’t known whether children and adolescents with a diagnosis of ADHD still had ADHD at the time of the survey

Study Conclusions:

Related Material: The invited commentary, “Paying Attention to Attention-Deficit/Hyperactivity Disorder,” by Daniel P. Dickstein, M.D., of Brown University, East Providence, Rhode Island, also is available on the For The Media website.

To Learn More: The full study is available on the For The Media website.

(doi:10.1001/jamanetworkopen.2018.1471)