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Pediatrics

Adult ADHD Prevalence Has Doubled Over 10 Years

The prevalence and incidence of adult attention-deficit hyperactivity disorder (ADHD) are increasing, according to the results of a large study of Californian adults.

Although there has been an increased prevalence in the diagnosis and treated of adults ADHD in the clinical setting, demographic and outcomes trends in the United States is limited.

To explore these trends, the researchers conducted a study involving 5,282,877 adult patients in northern California who identified as African American or black, Native American, Pacific Islander, Latino or Hispanic, non-Hispanic white, Asian American, or other, as well as 864,453 children aged 5 to 11 years.

Overall, 59,371 of the adult patients received diagnoses of ADHD, with prevalence of the disorder increasing from 0.43% in 2007 to 0.96% in 2016. Among the child patients, prevalence increased from 2.96% in 2007 to 3.74% in 2016.

Adult prevalence increased among every race/ethnicity, although white patients had the highest prevalence rates. Younger age, male sex, white race, being divorced, being employed, and having higher median level of education were all associated with increased odds of ADHD diagnosis.

Further, having an eating disorder, depressive disorder, bipolar disorder, or anxiety disorder were associated with higher odds of receiving an ADHD diagnosis.

“Despite [the study’s] limitations, we confirmed increasing rates of ADHD diagnosis among adults over a 10-year period, albeit with substantially lower rates of detection among the major racial/ethnic subgroups in our sample,” the researchers concluded.

“Irrespective of the explanations for racial/ethnic differences in ADHD diagnoses, our findings suggest 2 important future efforts to bridge gaps in recognition, diagnosis, and treatment of ADHD in racial/ethnic subgroups. First, there should be an increased focus on careful, unbiased, structured screening and documentation of symptoms across development, especially as the field attempts to further delineate the temporal precedence of ADHD, patterns of comorbidity, and its consequences. Second, greater consideration must be placed on cultural influences on health care seeking and delivery, along with an increased understanding of the various social, psychological, and biological differences among races/ethnicities as well as culturally sensitive approaches to identify and treat ADHD in the total population.”

—Michael Potts

Reference:

Chung W, Jiang S, Paksarian D, et al. Trends in the prevalence and incidence of attention-deficit/hyperactivity disorder among adults and children of different racial and ethnic groups [published online November 1, 2019]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2019.14344.