Attention-deficit hyperactivity disorder diagnoses and prescriptions in UK primary care, 2000–2018: population-based cohort study

Abstract

Background Rates of diagnosed attention-deficit hyperactivity disorder (ADHD) may be increasing in the UK. Aims Estimate incidence and prevalence of ADHD diagnoses and ADHD prescriptions in UK adults and children in primary care. Method We conducted a cohort study using IQVIA Medical Research Data, a UK primary care database. Rates of ADHD diagnoses and ADHD prescriptions were calculated between 2000 and 2018 for individuals aged 3–99 years, analysed by age, gender, social deprivation status and calendar year. Results Of 7 655 931 individuals, 35 877 (0.5%) had ADHD diagnoses; 18 518 (0.2%) received ADHD medication prescriptions. Diagnoses and prescription rates were greater in men versus women, children versus adults, and deprivation status (nearly double in most deprived versus least deprived quintile). By 2018, the proportion of ADHD diagnoses was 255 per 10 000 (95% CI 247–263) in boys and 67.7 per 10 000 (95% CI 63.5–71.9) in girls; for adults, it was 74.3 per 10 000 (95% CI 72.3–76.2) in men and 20 per 10 000 (95%CI 19.0–21.0) in women. Corresponding figures for prescriptions were 156 per 10 000 (95% CI 150–163) in boys, 36.8 per 10 000 (95% CI 33.8–40.0) in girls, 13.3 per 10 000 (95% CI 12.5–14.1) in men and 4.5 per 10 000 (95% CI 4.1–5.0) in women. Except among 3- to 5-year-olds, the incidence and prevalence of ADHD diagnoses and prescriptions have increased from 2000 to 2018 in all age groups. The absolute increase was highest in children, but the relative increase was largest among adults (e.g. among men aged 18–29 years, approximately 20-fold and nearly 50-fold increases in diagnoses and prescriptions, respectively). Conclusions The incidence and prevalence of both ADHD diagnoses and medication are highest among children. Proportionally, rates increased most among adults during 2000–2018. ADHD diagnoses and prescriptions are associated with socioeconomic deprivation.

The Physical Health Trajectories of Young People with Neurodevelopmental Conditions: A Protocol for a Systematic Review of Longitudinal Studies

“…The number of young people being diagnosed with a neurodevelopmental condition (NDC), has dramatically increased in recent years [1]. Specifically, there has been a substantial upsurge in the number of children and adolescents being referred to mental health services for suspected Attention Deficit Hyperactivity Disorder (ADHD), Autism and Tic Disorders (i.e., Transient or Chronic Tic Disorders and Tourette's Syndrome), without an associated intellectual disability [2,3,4,5,6]. While many of these conditions were previously conceptualized as being limited to childhood, they are now known to be lifelong [7].…”

Association between 5-min Apgar score and attention deficit hyperactivity disorder: a Scotland-wide record linkage study of 758,423 school children

“…Based on administrative data, Holden estimated a childhood UK prevalence of 0.55% (0.93% in boys, and 0.15% in girls [ 5 ]. Additionally, a more recent retrospective cohort study in the UK indicated that the childhood prevalence of ADHD was 1.8% among boys and 0.4% among girls [ 6 ]. Due to increased knowledge, recognition, and diagnosis, the prevalence of ADHD amongst children in the UK has increased in recent years [ 5 , 6 ].…”