Challenges in defining the rates of ADHD diagnosis and treatment: Trends over the last decade

Background: There is a global trend of large increases in the prevalence and incidence of Attention Deficit Hyperactivity Disorder (ADHD). This study aimed to address potential causes of these major changes. Methods: The authors used a large cohort to analyze data employing patients' electronic medical records, with physicians' diagnosis of ADHD, including records of medication purchases. Results: The prevalence of ADHD diagnoses rose twofold from 6.8% to 14.4% between 2005 and 2014 (p<0.001), while the ratio of males to females with ADHD decreased from 2.94 in 2005 to 1.86 in 2014 (p< 0.001). The incidence increased, peaking in 2011 before declining in 2014. ADHD medication usage by children and adolescents was 3.57% in 2005 and 8.51% by 2014 (p< 0.001). Conclusions: We report a dramatic increase in the rate of ADHD diagnoses. One of the leading factors to which we attribute this increase is the physicians' and parents' changed attitude towards diagnosing attention/hyperactivity problems, with more parents appear to consider ADHD diagnosis and treatment as a means to improve their child's academic achievements, commonly with the aid of medications. This change in attitude may also be associated with the dramatic increase in female ADHD diagnosis prevalence.