Diagnoses Increasing at a Much Higher Rate in Adults Than Children

NEW YORK, NY – Researchers from the Child Mind Institute and colleagues have found that diagnosis of attention deficit hyperactivity disorder (ADHD) in adults more than doubled over a ten year period, far surpassing the increased diagnosis rate in children. Notably, white adult patients had significantly higher rates of diagnosis compared to other racial and ethnic subgroups.

The findings, published today in JAMA Network Open, are from a retrospective cohort study of the incidence and prevalence of adult ADHD in six racial and ethnic groups over a decade (Jan. 2007 to December 2016). Researchers analyzed data from more than 5 million Kaiser Permanente Northern California patients and found that the percentage of adults with a current diagnosis of ADHD more than doubled between less than half a percent ((0.43%) in 2007 to almost 1 percent (0.96%) in 2016. The study found that increases in children aged 5-11 were far less significant, increasing just 26% from 2.96% in 2007 to 3.74% in 2016. Rates in white adults increased most dramatically (0.67% in 2007 to 1.42% in 2016).

Researchers found that presence of other psychiatric diagnoses, specifically eating, depressive, bipolar and anxiety disorders in adults was associated with higher odds of being diagnosed with ADHD. Adults with ADHD also had significantly higher rates of healthcare utilization and sexually transmitted infections (STI).

“While we can’t pinpoint the source of the increase in ADHD rates in adults, we can surmise that is has to do with growing recognition of ADHD in the adult populations by doctors and service providers, as well as increase public awareness of ADHD over all,” said co-author Michael P. Milham, MD, PhD, vice-president of research at the Child Mind Institute. “More work needs to be done to better understand why rates are higher in white adults, particularly whether there are deficiencies in detection and diagnoses among non-white adults. And we must develop more effective diagnostic tools and standards for adults, who, in general, remain more challenging to diagnose than children.”

Lead author Winston Chung, MD, MS, a psychiatrist with Kaiser Permanente in San Francisco, noted the potential for cultural influences on mental health disorders such as ADHD, with people in some cultures being less likely to see certain behaviors as a medical problem or to seek out help for them. “It’s always been just understood that different cultures and races might vary in meaningful ways in how they cope with stress or expressing emotions,” said Chung. “But this is something we don’t actually have definitive answers to,” he added, noting the need for more research to tease out the role of culture in mental illness diagnosis.

Funding for the research came from a Kaiser Permanente community benefit grant.

About the Child Mind Institute

The Child Mind Institute is an independent nonprofit dedicated to transforming the lives of children and families struggling with mental health and learning disorders. Our teams work every day to deliver the highest standards of care, advance the science of the developing brain, and empower parents, professionals and policymakers to support children when and where they need it most. Together with our supporters, we’re helping children reach their full potential in school and in life. We share all of our resources freely and do not accept any funding from the pharmaceutical industry. Learn more at childmind.org.