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

Summary & key facts

This study looked at medical records from one large Israeli health insurer for children aged 5–17 between 2005 and 2014. It found that recorded ADHD diagnoses roughly doubled (from 6.8% to 14.4%) and that ADHD medication use increased (from 3.57% to 8.51%). The authors note that changes in how doctors and parents view and record attention and hyperactivity problems likely helped drive these trends, and they explain that different ways of counting cases and recording diagnoses affect the numbers.

Key facts:

• Prevalence of recorded ADHD diagnoses in the study cohort rose from 6.8% in 2005 to 14.4% in 2014 (a twofold increase; p < 0.001).
• ADHD medication use among children and adolescents in the cohort increased from 3.57% in 2005 to 8.51% in 2014 (p < 0.001).
• The annual incidence of recorded ADHD diagnoses rose, peaked in 2011, and then declined by 2014 (the paper reports a peak in 2011 but a downward change by 2014).
• The male-to-female ratio among recorded ADHD cases decreased from 2.94 in 2005 to 1.86 in 2014 (p < 0.001), indicating relatively more girls were being diagnosed over time.
• Case definition used: any child aged 5–17 with a physician-recorded ADHD diagnosis and/or two purchases of ADHD medication between 2005–2014. The database included 39.7% with diagnosis only, 58.7% with both diagnosis and medication purchase
• To check how many diagnoses were “definitive,” the authors reviewed samples of records: 27% of diagnoses recorded only by primary physicians were judged definitive, while 64% of expert (neurologist/psychiatrist) diagnoses were definitive. F
• Data came from Maccabi Healthcare Services, an insurer that serves about 25% of Israel’s population, and the study included children aged 5 to 17 over the years 2005–2014.

Topics

Attention Deficit Hyperactivity Disorder Neural and Behavioral Psychology Studies

Categories

Health Sciences Medicine Psychiatry and Mental health

Tags

Attention deficit Attention deficit hyperactivity disorder Cohort Incidence (geometry) Internal medicine Medical diagnosis Medical record Medicine Optics Pathology Pediatrics Physics Psychiatry

Conditions & symptoms

ADHD Difficulty focusing