November 8, 2023
A research team used Sweden's Total Population Register to identify all 445,790 individuals born in the five years from 1987 through 1991 who remained alive and resident in Sweden during the follow-up period (2001-2014).
The team then consulted the National Patient Register (NPR) to identify the 3,534 members of this cohort who received an ADHD diagnosis before turning eighteen.
Next, they used two national registers (the NPR and the Swedish Prescribed Drug Register) to identify those who also received an ADHD diagnosis or medication prescription in adulthood. They categorized these as "ADHD persisters," as opposed to "ADHD remitters," who did not seek further ADHD-related contact with healthcare services in adulthood.
Using national personal identification numbers, they were also able to link this data to demographic data in the Longitudinal Integration Database for Health Insurance and Labor Market Studies and to cost data in the Cost Per Patient database.
The team adjusted for known confounders. Parental education and family income were used as proxies for socioeconomic status. They also adjusted fr sex and year of birth.
Of the 3,534 individuals who received an ADHD diagnosis in childhood, 62 percent were classified as persisters and 38 percent as remitters in young adulthood.
The mean annual healthcare expenditure for individuals with a childhood ADHD diagnosis was three times higher than for those without such a diagnosis: $1,223 versus $418(after conversion from Swedish króna into U.S. dollars). Broken down further, it was $854 versus $226 for inpatient care, $209 versus $104 for outpatient care, and $158 versus $87 for medication.
Focusing just on the ADHD group, the mean annual healthcare expenditure for those whose ADHD care persisted into young adulthood was 74 percent greater than for remitters:$1,456 versus $837 (which was still twice as high as for no childhood diagnosis). Broken down further, it was $1,014 versus $589 for inpatient care,$246 versus $151 for outpatient care, and $196 versus $96 for medication.
Inpatient care was the main driver of costs in individuals with a childhood ADHD diagnosis. Delving deeper into causes, almost a third of inpatient care was associated with drug or alcohol abuse, 15 percent with injuries, 14 percent with various somatic ailments, and the remainder with comorbid psychiatric disorders(primarily autism, schizophrenia, depression, anxiety).
The authors emphasized that "A novel finding in this study was that individuals with childhood ADHD who no longer had ADHD-related contact with healthcare services in adulthood (remitters) continued to show severe psychiatric and somatic health problems, often leading to hospitalization. This group of individuals showed intermediate profiles on outcomes, with values lower than the ADHD persistent group but higher than the non-ADHD group."
Ebba Du Rietz, Andreas Jangmo, Ralf Kuja-Halkola, Zheng Chang, Brian M. D'Onofrio, EwaAhnemark, Tamara Werner-Kiechle, and Henrik Larsson, "Trajectories of healthcare utilization and costs of psychiatric and somatic multimorbidity in adults with childhood ADHD: a prospective register-based study," Journal of child Psychology and Psychiatry 61:9 (2020), 959-968, https://doi.org/10.1111/jcpp.13206.
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A recent study from Istanbul sheds light on how psychiatric admissions and diagnoses changed during the first few months of the pandemic compared to previous periods, offering critical insights for parents, clinicians, and policymakers.
This study, conducted by a team of researchers led by Ozalp Ekinci, examined psychiatric admissions among children and adolescents during 2019 and 2020.
By looking at diagnosis rates for various psychiatric conditions, the researchers aimed to pinpoint shifts in the mental health landscape as a direct response to the pandemic.
The analysis revealed several notable trends in psychiatric diagnoses among children and adolescents:
This study’s findings highlight some key takeaways that can guide mental health support efforts for children and adolescents:
As we continue to see the effects of the COVID-19 pandemic on mental health, studies like this one serve as important reminders of the unique mental health needs of young people. Supporting children and adolescents through proactive and targeted mental health services—especially during times of crisis—will be crucial to fostering resilience and well-being in future generations.
Adult ADHD has long been a subject of debate in the field of mental health, with previous estimates of its prevalence varying widely. To achieve a more precise understanding, an international team of researchers conducted a new umbrella review and meta-analysis, offering an updated estimate of adult ADHD rates worldwide.
This large-scale analysis combined five systematic reviews and meta-analyses, incorporating data from 57 unique primary studies. Altogether, the research synthesized findings from a pooled total of over 21 million participants. This comprehensive approach provided a more accurate estimate of the global prevalence of ADHD in adults.
The study concluded that the worldwide prevalence of adult ADHD is 3.1%, with a 95% confidence interval ranging from 2.6% to 3.6%. This estimate falls within the range of earlier reports but provides a more targeted understanding of the rate at which ADHD affects adults globally.
The researchers described this prevalence rate as “relatively high.” They noted that it is only slightly lower than the estimated prevalence of major mental health conditions like schizophrenia (4%) and major depressive disorder (5%)—disorders that have historically received significant attention and resources worldwide.
Moreover, the prevalence of adult ADHD is higher than that of several other well-known mental health conditions, including bipolar disorder (1%), as well as anxiety disorders such as PTSD (Post-Traumatic Stress Disorder), OCD (Obsessive-Compulsive Disorder), GAD (Generalized Anxiety Disorder), and panic disorders.
This updated estimate emphasizes that ADHD is a significant global mental health concern in adults, comparable to or exceeding the prevalence of other disorders that are often more widely recognized. These findings underscore the need for greater awareness, research, and treatment options for adult ADHD, which is still frequently misunderstood or overlooked in the broader discourse of mental health.
By providing a clearer picture of how prevalent ADHD is in adult populations around the world, this study contributes valuable data that could shape future research, policy, and clinical approaches.
Attention-Deficit/Hyperactivity Disorder (ADHD) remains a prevalent condition among children and adolescents in the United States. A recent analysis based on the National Health Interview Survey (NHIS), conducted by the National Center for Health Statistics at the CDC, provides an updated look at ADHD prevalence from 2018 to 2021. Here’s a closer look at what the data reveals.
The NHIS is an annual survey primarily conducted through face-to-face interviews in respondents’ homes. Telephone interviews are used as a substitute in cases where travel is impractical. For each family interviewed, one child aged 3-17 is randomly selected for the survey through a computer program. Over the four years studied (2018-2021), a total of 26,422 households with children or adolescents participated.
The analysis found that 9.5% of children and adolescents in the United States had been diagnosed with ADHD, based on reports from family members. However, the prevalence varied significantly with age:
The increase in ADHD diagnosis with age underscores the importance of monitoring children’s developmental needs as they progress through school and adolescence.
The survey revealed a notable difference in ADHD prevalence between genders, with 12.4% of males diagnosed compared to 6.6% of females—nearly a two-to-one gap. This aligns with previous research indicating that ADHD is more frequently diagnosed in boys than girls, though awareness of how ADHD presents differently across genders is growing.
Family income played a significant role in ADHD prevalence, particularly among lower-income groups:
This pattern suggests that socioeconomic factors might influence the diagnosis and management of ADHD, with lower-income families possibly experiencing greater barriers to early diagnosis or consistent treatment.
Geographic location also impacted ADHD rates. Prevalence was highest in the South (11.3%), followed by the Midwest (10%), the Northeast (9.1%), and significantly lower in the West (6.9%). These variations could reflect regional differences in healthcare access, diagnostic practices, or cultural attitudes towards ADHD.
Despite these variations in demographics, the overall prevalence of ADHD remained relatively stable across the study period from 2018 to 2021, showing no significant changes by year.
The findings from this updated analysis provide a clearer picture of ADHD’s prevalence across different demographic groups in the United States. They highlight the need for tailored approaches to diagnosis and care, taking into account factors like age, gender, income, and geographic location. With ADHD being a common condition affecting nearly 1 in 10 children, ongoing research and support for families are crucial to ensure that those with ADHD receive the care and resources they need.
This study reinforces the importance of awareness and early intervention, especially for families in underserved regions or those facing economic challenges. As clinicians and educators continue to support children with ADHD, understanding these demographic trends can help in creating more equitable access to diagnosis and treatment.
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