Databyte: Paying Attention to the Rise in A.D.H.D.

Published on April 17, 2013by Dana March

Recently, the New York Times analyzed data from the Centers for Disease Control (C.D.C.), reporting that diagnoses of Attention Deficit Hyperactivity Disorder (A.D.H.D.) in children ages four through 17 are on the rise.

Data collected in the National Survey of Children’s Health (NSCH) in 2011-12 show that approximately 11 percent of all children have had a diagnosis of A.D.H.D.  The prevalence of A.D.H.D. in boys is approximately twice that of girls.

Diagnoses are linked to age as well as gender. According to the 2011-12 NSCH data, nearly 20 percent of boys ages 14 to 17 are diagnosed with A.D.H.D.

These figures are high—indeed, incredible to some experts. “There’s no way that one in five high-school boys has A.D.H.D.,” James Swanson, a professor of psychiatry at Florida International University, told the New York Times.

The C.D.C. has assembled survey data over the years that address A.D.H.D., including the NSHC and the National Health Interview Survey (NHIS). Both collect nationally representative data via phone interviews. Regardless of the data source, and specific age-gender associations observed in the data, the overall trend is clear. The prevalence of A.D.H.D. diagnoses has increased substantially over time.

What remains unclear, however, is why.

Dr. William Graf, a professor of pediatrics and neurology at Yale School of Medicine speculated on NPR, “[I]t could be that kids are actually changing, and there is actually more ADHD out there. But most people probably don’t believe that. Kids are spending more time in front of their computers, and they might be exercising less than in the past. Those are probably true. But whether or not that translates to a diagnosis of ADHD is less clear.”

Ultimately, Dr. Graf offered another explanation. “[T]here’s a lot of surveillance for this, so people are looking for it. There’s greater awareness and acceptance of the disorder and in part because the pharma industry has direct-to-consumer advertising, and they’ve succeeded in selling this.”

Given the increase over time in prescriptions for A.D.H.D. medications, which have the potential for abuse and/or misuse for performance optimization, as well as the alarming shortage of A.D.H.D. medications for those who legitimately need them, the rise in A.D.H.D. diagnoses is certainly a population-level phenomenon worth paying attention to.