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Jump In ADHD Diagnoses: Study

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  • Jump In ADHD Diagnoses: Study

    Marked Jump in ADHD Diagnoses
    Medscape Medical News
    Jan 21, 2013

    Rates of childhood diagnoses of attention-deficit/hyperactivity disorder (ADHD) increased markedly in the United States during the last decade, new research shows.

    Investigators from Kaiser Permanente Southern California's Department of Research and Evaluation found that rates of ADHD diagnosis increased from 2.5% in 2001 to 3.1% in 2010, a relative increase of 24%.

    "This is a significant increase over the 10-year period," lead investigator Darios Getahun, MD, PhD, told Medscape Medical News.

    The study also revealed "disproportionately high ADHD diagnosis rates among white children and notable increases among black girls."

    "While the reasons for increasing ADHD diagnosis rates are not well understood, contributing factors may include heightened ADHD awareness among parents and physicians as well as increased utilization of screening and other prevention programs," said Dr. Getahun.

    The study was published online January 21 in JAMA Pediatrics.

    Minority Sex Gap Closing
    For the study, researchers examined the electronic health records of 842,830 ethnically diverse children, aged 5 to 11 years, who received care at Kaiser Permanente Southern California between 2001 and 2010.

    "We observed wide variation in recent ADHD diagnosis trends by child age, sex, race/ethnicity, and median household income," Dr. Getahun said. "White, black, and Hispanic children were more likely to be diagnosed as having ADHD than Asian/Pacific Islanders and children of other races/ethnicities."

    Overall, 39,200 of 842,830 children (4.9%) had a diagnosis of ADHD. In 2010, 5.6% of white children had an ADHD diagnosis, as did 4.1% of black children, 2.5% of Hispanic, and 1.2% of Asian/Pacific Islander children.

    As mentioned, the incidence of newly diagnosed ADHD cases rose from 2.5% in 2001 to 3.1% in 2010 (24% relative increase).

    Black children showed the greatest increase in ADHD incidence, from 2.6% in 2001 to 4.1% in 2010, a 70% relative increase. The increase in rates of ADHD diagnosis among blacks was largely driven by an increase in girls (90% relative increase), the authors write.

    "Although boys were more likely to be diagnosed as having ADHD than girls, results suggest the sex gap for blacks may be closing over time," they note.

    ADHD rates among Hispanic children showed a 60% relative increase, from 1.7% in 2001 to 2.5% in 2010. White children showed a 30% relative increase, from 4.7% in 2001 to 5.6% in 2010. Rates for Asian/Pacific Islander children and other racial groups remained unchanged over time.

    "The mean age at ADHD diagnosis for Hispanic girls increased during the study period, suggesting a delayed diagnosis," Dr. Getahun reported. Children of parents with high median household incomes were also at increased risk for ADHD diagnosis, he said.

    "Serious" Concern
    Reached for comment, Joseph Biederman, MD, from the Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD in the Department of Psychiatry at Massachusetts General Hospital in Boston, told Medscape Medical News there is "nothing particularly surprising" about the study "beyond pointing out that physicians are a bit more willing to diagnose and treat this very morbid and treatable condition, including girls and minorities."

    "If anything, the article stresses the very large remaining gap of undiagnosed and untreated children with ADHD that represents, in my opinion, a very serious public health concern," said Dr. Biederman, who was not involved in the study.

    Dr. Getahun said the "large amount of missing race/ethnicity data observed in our cohort is a significant limitation. However, sensitivity analyses after classifying children with missing race/ethnicity data in each year to each race/ethnicity group data within the same year yielded similar estimates."
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  • #2
    Re: Jump In ADHD Diagnoses: Study

    Following up on Steve's earlier post, I found this CBC Radio piece with some Canadian stats.
    The CBC rebroadcast this piece as part of their 2014 summer schedule.

    Diagnosing ADHD: Are we getting it right?
    Tuesday, April 9, 2013 | Categories: Canadian , Episodes , Health
    The Current with Anna Marie Tremonti, CBC Radio

    On the heels of news that rates of ADHD have jumped over the last decade in the U.S., we're tracking ADHD in Canada. Here, the numbers may be smaller but the concerns are just as amplified and divided.

    Parents of PJ, Robert and Mary-Ann Costanzo

    After school can be peak craziness at Robert and Mary-Ann Costanzo's home in Toronto. With three kids under 7, it goes with the territory. Earlier this year, their oldest son's teacher believed PJ might have Attention Deficit Hyperactivity Disorder or ADHD.

    Over the last decade, the number of ADHD diagnoses has climbed all over the world. Some say that's because we're finally taking the condition seriously. But others -- including Robert, who is a teacher -- worry we've gone too far the other way ... that we may be over-diagnosing and over-medicating kids.

    Sociologist Marie-Christine Brault published ADHD study in Canada

    Last week, after examining test data from the U.S. Centers for Disease Control and Prevention,The New York Times reported that at some point in their lives, 11 per cent of U.S. children aged 4 to 17 had been diagnosed with ADHD. That's up 53 per cent over the last decade. Here in Canada, the rates are climbing too.

    Marie-Christine Brault is a Sociologist at the Université de Montréal. A little over a year ago, she published a study of ADHD rates in Canada. She was in Montreal.

    Centre for ADHD Awareness Canada, Heidi Bernhardt

    Still, if ADHD isn't diagnosed correctly, there may be significant impairments in adulthood. So, there are lots of good reasons to get this right and my next guest isn't so worried by the sharp increase in diagnoses.

    Heidi Bernhardt is the President and Executive Director of what's called CADDAC, the Centre for ADHD Awareness Canada. She has three sons diagnosed with ADHD. Heidi Bernhardt was in our Toronto studio.

    Last Word - Margaret Thatcher

    One of the more astonishing personalities of the last century left us this week. People found former British Prime Minister Margaret Thatcher ferocious, unyielding, principled and an ideologue.
    She was many things to many people. One of the consequences of a long life in the public eye is that so much of that life is recorded. Biographers will have much to pick over, but even the casual observer can witness Mrs. Thatcher's growth on film and video.
    In her early career, she sounds a little hesitant, even deferential, then her confidence grew. Strident, scolding and occasionally imperious, Margaret Thatcher was one of a kind. For today's Last Word, a little of the forging of The Iron Lady.

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