HQ Team
January 22, 2025: US adults with attention deficit hyperactivity disorder (ADHD) rose from 10.6% to 15.2% between 2020 and 2023, and Covid-19 pandemic may be a major factor, according to a study published in Psychiatric Research and Clinical Practice.
The research, one of the largest retrospective cohort studies that evaluated the incidence rates of new ADHD diagnoses among adolescents and adults in clinical practice between 2016 and 2023, was done on 144,103 US participants without a diagnostic history of the disorder.
During the years of the Covid-19 pandemic, the study’s findings indicated stability in new ADHD diagnoses among adolescents (aged 10-18 years) and an upward trend among adults (aged 19-50 years).
“The Covid‐19 pandemic had a substantial impact on mental health, including some indications of worsening ADHD symptoms and new‐onset diagnoses of ADHD, which may have contributed to our findings of an increased ADHD incidence rate among adults.”
Among adolescents, the observed disorder incidence was 2.89% in 2016 and fell to 1.67% in 2023. The trend from 2016 to 2020 showed a statistically significant decrease.
Inability to function at home, work
Between these years, the relative decrease in the incidence on adolescents was 26.1% annually. However, the trend from 2020 to 2023 did not show a statistically significant change.
In adults, the observed incidence of the disorder started at 0.78% in 2016 and ended at 0.93% in 2023. Between 2016 and 2020, the relative annual per cent change was 10.6%, and between 2020 and 2023, the trend reversed, and the average relative increase was 15.2%, according to the authors.
ADHD is marked by a persistent pattern of inattention or hyperactivity and impulsivity that makes it hard to function in at least two areas of life, such as at home, school, or work. It can be diagnosed in childhood or adulthood. However, adults must have shown symptoms much earlier, starting before age 12.
The main difference between diagnosing ADHD in children and adults is the number of symptoms. Adults or adolescents over 16 years must show five — instead of six — symptoms of inattention or hyperactivity and impulsivity, according to the National Institutes of Health.
Strained relationships
Adults with ADHD often have a history of poor academic performance, work problems, or strained relationships.
They may find it challenging to stay organized, stick to a job, keep appointments, perform daily tasks, or complete large projects. They may be restless, try to do multiple things at once, or engage in risky or impulsive behaviours.
These study’s findings indicate that the incidence rate of ADHD diagnoses among adults and adolescents has fluctuated over the years, with distinct trends observed during different periods.
“Fluctuations in incidence rates are likely due to a complex interplay of various factors, such as increased knowledge and destigmatization of ADHD, changes in diagnostic practices, increased access to healthcare services and treatment‐seeking patterns, and the impact of the COVID‐19 pandemic on mental health,” the authors wrote.
Increased awareness and destigmatisation of ADHD can lead to more diagnoses being made, resulting in higher incidence rates.
New diagnosis criteria
As knowledge about ADHD symptoms improves among healthcare providers, parents, and teachers, more cases may be identified and diagnosed.
Changes in diagnostic criteria or guidelines for ADHD can also influence incidence rates. For example, the expansion of ADHD criteria in the DSM‐5 compared to previous editions may have contributed to an increase in diagnoses.
However, variations in diagnostic practices and assessment methods across clinics and regions can lead to differences in incidence rates. “We cannot be certain that our findings would be fully generalizable to other healthcare systems across other regions of the United States.”
