Research

ADHD on the rise in the U.S.


Young bored boy balancing a pencil on his nose.
By Cindy George | September 7, 2018

Attention deficit hyperactivity disorder, known as ADHD, has nearly doubled over the last generation to include more than 10 percent of U.S. children, according to a recent study published in JAMA Network Open.

Between 1997-1998 and 2015-2016, the prevalence of the diagnosis increased across age, gender, race/ethnicity, income and geography, but is notably twice as high in girls and Hispanic children and has more than doubled for Black children.

The results contain several qualifiers, such as the findings “suggest” an “estimated” prevalence of 10 percent.

Several Texas Medical Center experts said the analysis confirmed the trends they have observed over the last two decades.

Adiaha I. A. Spinks-Franklin, M.D., MPH
Adiaha I. A. Spinks-Franklin, M.D., MPH, a developmental-behavioral pediatrician at Texas Children’s Hospital and an assistant professor of development pediatrics at Baylor College of Medicine

“It isn’t surprising that the number has gone up over time considering all of the factors involved,” said Adiaha I. A. Spinks-Franklin, M.D., MPH, a developmental-behavioral pediatrician at Texas Children’s Hospital and an assistant professor of developmental pediatrics at Baylor College of Medicine. “The results are very compelling. What the results show is what many of us in medicine have suspected for a long time—that the prevalence has gone up. We really didn’t have the hard-core national numbers to back that up. I wasn’t surprised when I read the study at all.”

She noted that the research was based on parent reports and not medical records.

ADHD is one of the most common mental disorders affecting children, according to the American Psychiatric Association, with symptoms including inattention, hyperactivity and impulsivity.

The recent analysis examined data for 186,457 children ages 4 to 17 from in-person household interviews where a child in each family was randomly selected and a parent was asked: “Has a doctor or health professional ever told you that [the sample child] had attention-deficit/hyperactivity disorder (ADHD) or attention-deficit disorder (ADD)?” Each parent in the 2016 survey also received an inquiry about whether the sample child currently had ADHD or ADD.

For Spinks-Franklin, the arc of the research tracks with her career; she was in medical school in 1997 and has been a pediatrician nearly 20 years.

“There are a whole lot of prenatal and perinatal factors that are related to the risk of having ADHD too, including genetics,” she said. “If a parent has ADHD, their likelihood of having a child with ADHD is very high. If a mother smokes or uses alcohol or drugs or has poor nutrition or was under significant stress during her pregnancy, it increases the risk of the child being diagnosed with ADHD.”

Criteria has broadened

Both Spinks-Franklin and Memorial Hermann Health System child psychiatrist Carlos Guerra, M.D., pointed out that the criteria the scientific community uses for diagnosing ADHD has broadened over the last two decades.

Carlos Guerra, M.D.
Carlos Guerra, M.D., a child psychiatrist who serves as medical director for adolescent psychiatric services at the Memorial Hermann Health System’s Prevention and Recovery Center, known as PaRC.

“It used to be a hard-and-fast rule that you must have been diagnosed or at least have had significant impairment before the age of 7. Well, that’s no longer the case,” Guerra said, adding that the baseline age was lifted to 12 under the DSM-5, the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition,” published in 2013.

“You’re seeing an increase because you have better ability to diagnose, less stigma and maybe more access to medical care,” he said. “Many parents recognize that they have it, so they are willing to let their kids be diagnosed. And then you’re looking at the criteria change—and that’s made a lot of difference. Now you’re able to capture a bigger population.”

Guerra, a fast talker who serves as medical director for adolescent psychiatric services at Memorial Hermann Health System’s Prevention and Recovery Center, known as PaRC, also disclosed that he was diagnosed at age 31.

“I didn’t get diagnosed until I got out in the ‘real world’ when I left my residency and was in private practice. That’s when I started to see it affect my world,” he said. “If you can compensate and you’re smart enough, you can get missed for a long period of time … as long as you’re not hyper and not causing destruction in class. I wasn’t bouncing off the walls.”

The study was published online on August 31, 2018 as an open access article in the area of pediatrics. All five authors work for the University of Iowa at the Stead Family Children’s Hospital and/or the College of Public Health.




Social Posts

profile_image

BCMHouston

@bcmhouston

RT @TXMedCenter: .@bcmhouston co-hosted its annual “Update on Alzheimer’s Disease” last week in partnership with the Alzheimer’s Associatio…

21 mins ago
profile_image

Veterans Affairs

@DeptVetAffairs

Local Veteran finding peace with PTSD diagnosis https://t.co/2EchJgrEKv via @WEAU13News

23 mins ago
profile_image

University of Houston

@UHouston

@CozyGentry @uhparking

26 mins ago
profile_image

U.S. Department of Veterans Affairs

VeteransAffairs

This Veterans Month, we honor those who have sworn an oath to defend our nation. Thank you for your service and your sacrifices.#ExploreVA: http://bit.ly/2T4jMLD

29 mins ago
profile_image

Texas Children's

@TexasChildrens

Join the @HoustonTexans and Texas Children's Hospital at @levyparkhouston on Monday, December 3 for an evening of fun-filled events to keep your kids active!Learn more -->https://t.co/MXzaMNN0b2 https://t.co/HcNKGCHAcy

33 mins ago
profile_image

University of Houston

@UHouston

@TrojanU_SHHS @martinezmilton3 https://t.co/YWEjEqK9ao

38 mins ago
profile_image

Texas Children's

@TexasChildrens

How a family's search for answers led them to Texas Children's Neuroscience Center: https://t.co/DveuHuLD2W #texaschildrens

45 mins ago
profile_image

BCMHouston

@bcmhouston

Third-year medical student, Evan Schauer shares his journey in managing depression. https://t.co/8cEJDxIsDP #depression https://t.co/D2oDASZUt9

55 mins ago
profile_image

BCMHouston

@bcmhouston

RT @BCMHouston_News: For women who are pregnant this #Thanksgiving, @bcmhouston's Dr. Nina Ali shares her recommendations on foods to limit…

1 hour ago
profile_image

Rice University

@RiceUniversity

RT @RiceDining: one taught me love 🍰 one taught me patience ⏱ and one taught me pain 😭 https://t.co/DgkU32fZL0

1 hour ago
profile_image

Harris Health System

HarrisHealthSystem

The #GreatAmericanSmokeout is Thursday, Nov. 15. Are you ready to quit #smoking? Quitting smoking isn't easy--it takes time and a plan. Watch and learn how to make a solid plan that will keep you on the path to being smoke-free.

1 hour ago
profile_image

Veterans Affairs

@DeptVetAffairs

SBA and VA Celebrate National Veterans Small Business Week https://t.co/263lCQFoW6 via @smallbiztrends

1 hour ago
profile_image

Rice University

@RiceUniversity

RT @NSF_BIO: ICYMI: #NSFfunded! https://t.co/VsVp3DhRof

2 hours ago
profile_image

MD Anderson Cancer Center

@MDAndersonNews

Rob Moss finds success in managing both #HepC and stage IV non-Hodgkin’s #lymphoma at MD Anderson: https://t.co/s4NCWugMWY #lymsm #endcancer https://t.co/Lht7C4QqHl

2 hours ago
profile_image

CHI St. Luke's Health

@CHI_StLukes

Have some spare time on your commute? It takes less than three minutes to join our #CommunityVoice, a place to share your opinions on programs, services, and how we can continue to improve patient education and care: https://t.co/7MmYvX4yA5 https://t.co/43SsRG6qsL

2 hours ago