The number of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) continues to climb, according to new data from the Centers for Disease Control and Prevention.
There has been a 42% increase in the number of reported cases of ADHD since 2003, according to a CDC-led study published in the Journal of the American Academy of Child and Adolescent Psychiatry.
Today, 6.4 million children between the ages of 4 and 17 - 11% of kids in this age group - have received an ADHD diagnosis, according to the study, which is based on a survey of parents. That's 2 million more children than in 2007.
The number of children using medications to treat ADHD is also rising. Since the last survey taken in 2007, there has been a 28% increase in children taking drugs to manage the disorder. More than 3.5 million children in the 4 to 17 age group, or 6%, are taking ADHD medications, the survey found.
These data are part of the CDC's National Survey of Children's Health, a national cross-sectional, randomized telephone survey. The survey is conducted every four years, and questions about ADHD diagnosis have been included since 2003. The latest data are from interviews conducted via telephone from February 2011 and June 2012, with 95,677 interviews completed and an overall response rate of 23%.
But while rising rates of ADHD diagnosis may be an alarming headline, Dr. John Walkup, director of child and adolescent psychiatry at Weill Cornell Medical College and New York-Presbyterian Hospital, found some positive news when looking at rates of prevalence and treatment. In his view, the data suggest that the increasing diagnosis rate of ADHD is getting closer to the true prevalence of ADHD, which is even higher.
"We've been working so hard for so long to improve treatment," Walkup said. "If the prevalence rate is 9 to 11% and we're getting 8% currently diagnosed, it suggests that the public advocacy for treatment is paying off."
Walkup, who wrote an editorial in the same edition of the journal but was not involved in the study, pointed out that the survey found that only 70% of diagnosed children were getting treated. "It's hard to argue that we're overtreating."
But Dr. Allen Frances, former chairman of the psychiatry department at Duke University, is wary.
"The numbers shouldn't be taken at face value. The history of psychiatry is a history of fads, and we are now suffering from a fad of ADHD," Frances said. He says the rates have tripled over the past 15 years because of sales pressure from pharmaceutical companies selling stimulants to treat ADHD.
"We are medicalizing immaturity and turning childhood into a disease," Frances said.
Susanna Visser, lead author of the study, says she understands Frances' concern. She pointed out that according to the survey, more than half of ADHD diagnosis were done by age 6.
"A lot of symptoms of ADHD, like hyperactivity, can also be appropriate developmental markers of age," she said. "You have to see a more 'wait and see' approach. Can they better be attributed to other things: sleep, divorce, trauma? A lot of things can look like ADHD, and once those symptoms aren't appropriate for a child's age, then we need to get treatment."
Visser, an epidemiologist with the CDC, added, "I don't think we have our doctors out there labeling children irresponsibly. In general, physicians are trying to help children with their needs."