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Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011

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Objective

Data from the 2003 and 2007 National Survey of Children’s Health (NSCH) reflect the increasing prevalence of parent-reported attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment by health care providers. This report updates these prevalence estimates for 2011 and describes temporal trends.

Method

Weighted analyses were conducted with 2011 NSCH data to estimate prevalence of parent-reported ADHD diagnosis, current ADHD, current medication treatment, ADHD severity, and mean age of diagnosis for U.S. children/adolescents aged 4 to 17 years and among demographic subgroups. A history of ADHD diagnosis (2003–2011), as well as current ADHD and medication treatment prevalence (2007–2011), were compared using prevalence ratios and 95% confidence intervals.

Results

In 2011, 11% of children/adolescents aged 4 to 17 years had ever received an ADHD diagnosis (6.4 million children). Among those with a history of ADHD diagnosis, 83% were reported as currently having ADHD (8.8%); 69% of children with current ADHD were taking medication for ADHD (6.1%, 3.5 million children). A parent-reported history of ADHD increased by 42% from 2003 to 2011. Prevalence of a history of ADHD, current ADHD, medicated ADHD, and moderate/severe ADHD increased significantly from 2007 estimates. Prevalence of medicated ADHD increased by 28% from 2007 to 2011.

Conclusions

Approximately 2 million more U.S. children/adolescents aged 4 to 17 years had been diagnosed with ADHD in 2011, compared to 2003. More than two-thirds of those with current ADHD were taking medication for treatment in 2011. This suggests an increasing burden of ADHD on the U.S. health care system. Efforts to further understand ADHD diagnostic and treatment patterns are warranted.

Section snippets

Method

The NSCH is a national cross-sectional, random-digit–dialed telephone survey conducted in 2003 to 2004 (designated as “2003”), 2007 to 2008 (“2007”), and 2011–2012 (“2011”).24, 25, 30 The NSCH uses the sampling frame of the National Immunization Survey31; because of the rise in the prevalence of cell-phone–only households, the 2011 NSCH added a sample of cell-phone numbers. Between February 2011 and June 2012, 95,677 interviews were completed, resulting in landline and cell-phone interview

Results

All ADHD survey indicators extended from parent-reported data for children/adolescents aged 4 to 17 years; for brevity, the term “parent-reported” and age (4–17 years) is excluded as a qualifier of the relevant estimates that follow.

Discussion

The epidemiological profile for ADHD diagnosis and treatment continues to evolve. Based on parent-reported indicators of health care provider–diagnosed ADHD diagnosis and treatment, more than 1 in 10 school-aged children (11%) had received an ADHD diagnosis by a health care provider by 2011, representing more than 6.4 million children nationally. Nearly 1 in 5 high school boys and 1 in 11 high school girls had been diagnosed with ADHD. Of those with a history of ADHD, 83% had current ADHD in

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    This article is discussed in an editorial by Dr. John T. Walkup on page 14.

    Clinical guidance is available at the end of this article.

    An interview with the authors is available by podcast at www.jaacap.org or by scanning the QR code to the right.

    Ms. Danielson served as the statistical expert for this research.

    Disclaimer: The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

    The National Survey of Children’s Health is a module of the Centers for Disease Control and Prevention’s State and Local Area Integrated Telephone Survey and was sponsored by the Maternal and Child Health Bureau of the Health Resources and Services Administration.

    Disclosure: Drs. Bitsko, Holbrook, Kogan, Ghandour, Perou, and Blumberg, and Ms. Visser and Ms. Danielson report no biomedical financial interests or potential conflicts of interest.

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