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Attention deficit/hyperactivity disorder (ADHD) in children: more focus on care and support, less on diagnosis

BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2022-073448 (Published 08 February 2024) Cite this as: BMJ 2024;384:e073448
  1. Luise Kazda, research fellow1 2 3,
  2. Katy Bell, professor of clinical epidemiology1 2,
  3. Rae Thomas, associate professor of evidence based healthcare and research education lead2 4 5,
  4. Leah Hardiman, independent consumer representative2 6,
  5. Iona Heath, former general practitioner7,
  6. Alexandra Barratt, professor of public health1 2
  1. 1Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia
  2. 2Wiser Healthcare, Australia
  3. 3NHMRC Healthy Environments and Lives (HEAL) National Research Network, Health Research Institute, University of Canberra, Canberra, ACT, Australia
  4. 4Institute for Evidence Based Healthcare, Bond University, QLD, Australia
  5. 5Tropical Australian Academic Health Centre, Townsville, QLD, Australia
  6. 6Brisbane, QLD, Australia
  7. 7London, UK
  1. Correspondence to: L Kazda Luise.Kazda{at}sydney.edu.au

ADHD diagnoses continue to increase, but Luise Kazda and colleagues argue that the push for diagnosis could be hampering access to care and support for children

Key messages

  • Diagnoses of attention deficit/hyperactivity disorder (ADHD) in children and adolescents have increased globally over the past 30 years

  • Diagnosing ADHD in children is assumed to result in better long term outcomes for them, but this is not well supported by evidence

  • Potential benefits of an ADHD diagnosis for access to interventions are often overemphasised in research and guideline development, whereas potential harms are generally overlooked

  • Providing symptom appropriate care and support for children with inattentive/hyperactive behaviours, regardless of diagnosis, might improve access to beneficial interventions while limiting harms from the diagnostic label

  • Robust studies on who is most likely to benefit, or be harmed, by an ADHD diagnosis are needed

The prevalence of attention deficit/hyperactivity disorder (ADHD) in children has been rising for several decades,1234 including in countries with previously low rates.5 In Germany, for example, the prevalence of ADHD in children rose by 77% over 10 years, from 2.2% in 2004 to 3.8% in 2013.6 Enhanced awareness of mental wellbeing and neurodiversity during the covid-19 pandemic has led to a change in public discourse around ADHD.78

Highly viewed videos on social media describe a variety of ADHD symptoms and encourage viewers to seek diagnostic evaluation.8910 Many of the most highly viewed TikTok videos (the #adhd hashtag stands at over 30 billion views) are easy to understand and relatable, but most provide content created by non-healthcare professionals that is often misleading or wrong,10 which can lead to “unrealistic expectations.”8 Diagnosis of ADHD, however, depends on an assessment of the frequency and severity of hyperactive and inattentive behaviours that exist on a …

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