Editing Attention deficit hyperactivity disorder (section)

==Epidemiology==
{{Main|Epidemiology of attention deficit hyperactive disorder}}

[[File:Map-Ever-Diagnosed-2011-550px.jpg|thumb|upright=1.35|Percentage of people 4–17 ever diagnosed in the US as of 2011<ref>{{cite web |title=State-based Prevalence Data of Parent Reported ADHD |url=https://www.cdc.gov/ncbddd/adhd/prevalence.html |website=Centers for Disease Control and Prevention |access-date=31 March 2020 |date=13 February 2017 |archive-date=30 March 2019 |archive-url=https://web.archive.org/web/20190330123802/https://www.cdc.gov/ncbddd/adhd/prevalence.html |url-status=live }}</ref>]]
ADHD is estimated to affect about&nbsp;6–7% of people aged 18 and under when diagnosed via the DSM-IV criteria.<ref name="pmid22976615"/> When diagnosed via the ICD-10 criteria, rates in this age group are estimated around&nbsp;1–2%.<ref name="Cowen_2012">{{cite book |vauthors=Cowen P, Harrison P, Burns T |url={{google books|O3sSd-OAdP0C|plainurl=yes}} |title=Shorter Oxford Textbook of Psychiatry |publisher=[[Oxford University Press]] |year=2012 |isbn=978-0-19-960561-3 |edition=6th |pages=[{{google books|O3sSd-OAdP0C |page=546|plainurl=yes}} 546] |chapter=Drugs and other physical treatments |chapter-url={{google books|O3sSd-OAdP0C |page=507|plainurl=yes}} |via=Google Books}}</ref> Rates are similar between countries and differences in rates depend mostly on how it is diagnosed.<ref name="Jones_2011">{{cite book |title=Textbook of Psychiatric Epidemiology |vauthors=Faraone SV |publisher=[[John Wiley & Sons]] |year=2011 |isbn=978-0-470-97740-8 |veditors=Tsuang MT, Tohen M, Jones P |edition=3rd |page=450 |chapter=Ch. 25: Epidemiology of Attention Deficit Hyperactivity Disorder |access-date=1 February 2016 |chapter-url=https://books.google.com/books?id=fOc4pdXe43EC&pg=PA450 |archive-url=https://web.archive.org/web/20201222193454/https://books.google.com/books?id=fOc4pdXe43EC&pg=PA450 |archive-date=22 December 2020 |url-status=live}}</ref> Children in North America appear to have a higher rate of ADHD than children in Africa and the Middle East; this is believed to be due to differing methods of diagnosis rather than a difference in underlying frequency. (The same publication which describes this difference also notes that the difference may be rooted in the available studies from these respective regions, as far more studies were from North America than from Africa and the Middle East.)<ref name="Polanczyk_2007">{{cite journal |vauthors=Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA |title=The worldwide prevalence of ADHD: a systematic review and metaregression analysis |journal=[[The American Journal of Psychiatry]] |volume=164 |issue=6 |pages=942–948 |date=June 2007 |pmid=17541055 |doi=10.1176/appi.ajp.164.6.942 |lccn=22024537 |doi-access=free |oclc=1480183 |eissn=1535-7228}}</ref><!--From recollection, this article may be better summarised as "kids in NA have a higher rate of DIAGNOSIS". It may be a subtle difference but it's very important.--> {{As of|2019|post=,}} it was estimated to affect 84.7 million people globally.<ref name=GBD2019>{{Cite journal |author=[[Institute for Health Metrics and Evaluation]] |date=17 October 2020 |title=Global Burden of Disease Study 2019: Attention-deficit/hyperactivity disorder—Level 3 cause |url=https://www.thelancet.com/pb-assets/Lancet/gbd/summaries/diseases/adhd.pdf |journal=[[The Lancet]] |volume=396 |issue=10258 |via= |access-date=7 January 2021 |archive-date=7 January 2021 |archive-url=https://web.archive.org/web/20210107135215/https://www.thelancet.com/pb-assets/Lancet/gbd/summaries/diseases/adhd.pdf |url-status=live |at=Table 1}}. Both DSM-IV-TR and ICD-10 criteria were used.</ref>

ADHD is diagnosed approximately twice as often in boys as in girls,<ref name="DSM5TR" /><ref name="pmid22976615">{{cite journal |vauthors=Willcutt EG |title=The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490–499 |date=July 2012 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8}}</ref> and 1.6 times more often in men than in women,<ref name="DSM5TR" /> although the disorder is overlooked in girls or diagnosed in later life because their symptoms sometimes differ from diagnostic criteria.{{refn|<ref>{{cite journal |vauthors=Young S, Adamo N, Ásgeirsdóttir BB, Branney P, Beckett M, Colley W, Cubbin S, Deeley Q, Farrag E, Gudjonsson G, Hill P, Hollingdale J, Kilic O, Lloyd T, Mason P, Paliokosta E, Perecherla S, Sedgwick J, Skirrow C, Tierney K, van Rensburg K, Woodhouse E |title=Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women |journal=[[BMC Psychiatry]] |volume=20 |issue=1 |page=404 |date=August 2020 |pmid=32787804 |pmc=7422602 |doi=10.1186/s12888-020-02707-9 |doi-access=free}}</ref><ref>{{cite journal |vauthors=Crawford N |date=February 2003 |title=ADHD: a women's issue |journal=Monitor on Psychology |volume=34 |issue=2 |page=28 |url=http://www.apa.org/monitor/feb03/adhd.aspx |url-status=live |archive-url=https://web.archive.org/web/20170409110923/http://www.apa.org/monitor/feb03/adhd.aspx |archive-date=9 April 2017}}</ref><ref name="pmid19393378">{{cite journal |vauthors=Emond V, Joyal C, Poissant H |title=[Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)] |language=fr |journal=L'Encephale |volume=35 |issue=2 |pages=107–114 |date=April 2009 |pmid=19393378 |doi=10.1016/j.encep.2008.01.005 |trans-title=Structural and functional neuroanatomy of attention-deficit hyperactivity disorder (ADHD)}}</ref><ref name="Singh_2008">{{cite journal |vauthors=Singh I |title=Beyond polemics: science and ethics of ADHD |journal=[[Nature Reviews Neuroscience]] |volume=9 |issue=12 |pages=957–964 |date=December 2008 |pmid=19020513 |doi=10.1038/nrn2514 |s2cid=205504587}}</ref>}}<ref>{{cite journal |vauthors=Staller J, Faraone SV |title=Attention-deficit hyperactivity disorder in girls: epidemiology and management |journal=[[CNS Drugs]] |volume=20 |issue=2 |pages=107–123 |year=2006 |pmid=16478287 |doi=10.2165/00023210-200620020-00003 |s2cid=25835322}}</ref> In 2014, [[Keith Conners]], one of the early advocates for recognition of the disorder, spoke out against overdiagnosis in a ''[[New York Times]]'' article.<ref name="NYT2013">{{cite news |vauthors=Schwarz A |title=The Selling of Attention Deficit Disorder |url=https://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html |access-date=26 February 2015 |newspaper=The New York Times |date=14 December 2013 |url-status=live |archive-url=https://web.archive.org/web/20150301054334/http://www.nytimes.com/2013/12/15/health/the-selling-of-attention-deficit-disorder.html |archive-date=1 March 2015}}</ref> In contrast, a 2014 peer-reviewed medical literature review indicated that ADHD is underdiagnosed in adults.<ref name="Ginsberg_2014" />

Studies from multiple countries have reported that children born closer to the start of the school year are more frequently diagnosed with and medicated for ADHD than their older classmates.<ref>{{cite journal |vauthors=Whitely M, Raven M, Timimi S, Jureidini J, Phillimore J, Leo J, Moncrieff J, Landman P |title=Attention deficit hyperactivity disorder late birthdate effect common in both high and low prescribing international jurisdictions: a systematic review |journal=[[Journal of Child Psychology and Psychiatry|Journal of Child Psychology and Psychiatry, and Allied Disciplines]] |volume=60 |issue=4 |pages=380–391 |date=April 2019 |pmid=30317644 |pmc=7379308 |doi=10.1111/jcpp.12991}}</ref> Boys who were born in December where the school age cut-off was 31 December were shown to be 30% more likely to be diagnosed and 41% more likely to be treated than those born in January. Girls born in December had a diagnosis and treatment percentage increase of 70% and 77% respectively compared to those born in January. Children who were born at the last three days of a calendar year were reported to have significantly higher levels of diagnosis and treatment for ADHD than children born at the first three days of a calendar year. The studies suggest that ADHD diagnosis is prone to subjective analysis.<ref name="Ford-Jones_2015" />

Rates of diagnosis and treatment have increased in both the United Kingdom and the United States since the 1970s. Prior to 1970, it was rare for children to be diagnosed with ADHD, while in the 1970s rates were about 1%.<ref>{{cite periodical |vauthors=Connor DF |date=2011 |title=Problems of overdiagnosis and overprescribing in ADHD: are they legitimate? |url=https://www.psychiatrictimes.com/view/problems-overdiagnosis-and-overprescribing-adhd |url-status=live |archive-url=https://web.archive.org/web/20210812122049/https://www.psychiatrictimes.com/view/problems-overdiagnosis-and-overprescribing-adhd |archive-date=12 August 2021 |magazine=Psychiatric Times |volume=28 |issue=8 |page=14}}</ref> This is believed to be primarily due to changes in how the condition is diagnosed<ref name="CDCTime2013" /> and how readily people are willing to treat it with medications rather than a true change in incidence.<ref name="Cowen_2012" /> With widely differing rates of diagnosis across countries, states within countries, races, and ethnicities, some suspect factors other than symptoms of ADHD are playing a role in diagnosis, such as cultural norms.<ref name="Elder-2010">{{cite journal |vauthors=Elder TE |title=The importance of relative standards in ADHD diagnoses: evidence based on exact birth dates |journal=[[Journal of Health Economics]] |volume=29 |issue=5 |pages=641–656 |date=September 2010 |pmid=20638739 |pmc=2933294 |doi=10.1016/j.jhealeco.2010.06.003}}</ref><ref name="Ford-Jones_2015">{{cite journal |vauthors=Ford-Jones PC |title=Misdiagnosis of attention deficit hyperactivity disorder: 'Normal behaviour' and relative maturity |journal=[[Paediatrics & Child Health]] |volume=20 |issue=4 |pages=200–202 |date=May 2015 |pmid=26038639 |pmc=4443828 |doi=10.1093/pch/20.4.200}}</ref>

Despite showing a higher frequency of symptoms associated with ADHD, [[people of color|non-White]] children in the US are less likely than [[White American|White]] children to be diagnosed or treated for ADHD, a finding that is often explained by bias among health professionals, as well as parents who may be reluctant to acknowledge that their child has ADHD.<ref>{{cite journal |vauthors=Coker TR, Elliott MN, Toomey SL, Schwebel DC, Cuccaro P, Tortolero Emery S, Davies SL, Visser SN, Schuster MA |title=Racial and Ethnic Disparities in ADHD Diagnosis and Treatment |journal=[[Pediatrics (journal)|Pediatrics]] |volume=138 |issue=3 |pages=e20160407 |date=September 2016 |pmid=27553219 |pmc=5684883 |doi=10.1542/peds.2016-0407 |quote=There are various improvements in care that may help in closing this gap in diagnosis and treatment. These include actively and universally eliciting parental concerns about child behavior and academic performance (at home and school) at well-visits,32,33 providing care that is culturally relevant in families' preferred languages,34 and linking with community resources to provide mental health education, guidance, and services to families (eg, parent training courses for parents of children with ADHD).35–39 Pediatric clinicians also may need to consider universal behavioral health screening tools for children to improve diagnostic capabilities and recognize when a child has ADHD symptoms, even if the problem is not recognized by the parent. Because the rates of diagnosis and treatment are rising in the general population of US children, a significant need remains to identify and treat African-American and Latino children who have ADHD and avoid a widening of these disparities.}}</ref> Crosscultural differences in diagnosis of ADHD can also be attributed to the long-lasting effects of harmful, racially targeted medical practices. Medical pseudosciences, particularly those that targeted Black populations during the period of slavery in the US, lead to a distrust of medical practices within certain communities. The combination of ADHD symptoms often being regarded as misbehaviour rather than as a psychiatric condition, and the use of drugs to regulate ADHD, result in a hesitancy to trust a diagnosis of ADHD. Cases of misdiagnosis in ADHD can also occur due to stereotyping of people of color. Due to ADHD's subjectively determined symptoms, medical professionals may diagnose individuals based on stereotyped behaviour or misdiagnose due to cultural differences in symptom presentation.<ref name="Slobodin_2020">{{cite journal |vauthors=Slobodin O, Masalha R |title=Challenges in ADHD care for ethnic minority children: A review of the current literature |journal=Transcultural Psychiatry |volume=57 |issue=3 |pages=468–483 |date=June 2020 |pmid=32233772 |doi=10.1177/1363461520902885 |s2cid=214768588}}</ref>

A 2024 study in [[Centers for Disease Control and Prevention|CDC]]'s [[Morbidity and Mortality Weekly Report]] reports around 15.5 million U.S. adults have attention-deficit hyperactivity disorder, with many facing challenges in accessing treatment.<ref>{{Cite journal |last=Staley |first=Brooke S. |date=2024 |title=Attention-Deficit/Hyperactivity Disorder Diagnosis, Treatment, and Telehealth Use in Adults — National Center for Health Statistics Rapid Surveys System, United States, October–November 2023 |url=https://www.cdc.gov/mmwr/volumes/73/wr/mm7340a1.htm?s_cid=mm7340a1_w |journal=MMWR. Morbidity and Mortality Weekly Report |language=en-us |volume=73 |issue=40 |pages=890–895 |doi=10.15585/mmwr.mm7340a1 |pmid=39388378 |pmc=11466376 |issn=0149-2195}}</ref> One-third of diagnosed individuals had received a prescription for a stimulant drug in the past year but nearly three-quarters of them reported difficulties filling the prescription due to medication shortages.<ref>{{Cite news |last=Singh |first=Puyaan |date=10 October 2024 |title=More than 15 million US adults have ADHD, new study estimates |url=https://www.reuters.com/business/healthcare-pharmaceuticals/more-than-15-million-us-adults-have-adhd-new-study-estimates-2024-10-10/ |work=[[Reuters]]}}</ref>