Paul Margaret L, Sheth Poorva, Davis Regan, Chrusciel Timothy, Messias Erick
Department of Psychology Saint Louis University St Louis Missouri USA.
School of Medicine Saint Louis University St Louis Missouri USA.
Psychiatr Res Clin Pract. 2025 Jan 13;7(1):18-24. doi: 10.1176/appi.prcp.20240121. eCollection 2025 Spring.
The present retrospective cohort study sought to advance our understanding of the incidence and recent trends in new ADHD diagnoses among adolescents and adults between 2016 and 2023 in a clinical setting.
Participants ( = 144,103) included adolescents and adult patients who actively utilized Sisters of Saint Mary (SSM) healthcare services. ICD-10 codes were used to identify new ADHD diagnoses in patient charts. Joinpoint regression analysis determined incidence rates and trends of ADHD diagnoses, stratified by age group.
In adults, a significant (-10.6%; 95% CI -25.0%, -2.8%) downward trend in ADHD incidence was observed from 2016 to 2020, whereas a significant (+15.2%; 95% CI: 2.0%, 40.3%) upward trend was indicated from 2020 to 2023. Among adolescents, a significant (-26.1%; 95% CI: -33.4%, -14.4%) downward trend was observed between 2016 and 2018, while the incidence rate remained stable during 2018-2023.
This study is one of the largest retrospective cohort studies to investigate the incidence of new ADHD diagnoses among adolescents and adults in clinical practice, including before, during, and after the height of the COVID-19 pandemic. Results indicate fluctuations in the incidence rates of new ADHD diagnoses in recent years, with well-defined trends observed for adolescents and adults. Future directions should include the investigation of the underlying factors contributing to these diagnostic trends.
Advancing our understanding of diagnostic trends in clinical practice promotes accurate diagnosis and improved management of ADHD. Study findings support future investigation in identifying potential modifiable risk factors, ensuring sufficient treatment resources, developing targeted interventions, and addressing diagnostic disparities.
本项回顾性队列研究旨在增进我们对2016年至2023年期间临床环境中青少年和成人新诊断注意力缺陷多动障碍（ADHD）的发病率及近期趋势的理解。
参与者（n = 144,103）包括积极使用圣玛丽修女会（SSM）医疗服务的青少年和成年患者。使用国际疾病分类第十版（ICD - 10）编码在患者病历中识别新的ADHD诊断。连接点回归分析确定了按年龄组分层的ADHD诊断发病率和趋势。
在成人中，2016年至2020年观察到ADHD发病率显著下降（-10.6%；95%置信区间 - 25.0%，-2.8%），而2020年至2023年则呈现显著上升趋势（+15.2%；95%置信区间：2.0%，40.3%）。在青少年中，2016年至2018年观察到显著下降趋势（-26.1%；95%置信区间：-33.4%，-14.4%），而在2018 - 2023年期间发病率保持稳定。
本研究是调查临床实践中青少年和成人新诊断ADHD发病率的最大规模回顾性队列研究之一，涵盖了新冠疫情高峰期之前、期间和之后。结果表明近年来新诊断ADHD的发病率存在波动，青少年和成人呈现出明确的趋势。未来的研究方向应包括调查导致这些诊断趋势的潜在因素。
增进我们对临床实践中诊断趋势的理解有助于ADHD的准确诊断和改善管理。研究结果支持未来开展调查，以确定潜在的可改变风险因素、确保足够的治疗资源、制定有针对性的干预措施并解决诊断差异。
