Incidence of Attention-Deficit/Hyperactivity Disorder Between 2016 and 2023: A Retrospective Cohort.

OBJECTIVE

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.

METHOD

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.

RESULTS

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.

CONCLUSIONS

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.

RELEVANCE TO CLINICAL PRACTICE

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.