Trafford Alex M, Carr Matthew J, Ashcroft Darren M, Chew-Graham Carolyn A, Cockcroft Emma, Cybulski Lukasz, Garavini Emma, Garg Shruti, Hussey Louise, Kabir Thomas, Kapur Nav, Temple Rachel K, Webb Roger T, Mok Pearl Lh
Centre for Pharmacoepidemiology & Drug Safety, Division of Pharmacy & Optometry, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.
NIHR Greater Manchester Patient Safety Research Collaboration, University of Manchester, Manchester, UK.
Br J Gen Pract. 2025 Aug 28;75(758):e566-e576. doi: 10.3399/BJGP.2024.0804. Print 2025 Sep 1.
Despite growing concerns about young people's mental health, it remains unclear how rates of psychiatric diagnoses and psychotropic medication prescribing have changed.
To investigate temporal trends in UK primary care-recorded incidence of (1) psychiatric diagnoses: attention deficit hyperactivity disorders (ADHD), autism spectrum conditions, anxiety disorders, depression, substance misuse, and personality disorders, and (2) psychotropic medication prescribing, in individuals aged 1-24 years.
This was a population-based study using primary care data from the Clinical Practice Research Datalink.
The monthly incidence of each outcome from January 2010 to March 2022 were calculated. Negative binomial regression was used to predict expected incidence rates when the COVID-19 pandemic began in March 2020, based on antecedent trends. Observed and predicted (that is, expected) rates were compared.
In the 2 years following March 2020, the incidence of ADHD diagnoses in females was 24.7% (95% confidence interval = 11.9 to 38.9%) greater than the expected incidence rate predicted from the trends before the pandemic. The increase in ADHD diagnoses occurred more commonly for females aged 20-24 years, followed by those aged 17-19 years, as well as among females from less deprived areas. Similar trends were observed for ADHD medications. Observed rates of other outcomes, including common mental illnesses, were below or close to the expected levels, with the differentials between observed and expected rates being greater for males than females.
Increased ADHD awareness may partly explain the study's findings. However, the fall in other diagnoses may reflect barriers to accessing health services at the height of the pandemic. Early identification and timely treatment of mental health difficulties and neurodevelopmental conditions are crucial.
尽管人们越来越关注年轻人的心理健康，但尚不清楚精神疾病诊断率和精神药物处方率是如何变化的。
调查英国初级保健记录的1至24岁个体中（1）精神疾病诊断的时间趋势：注意力缺陷多动障碍（ADHD）、自闭症谱系障碍、焦虑症、抑郁症、物质滥用和人格障碍，以及（2）精神药物处方情况。
这是一项基于人群的研究，使用了来自临床实践研究数据链的初级保健数据。
计算了2010年1月至2022年3月每个结果的月度发病率。采用负二项回归，根据疫情前的趋势预测2020年3月新冠疫情开始时的预期发病率。比较了观察到的发病率和预测的（即预期的）发病率。
在2020年3月后的两年里，女性ADHD诊断发病率比疫情前趋势预测的预期发病率高24.7%（95%置信区间=11.9%至38.9%）。ADHD诊断增加在20至24岁的女性中更为常见，其次是17至19岁的女性，以及来自贫困程度较低地区的女性。ADHD药物也观察到类似趋势。包括常见精神疾病在内的其他结果的观察发病率低于或接近预期水平，男性观察发病率与预期发病率之间的差异大于女性。
ADHD意识的提高可能部分解释了该研究的结果。然而，其他诊断的下降可能反映了疫情高峰期获得医疗服务的障碍。早期识别和及时治疗心理健康问题和神经发育疾病至关重要。
