Introduction:
Public discussion about ADHD in the UK has intensified in recent years. A common claim in media commentary and public debate is that ADHD is now widely over-diagnosed. A recent editorial in The British Journal of Psychiatry examines that claim and reviews the available evidence.
The authors include leading clinicians and researchers in child and adolescent psychiatry. Their purpose is not to dismiss concerns about diagnostic practice, but to assess whether the evidence supports the claim that ADHD is being over-diagnosed.
Research:
The editorial reviews population studies and healthcare data.
When rigorous diagnostic criteria are applied, international research suggests that around 5.4% of children and adolescents meet diagnostic criteria for ADHD. In England, the NHS Digital Mental Health of Children and Young People Survey (2017) estimated that around 3.1% of children and young people meet DSM-5 criteria for ADHD.
By contrast, the proportion of people who actually receive a diagnosis in health services — often called administrative prevalence — is lower.
Although recorded ADHD diagnoses have increased over the past two decades, the editorial notes that administrative prevalence in England remains below expected population prevalence.
The authors therefore suggest that rising diagnosis rates may reflect greater awareness and improved identification, rather than excessive diagnosis. The paper also highlights pressure on ADHD services. It refers to evidence given to Parliament that many children and young people face waits of one to three years for NHS ADHD assessments.
Findings and Conclusion:
The editorial concludes that there is currently no published evidence that ADHD is over-diagnosed in the UK at a population level.
The authors accept that some people may be misdiagnosed, especially where assessments are incomplete or other explanations have not been properly considered. However, they make clear that this is not the same as widespread or systemic over-diagnosis.
Instead, the available evidence suggests that many people with ADHD are still not being diagnosed or supported.
The authors therefore warn that too much focus on alleged over-diagnosis may distract from the more pressing problem: the gap between the number of people who need ADHD assessment and support, and the capacity of services to provide it.
Study: https://www.cambridge.org/
This is a neutral summary.
Sean Kennedy
