Attention deficit hyperactivity disorder (ADHD) is a clinically heterogeneous disorder whose diagnosis relies on a combination of questionnaires (self, parent or teacher-reported), clinical interviews and, in some cases, neuropsychiatric testing.
Accurate diagnosis of ADHD is important as, if left untreated, it is associated with negative socioeconomic outcomes such as poor scholastic performance, unemployment, criminality and increased risk of developing other mental health conditions such as substance abuse disorder. The results from a GlobalData high-prescriber survey performed in January 2024 suggest that diagnostic trends for ADHD across the seven major markets (7MM: France, Germany, Italy, Japan, Spain, the UK and the US) are being shaped by standardised practices and tools. The survey, which included 125 clinicians from across these countries, revealed that clinicians frequently use screening tools such as the ADHD Rating Scale (ADHD-RS) as diagnostic aids.
Growth driven primarily by the US
According to GlobalData’s ADHD: Opportunity Assessment and Forecast report, GlobalData forecasts a steady increase in the diagnosed prevalent ADHD cases across the 7MM, with a compound annual growth rate (CAGR) of 0.4% from 2022 to 2032. The number of diagnosed prevalent cases is expected to grow from 21.1 million in 2022 to 22 million by 2032. This growth is primarily driven by the US, which has the largest ADHD population (accounting for 80% of the diagnosed ADHD population in the 7MM) and the highest projected growth rate from 2022 to 2032 at a CAGR of 0.6%. The adult segment is a significant driver of this increase, with diagnosed cases in the US expected to rise from 16.9 million in 2022 to 17.9 million by 2032, at a CAGR of 0.7%.
While the reason for the continued increase in ADHD-diagnosed prevalent cases in recent years, particularly in adults, is not clear, it has occurred alongside increasing awareness of the prevalence of ADHD into adulthood and updates in established diagnostic guidelines in the 7MM that have made the diagnostic criteria for adult ADHD clearer for clinicians. For example, in 2013, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Illnesses (DSM) was updated to its fifth edition (DSM-V), and among the changes was the first direct reference within the DSM editions of the diagnosis of ADHD in individuals older than 17 years of age. The 11th revision of The International Classification of Diseases (ICD-11) guideline published by the World Health Organization came into effect in 2022, and while previous ICD guidelines had not formally recognised ADHD, the ICD-11 included both the diagnostic criteria for ADHD and the recognition of adult ADHD.
The reliance on American clinical guidelines is a notable trend highlighted by GlobalData’s survey. The most frequently utilised guideline for ADHD diagnosis and treatment across the 7MM was the American Academy of Pediatrics’s Clinical Practice Guideline for the Diagnosis, Evaluation and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents, to which 50.4% of surveyed clinicians adhered. The DSM-V was the second most used guideline, with 41.6% of surveyed clinicians reporting its use. Most ADHD screening tools are adapted from established diagnostic guidelines. The ADHD-RS is a paediatric tool based on the DSM guidelines, as are the most popular adult ADHD screening tools: the Adult ADHD Self-Report Scale (ASRS) and the Diagnostic Interview for Adult ADHD (DIVA). A total of 56% of surveyed clinicians reported the use of the ADHD-RS, while 43.2% and 36.0% reported the use of the ASRS and DIVA, respectively (Figure 1). The high use of these screening tools may reflect the broader trend of increased diagnosis of ADHD across the 7MM, especially in adults.
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The availability of clear ADHD diagnostic criteria coupled with established screening tools is particularly important for clinicians to identify the heterogenous symptoms of ADHD in both the adult and paediatric populations. These standardised practices and tools aid the accurate diagnosis of ADHD and could be associated with the continued increase in ADHD-diagnosed prevalent cases.
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By GlobalData