Experts have disputed Wes Streeting’s claim that attention deficit hyperactivity disorder (ADHD) is overdiagnosed in the UK, saying that if anything, the condition is actually likely to be underdiagnosed.
In a paper published in the British Journal of Psychiatry on Friday, 32 experts including clinicians, academics, and patients warned the main challenge surrounding ADHD is that services “cannot adequately support”.
“Alarmist” rhetoric around a fear of overdiagnosis of ADHD could work to “deny” people the care they need, the team said.
It comes after health secretary Wes Streeting ordered a review into the diagnosis of mental health and neurodevelopmental conditions including ADHD.
Mr Streeting reportedly tasked leading experts with investigating whether common human emotions have become “over-pathologised”.
In the paper, the authors highlighted how health records show a rise in the rate of actual diagnosis of the condition in clinical services between 2000 and 2018, but suggested rising rates of diagnosis of the condition are more likely to be due to heightened awareness of ADHD among clinicians and patients.
While diagnosis rates have increased, they said data suggests it is still “substantially below the ADHD population prevalence in the UK, providing no evidence at present that ADHD is overdiagnosed at a population level”.
Around one in 20 children (5.4 per cent) and 3.3 per cent of adults are estimated to have ADHD, the paper says.
However, they did concede some people may have been misdiagnosed “due to low-quality assessment, poor adherence to national guidance, or inappropriate differential diagnosis”.
Professor Chris Hollis, co-author of the study from the University of Nottingham, said: “While the incidence of ADHD diagnosis has increased significantly since 2020 – particularly in women and young adults – NHS administrative data in England shows no evidence of overdiagnosis with the rate of ADHD diagnosis remaining below the expected levels of ADHD in the population.
He described the recent rise in ADHD diagnosis as a “catch-up” of “many years of under recognition and under diagnosis”.
“Hence, rather than ‘overdiagnosis’ the real concern should be the unacceptably long waiting times, sometimes over years, that people experience in the NHS for diagnosis, support and treatment,” he continued.
Professor Samuele Cortese from the University of Southampton, and lead author of the paper, said that despite there being an “alarmistic tone” around increasing rates, the reality is that many go undiagnosed and their needs unmet.
“This is quite concerning, of course, because if not treated properly, ADHD exposes to significant risk for the individual and their family,” he continued.
Prof Cortese said these risks include accidental injuries, traumatic injuries, car accidents, suicide, substance misuse and increased risk of death. He added attention should move away from increases or decreases in diagnosis and towards better treatment and support for those with the condition.
“While misdiagnosis and inappropriate diagnosis do occur, the available evidence indicates that under diagnosis and under treatment remain the predominant challenges.”
