Whites Most Likely to Be Diagnosed With Adult ADHD

By Anne Harding

November 07, 2019

NEW YORK (Reuters Health) - Attention-deficit/hyperactivity disorder (ADHD) diagnoses in adults are on the rise, with markedly higher rates in whites than in other ethnic groups, new findings show.

"Clinicians may better serve patients by carefully considering symptoms across development, potential psychiatric comorbidities and cultural influences on health care seeking and delivery," Dr. Winston Chung of Kaiser Permanente Northern California (KPNC) in San Francisco, the study's first author, told Reuters Health by email.

Previous research has linked male sex, education level, divorced marital status and white ethnicity to higher odds of being diagnosed with ADHD, Dr. Chung and his team note in JAMA Network Open, online November 1.

To better understand trends in ADHD diagnoses based on race, they looked at more than 5 million adults and some 867,000 children aged 5 to 11 treated at KPNC in 2007-2016.

Among adults, 21.9% were aged 25-34, 50.5% were women, 41.7% were white and 1.12% were diagnosed with ADHD.

Prevalence of ADHD rose from 0.43% in 2007 to 0.96% in 2016. All ethnicities showed increases in adult diagnoses of ADHD over the study period, but prevalence among whites was consistently higher than in other ethnicities, increasing from 0.67% to 1.42%, compared to 0.22%-0.69% for black individuals, 0.56%-1.14% for Native Americans, 0.11%-0.39% for Pacific Islanders, 0.25%-0.65% for Latinos and 0.11%-0.35% for Asian Americans.

Factors associated with ADHD diagnosis included younger age, male sex, white race, divorced marital status, being employed and being more highly educated.

Several mental-health diagnoses were strongly associated with ADHD, including eating disorders (odds ratio, 5.2), depression (OR, 4.1), bipolar disorder (OR, 4.7) and anxiety disorder (OR, 2.4).

Adults with ADHD were also more likely to be frequent health care users and to have sexually transmitted infections.

ADHD prevalence in children increased from 2.96% in 2007 to 3.74% in 2016.

"Strategies for improving detection and treatment of ADHD in adults include careful, unbiased, structured screening and documentation of symptoms across development and increased understanding of the various social, psychological and biological differences among races/ethnicities as well as culturally sensitive approaches to identify and treat ADHD in the total population," Dr. Chung said.

SOURCE: https://bit.ly/36BrUd4

JAMA Netw Open 2019