ADHD Cases Soar But Medications May Carry Risks

Health experts say ADHD is an "expanding health concern" in the United States after national survey data showed that one million more children were diagnosed with ADHD in 2022 than in 2016.

While genetic, environmental, and social factors may play a role in the development of attention-deficit/hyperactivity disorder (ADHD), scientists still don't know for sure what causes the condition. Despite the unknowns about how it develops, the number of children diagnosed with ADHD continues to grow.

For example, data from the U.S. Centers for Disease Control and Prevention (CDC) released in March 2024 suggests that 11.3% or one in 10 American children have an ADHD diagnosis. In 2000, 6 to 8% of American children had the disorder, and that percentage jumped to approximately 9 to 10% in 2018.

However, according to a new analysis published on May 22 in the Journal of Clinical Child & Adolescent Psychology, that number may be even higher. The researchers say the results provide more evidence that ADHD "remains an ongoing and expanding public health concern."

To update the prevalence of ADHD among children in the United States, CDC researchers analyzed data from the 2022 National Survey of Children's Health (NSCH). The NSCH periodically surveys parents across the U.S. about their children's health and development.

Among those with current ADHD, 58.1% had moderate or severe symptoms, and nearly 78% had a co-occurring condition. The most common disorders occurring alongside ADHD were behavioral or conduct problems and anxiety.

Moreover, 36.5% of children with ADHD had a learning disability, and 21.7% had a developmental delay. In addition, the analysis found that approximately one out of seven children with ADHD also had autism spectrum disorder (ASD).

Who is more likely to have ADHD?

The data showed that boys were more likely to receive an ADHD diagnosis than girls. Moreover, the disorder was more common in white children than in Asian children, and Hispanic or Latino youngsters had a lower prevalence than non-Hispanic/Latino children.

Youngsters living in households where English was a second language were less likely to have ADHD than those residing in primarily English-speaking households.

In addition, children living in lower-income households and homes with high school as the highest level of education had a higher chance of having ADHD.

Location also influenced the disorder's prevalence. The analysis revealed that children living in the Northeast, Midwest, or South had a higher incidence of ADHD than those in the West. Moreover, youngsters in rural or suburban areas had higher rates of the condition compared to those living in urban locations.

Potential reasons for the increase in ADHD

According to the study's authors, the rising number of ADHD diagnoses could be the result of increased awareness of the condition. However, the COVID-19 pandemic may have played a role as well.

They note that the pandemic has been associated with adverse effects on children's mental health and an increase in ADHD symptoms.

"Relatedly, children experiencing symptoms of stress, depression, and anxiety during the pandemic may also exhibit symptoms of inattention and impulsivity — potentially leading to a diagnosis of ADHD when other diagnoses may be more appropriate," the authors wrote.

ADHD medications linked to heart risks

The data analysis also revealed that just over 50% of youngsters with a current ADHD diagnosis take medication for the disorder, and around 44% had received behavioral therapy in the past year. However, approximately 30% did not receive any ADHD-specific treatment.

Medications to treat ADHD include stimulant drugs such as amphetamine and dextroamphetamine (Adderall) and non-stimulants like atomoxetine (Strattera) or guanfacine (Intuniv).

Some research suggests that ADHD drugs may reduce the risk of mortality from unintentional injury, drug and alcohol overdose, and other unnatural causes. However, their impact on heart health has raised concerns among scientists.

For example, a 2023 study published in JAMA Psychiatry found that people who used ADHD medications for five years or more had a 23% increased risk of developing heart disease. The scientists say the increased high blood pressure and arterial disease risk associated with stimulant drugs may contribute to the higher cardiovascular disease risk found in the study.

In addition, a study recently published in the Journal of the American College of Cardiology found more associations between heart disease risks and ADHD medications.

The study's authors say that healthcare providers should consider a person's heart disease risk factors when prescribing medications, especially higher dosages over an extended period.

With the increasing prevalence of ADHD among children, further studies are needed to determine whether long-term use of ADHD medications among people in this age group poses similar heart-related health risks.