The video version of this podcast can be found here:

·      https://youtu.be/aDbEwtY3hw0

This video refers to a number of medical articles on ADHD published by a number of organisations (details below). Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by any of them.

My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I cover ADHD increasing incidence, especially in adults, always focusing on what is relevant in Primary Care only. The information is based on a number of published medical articles. The links to them are below.

I am not giving medical advice; this video is intended for health care professionals, it is only my summary and my interpretation of the guidelines and you must use your clinical judgement.  

Disclaimer:

The Video Content on this channel is for educational purposes and not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen on this YouTube channel. The statements made throughout this video are not to be used or relied on to diagnose, treat, cure or prevent health conditions.

In addition, transmission of this Content is not intended to create, and receipt by you does not constitute, a physician-patient relationship with Dr Fernando Florido, his employees, agents, independent contractors, or anyone acting on behalf of Dr Fernando Florido.

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There is a podcast version of this and other videos that you can access here:

Primary Care guidelines podcast:

·      Redcircle: https://redcircle.com/shows/primary-care-guidelines

·      Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK

·      Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148

There is a YouTube version of this and other videos that you can access here: 

• The Practical GP YouTube Channel: 

https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk

The resources consulted can be found here:

1.   Shah P et al. “Potential impact of social media and COVID-19 restrictions on adult attention-deficit rates.” BJPsych Bulletin, 2025.

https://pubmed.ncbi.nlm.nih.gov/41208391/

2.   Adult Psychiatric Morbidity Survey 2023–24, Chapter 9: ADHD (NHS England, 2024).

https://digital.nhs.uk/data-and-information/publications/statistical/adult-psychiatric-morbidity-survey/survey-of-mental-health-and-wellbeing-england-2023-24/attention-deficit-hyperactivity-disorder?utm

3.   McKechnie DGJ et al., UK primary-care database study, 1998–2018 – summarised by NIHR as “Significant rise in ADHD diagnoses in the UK” (2023).

https://www.nihr.ac.uk/news/significant-rise-adhd-diagnoses-uk?utm

4.   Gimbach S et al. “ADHD medicine consumption in Europe after COVID-19.” Public Health / Pharmacoepidemiology, 2024.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10854136/?utm

5.   Rzeszutek M et al. “Global Trends in ADHD Medication Use: Multiple Contexts and Populations.” Journal of Clinical Medicine, 2025.

https://www.mdpi.com/2077-0383/14/20/7338?utm

6.   Martin AF et al. “The changing prevalence of ADHD? A systematic review.” Journal of Affective Disorders, 2025.

https://www.sciencedirect.com/science/article/pii/S0165032725008638?utm

7.   Staley BS et al. “ADHD Diagnosis, Treatment, and Telehealth Use in Adults — United States, 2023.” MMWR (CDC), 2024.

https://www.cdc.gov/mmwr/volumes/73/wr/mm7340a1.htm?utm

8.   Butt DA et al. “Prevalence and Incidence Trends of Attention Deficit Hyperactivity Disorder in Canada.” Canadian Journal of Psychiatry, 2024.

https://journals.sagepub.com/doi/10.1177/07067437231213553?utm

9.   Therapeutics Initiative. “ADHD in adults.” Bulletin 144, 2023.

https://www.ti.ubc.ca/2023/09/29/144-adhd-adults/?utm

10. Bradlow RCJ et al. “Adult attention deficit hyperactivity disorder in Australia: how its current commercial model for diagnosis and treatment is encouraging misdiagnosis.” Medical Journal of Australia, 2025.

https://www.mja.com.au/journal/2025/223/8/adult-attention-deficit-hyperactivity-disorder-australia-how-its-current?utm

11. Woon LSC et al. “Online interest in ADHD predicts ADHD medication prescriptions in Australia from 2004 to 2023: a time-series analysis revealing COVID-19-related acceleration.” (2025).

https://pmc.ncbi.nlm.nih.gov/articles/PMC12138142/?utm

12. May T et al. “The Australian evidence-based clinical practice guideline for ADHD.” Australian Journal of General Practice / Australian guidelines consortium, 2023.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10363932/?utm

13. Cortese S et al. “Attention-deficit/hyperactivity disorder (ADHD) in adults.” World Psychiatry / World Psychiatric Association, 2025. PMC+2Wiley Online Library+2

https://pmc.ncbi.nlm.nih.gov/articles/PMC12434367/?utm

Transcript

If you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.

Hello and welcome, I’m Fernando, a GP in the UK. Today we are going to talk about the increasing number of ADHD diagnoses, especially in adults, always focusing on what is relevant in Primary Care only.

I have based this episode on a number of published medical articles. The links to them are in the episode description.

Right, let’s jump into it.

And the first question to ask is: why are we covering this topic now?

You may be aware that in the UK, the government has recently announced a formal review into surging mental-health and neurodevelopmental diagnoses, including ADHD and autism. This has sparked media coverage and public debate: are we seeing a real increase in ADHD, or are normal struggles being unnecessarily medicalised?

In other words, is this an epidemic of overdiagnosis, or does the rise in cases simply reflect that we’re starting to catch up with reality?

So now, it’s more important than ever to look at what the research actually shows, especially around adult ADHD diagnoses. And although we in primary care are not directly responsible for the full diagnosis and treatment process, the way we assess and support these patients at their first point of contact can make a huge difference. It shapes how they experience their care, whether they feel understood, and whether they receive the guidance and support they need.

Let’s start by reminding ourselves that attention-deficit/hyperactivity disorder, or ADHD, is a neurodevelopmental condition that affects a person’s ability to regulate attention, manage impulses, and maintain consistent levels of activity.

In adults, ADHD often looks very different from the stereotype of a hyperactive child. Adults tend to present with chronic distractibility, difficulty organising tasks, emotional impulsivity, forgetfulness, restlessness, and problems sustaining attention at work or in relationships. These symptoms can have real-world consequences, including difficulties with work and relationships, financial problems, and a persistent sense of underachievement.

The consensus is that ADHD is highly heritable and is associated with higher rates of anxiety, depression, and substance misuse. It’s also linked to measurable differences in executive brain function. And by this, we mean that the prefrontal cortex — the area responsible for focus, planning, impulse control, and emotional regulation — works differently in people with ADHD. Brain-imaging studies have repeatedly shown altered activity in this area.

So what this really means is that ADHD symptoms aren’t just behavioural. They reflect real differences in brain function.

Importantly, ADHD is not a condition people usually “grow out of.” For around two-thirds of children with ADHD, symptoms continue into adulthood, although sometimes in a more subtle or internalised form.

So, why are adult ADHD diagnoses increasing?

Research shows that adult ADHD is now better recognised. Historically, many adults — especially women — were simply missed in childhood because their symptoms were less disruptive, or because diagnostic criteria were focused on school performance rather than adult functioning.

A recent study from the UK found that adult referrals for ADHD assessment increased threefold between 2019 and 2023, with peaks during and after the COVID-19 pandemic. This is likely because the pandemic disrupted daily routines and removed coping structures, making previously manageable symptoms more difficult, and prompting more adults to seek help.

As diagnoses have increased, some people — including medical professionals — have expressed concerns that the condition might be overdiagnosed. After all, clinicians have always been wary of patients self-diagnosing, and the fact that some ADHD assessments rely on self-reported symptoms can create doubts for those who aren’t familiar with how structured and evidence-based these assessments actually are.

The numbers are stark. A large 20-year UK primary-care cohort study found that recorded ADHD diagnoses increased roughly twenty-fold, while ADHD medication prescribing rose fifty-fold. Some of the biggest proportional increases were seen in adults, particularly men aged 18 to 29.

Is this surprising? Not necessarily. ADHD is more common than many people realise. Multiple published reviews estimate the prevalence in children and adolescents to be between two and eight percent, and a major 2023 re-analysis placed it at 5.41 percent.

However, many studies showing steep increases in diagnosis have still reported prevalence rates well below this expected five percent.

Additionally, the most recent Adult Psychiatric Morbidity Survey shows that in England, although 13.9 percent of adults screened positive for probable ADHD, only 1.8 percent reported receiving a formal diagnosis. That suggests that many adults with ADHD still remain unidentified.

So, while there may be some isolated overdiagnosis, overall, the evidence suggests that ADHD remains underdiagnosed — particularly in adults.

What about internationally? Have there been similar rises across other Western countries?

The short answer is yes. Across Europe and other high-income countries, studies consistently show that ADHD medication use among adults has grown sharply, often by several hundred percent over the last decade, with a particularly striking rise in adult women. And a recent analysis in the United States showed that six percent of adults report a current ADHD diagnosis, and importantly, about half of them were first diagnosed in adulthood.

This increase in diagnosis, which may simply reflect that we are catching up with the reality of neurodivergence. Factors contributing to this better recognition include:

• greater understanding that ADHD persists into adulthood,

• the use of more adult-appropriate diagnostic criteria, and

• higher public awareness with reduced stigma.

What does an ADHD diagnosis actually mean for patients?

For many adults, receiving a diagnosis finally helps them make sense of lifelong challenges. And research consistently shows that after diagnosis, people often experience:

• improved self-esteem,

• better workplace functioning,

• more stable relationships, and

• a reduced risk of comorbid anxiety and depression.

It also gives them the opportunity to seek treatment. Treatment for ADHD is multimodal and includes:

• education and coaching,

• CBT,

• lifestyle structuring,

• and, when appropriate, medication — which remains one of the most effective interventions for ADHD symptoms in adults.

And by the way, if you want to learn more about ADHD treatment options, stay tuned — a full video on ADHD treatment is coming soon.

So that is it, a review of the increased number of ADHD diagnoses.

We have come to the end of this episode. Remember that this is not medical advice but only my summary and my interpretation of the guidelines. You must always use your clinical judgement.

Thank you for listening and goodbye.