ADHD - A Public Health Perspective
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurobehavioral disorder that may affect more than two million school-aged children and can last into adulthood.
ADHD manifests as an unusually high and chronic level of inattention, impulsive hyperactivity, or both. A person with ADHD may struggle with impairments in crucial areas of life, including relationships with peers and family members, and performance at school or work. Increases in unintentional injuries and health care utilization have been noted in some studies of people with ADHD.
As many as half of children with ADHD also have other behavior disorders. Some studies have demonstrated increases in substance abuse, risk-taking, and criminal behaviors among adolescents and adults who have ADHD and these other disorders.
The American Psychiatric Association's Diagnostic & Statistical Manual-IV-TR estimates that 3%-7% of children suffer from ADHD, and some studies have estimated higher prevalence rates in community samples. The cause(s) and risk factors contributing to ADHD are unknown, although it seems to be more prevalent among boys than girls.
During the past decade, prescription for ADHD medications increased dramatically across the United States, with consumption in many states more than quadrupling. Reasons for the increase, and the more recent decline, in the use of methylphenidate-containing drugs are not clear.
ADHD can be managed through medical and psychosocial interventions.
Recent research suggests that combining medical and behavioral therapies is an especially effective approach to treating ADHD and its comorbidities. However, information on the long-term effects of all treatments is lacking, as is knowledge of the effects of long-term use of ADHD medications in children. On-going, systematic monitoring of ADHD, comorbidities, and treatment modalities is needed.
CDC acknowledges the need for further research in ADHD. Specifically, key public health questions yet to be answered include:
What are the causes and risk factors of ADHD? What is the prevalence of ADHD? Is the prevalence increasing?
What social and economic impacts does ADHD have on families; schools; the workforce; and judicial and health systems?
Are ADHD and its comorbidities being appropriately diagnosed and treated? Are people with ADHD able to access appropriate and timely treatment?
How effective are current interventions? What are the long-term effects of drug treatments?