TOPLINE:

Diagnosis rates for attention-deficit/hyperactivity disorder (ADHD) in England were below global prevalence estimates across all age groups, with a recorded prevalence at 1.19%. Male individuals were diagnosed at a rate of 1.48%, and female individuals were diagnosed at a rate of 0.91%. The gap between recorded diagnosis and published prevalence estimates varied widely from approximately 28.71% in adults aged 18-24 years to more than 90% in those aged 65 years or older.

METHODOLOGY:

• Researchers conducted an observational study and analysed data from Clinical Practice Research Datalink Aurum, a large longitudinal database of records from primary care practices across England, to establish the point prevalence of recorded ADHD diagnoses as of June 2025.
• They included 3,536,476 patients (50.58% male individuals) in the prevalence cohort across 298 general practices and 42,241,788 patients (49.45% male individuals) in the incidence cohort across 1891 general practices.
• ADHD was identified using clinical diagnosis codes or prescription codes for medications.
• The crude incidence of ADHD per 1000 person-years was calculated over the study period, with annual incidence rates also calculated to understand trends in ADHD recording over time, stratified by sex and age groups.
• The observed diagnostic prevalence was compared with published global meta-analysis estimates of ADHD population prevalence as reference values, with a reference prevalence of 5% for children and adolescents younger than 18 years and age-specific estimates ranging from 0.77% to 5.05% for adults.

TAKEAWAY:

• The overall point prevalence of recorded ADHD in England was 1.19% (95% CI, 1.18%-1.21%), with a higher prevalence in male individuals at 1.48% than in female individuals at 0.91%, and the highest prevalence was observed in the age group of 18-24 years for both sexes (female individuals, 2.07% and male individuals, 3.60%).
• The crude incidence of recorded ADHD over the study period was 0.61 per 1000 person-years (95% CI, 0.61-0.61). Annual incidence rates remained low and stable between 2001 and 2009 (0.15-0.22 per 1000 person-years), increased steadily between 2010 and 2019 (reaching 0.67 per 1000 person-years in 2019), and then accelerated from 2021 (1.03 per 1000 person-years) to 2024 (2.53 per 1000 person-years).
• Comparison with global prevalence estimates revealed substantial gaps between recorded diagnosis rates and reference prevalence estimates, ranging from 28.71% in men aged 18-24 years to 93.51% in men aged 65 years or older and ranging from 59.01% for women aged 18-24 years to 93.51% for women aged 65 years or older.
• Incidence rates for adults aged 65 years or older remained very low and stable across the study period up to 2024.

IN PRACTICE:

"The results suggest that although ADHD diagnoses have increased substantially over the past decade, as of 2025, ADHD may remain under-recognised across all age groups in England," the authors wrote. "Our findings therefore highlight an urgent need for diagnostic and support services that are adequately resourced and accessible across the lifespan. Improving recognition and diagnosis of ADHD is likely to reduce long-term individual and societal costs," they added.

SOURCE:

The study was led by Amber John, Department of Psychology, University of Liverpool, Liverpool, and Gavin R. Stewart, Social, Genetic and Developmental Psychiatry Centre, King's College London, London, both in England. It was published online on June 15, 2026, in The Lancet Regional Health - Europe.

LIMITATIONS:

ADHD was identified using diagnosis and prescription codes recorded in primary care data. Some ADHD cases diagnosed in private practice may be missed. A small number of ADHD cases were identified through medication records alone without an accompanying diagnostic code. The reference prevalence estimates used were based on global meta-analyses having heterogeneous methodologies, with considerable variation in how ADHD is defined and assessed.

DISCLOSURES:

This study received support from the Medical Research Foundation and British Academy. Some authors disclosed receiving grant funding related to or outside the submitted work and/or honoraria, consultancy fees or payments for educational talks, and royalties from various sources. One author reported receiving salary support from UCL related to this work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.