What’s driving soaring rates of adult ADHD?
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Over the past eight years, the diagnosis of ADHD among Australian adults has surged, especially among women. And you might be surprised to find out where the ADHD capitals are in Australia. Today, Norman Swan on his Four Corners investigation into data that's never been collated before and whether it shows ADHD is being overdiagnosed. I'm Sam Hawley on Gadigal land in Sydney. This is ABC News Daily.
Norman, Frio or Fremantle in Perth, it's this old port area, although it's pretty ritzy nowadays, but you have found something really unique about the suburb, haven't you? Because it has a much higher rate of people diagnosed with ADHD than anywhere else in the country.
Yep. It's the hottest hotspot.
Hmm.
So Four Corners has been looking at ADHD in adults in Australia, and it's very hard to get data. So we commissioned a group at the University of New South Wales, the Medicines Intelligence Research Programme, who work with the Australian Bureau of Statistics. to look at ADHD diagnoses. Now there's no record of who gets diagnosed with ADHD in Australia. So you've got to infer it from who fills out prescriptions for ADHD drugs. So it doesn't matter how many scripts you fill in a year, You've just got to have filled it at least once. And so we can see for the first time ever, actually, in Australia, the geographic spread and variation of what we infer to be ADHD diagnosis rates. It's a dramatic map. And Western Australia stands out.
So to June 2024, 4.4% of adults in Fremantle filled a script for an ADHD drug. This is an extraordinary rise, by the way, over the last few years. And you look at women under the age of 44, it comes up roughly around 6%. But since then, the rate of prescriptions for ADHD drugs have gone up by another 30%, in fact, more than that. So then you're up around 8%. When you ask the experts what actually is the rate of ADHD in the community, it's between 2.5 and 3%. So something's going on because you've just got these sky-high diagnosis rates.
Right. Yeah. So in a suburb like Fremantle, experts would expect a rate of around 2.5% as everywhere else, but it's at 4.4%. On average. On average. So the question is, of course, why, which we will get to. But before we go on, I guess, why don't we just reflect on what the symptoms of ADHD are so we can get a better understanding of exactly what it is?
It is a neurodevelopmental disorder, meaning that it's been there probably since birth. In other words, you've got a genetic predisposition. And you cannot diagnose ADHD accurately without evidence of it being there in childhood in some shape or form. School reports... teacher reports, there needs to be correlation because there really isn't any such thing as ADHD which suddenly appears in adulthood.
What factors have contributed to the rise in adult ADHD diagnoses in Australia?
So it's a neurodevelopmental disorder and involves impulsivity. It involves problems with emotional regulation. It involves hyperactivity, which includes this inner restlessness. There are other features of it as well. And the key here with ADHD is that it's not a simple condition. There's no test for it. It's a matter of clinician judgment, which is why this variation may arise. Two clinicians may not agree on whether or not somebody has ADHD. And if you get it wrong, it can be serious because these symptoms could be symptoms of another mental health issue, which if it goes undiagnosed and untreated, means the person could come to harm.
Okay, well, Norman, let's return to Fremantle, because as you said, experts would expect about 2.5% on average of the population to have ADHD there, but it's far, far higher.
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