Cited by 1,223Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentAutism Spectrum Disorder Research

ADHD in Children and Young People: Prevalence, Care Pathways, and Service Provision

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Sayal, Kapil, Prasad, Vibhore, Daley, David, Ford, Tamsin, Coghill, David·2018·The Lancet Psychiatry

Abstract

Attention-deficit hyperactivity disorder (ADHD) is a common childhood behavioural disorder. Systematic reviews indicate that the community prevalence globally is between 2% and 7%, with an average of around 5%. At least a further 5% of children have substantial difficulties with overactivity, inattention, and impulsivity that are just under the threshold to meet full diagnostic criteria for ADHD. Estimates of the administrative prevalence (clinically diagnosed or recorded) vary worldwide, and have been increasing over time. However, ADHD is still relatively under-recognised and underdiagnosed in most countries, particularly in girls and older children. ADHD often persists into adulthood and is a risk factor for other mental health disorders and negative outcomes, including educational underachievement, difficulties with employment and relationships, and criminality. The timely recognition and treatment of children with ADHD-type difficulties provides an opportunity to improve long-term outcomes. This Review includes a systematic review of the community and administrative prevalence of ADHD in children and adolescents, an overview of barriers to accessing care, a description of associated costs, and a discussion of evidence-based pathways for the delivery of clinical care, including a focus on key issues for two specific age groups-younger children (aged ≤6 years) and adolescents requiring transition of care from child to adult services.

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  1. [83]83. Sayal K, Ford T, Goodman R. Trends in recognition and service use for ADHD in Britain, 1999-2004. Psychiatr Serv 2010; 61: 803-10.
  2. [89]89. Schlander M. Impact of ADHD on prescription drug spending for children and adolescents: increasing relevance of health economic evidence. Child Adolesc Psychiatry Ment Health 2007; 1: 13.
  3. [93]93. D'Amico F, Knapp M, Beecham J, Sandberg S, Taylor E, Sayal K. A 20-year follow-up of Childhood Hyperactivity and Conduct Problems: Service Use and Public Expenditure Costs in Adulthood. Br J Psychiatry 2014; 204: 441-47.
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  5. [110]110. The Cochrane Library. Expert reaction to Cochrane review of Medication for ADHD, 2015. http://www.sciencemediacentre.org/expert-reaction-to-cochrane- review-of-medication-for-adhd/

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Authors
Sayal, K., Prasad, V., Daley, D., Ford, T., & Coghill, D.
Affiliations
  • University of Nottingham (GB)
  • University of Exeter (GB)
  • The University of Melbourne (AU)
Corresponding author
Sayal, Kapil
Venue
The Lancet Psychiatry
Publisher
Elsevier BV
Published
2018-02
Volume
5
Issue
2
Pages
175-186
ISSN
2215-0366 (ISSN-L)
OpenAlex
W2614669943
Cited by
1,223
References
136
Citations by year
2026: 131 · 2025: 181 · 2024: 207 · 2023: 234 · 2022: 165 · 2021: 114 · 2020: 118 · 2019: 46 · 2018: 22 · 2017: 5
FWCI
7.89
Type
journal article
Language
en
Open access
Locations
  • The Lancet Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Open Research Exeter (University of Exeter) (acceptedVersion)
  • Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
  • Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by-nc-nd)
  • Discovery Research Portal (University of Dundee) (submittedVersion)
  • Nottingham ePrints (University of Nottingham) (submittedVersion)
  • Figshare (submittedVersion)
  • Nottingham Trent University's Institutional Repository (Nottingham Trent Repository) (submittedVersion)
Funders
National Institute for Health and Care Research (CL-2016-17-007, DRF-2011-04-116)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
attention deficit hyperactivity disorder, ADHD prevalence, underdiagnosis, barriers to care, care pathways, service delivery, transition to adult care, adolescents, young children, overactivity, inattention, impulsivity, psychiatric comorbidity, educational underachievement
MeSH terms
Problem Behavior, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Delivery of Health Care, United Kingdom, Health Services Accessibility, Humans, Sex Factors, Prevalence, Transition to Adult Care

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