Children with ADHD see GP twice as often in two years before diagnosis

Children and young people with attention deficit hyperactivity disorder (ADHD) see their GP twice as often as others of the same age in the two years leading up to diagnosis, researchers say.

Analysis of primary care records of more than 8,000 children and young people aged four to 17 years and 40,000 controls also found increased use of other healthcare services and receipt of prescriptions.

The strongest association for GP attendance related to mental and behavioural disorders but common reasons for a GP appointment also included for eye, ear, nose and throat problems as well as conditions such as asthma and eczema.

In addition to frequent GP visits, those in the study were also more likely to have an admission to hospital and even operations, compared to children without ADHD, the analysis showed.

Reporting the results in the Archives of Diseases in Childhood, the researchers said the increased frequency of contact may provide an opportunity for earlier recognition and diagnosis of ADHD.

This may be particularly important in cases where the primary reason for attendance is not a mental or behavioural symptom and where ADHD may already be suspected, they added.

More research is now needed to develop and test interventions to identify ADHD earlier in primary care as well as urgently review how the health services cater for young people with undiagnosed ADHD, they said.

NHS figures from July show prescribing of ADHD medications increased by 12% in children last year.

Study leader Dr Vibhore Prasad, a GP in Nottinghamshire as well as researcher at the University of Nottingham said previous studies have shown that ADHD diagnosis is often missed and delayed in the UK.

‘We know that children with ADHD often face long delays in diagnosis. We didn’t know, until now, that they seek help from the healthcare services twice as often as children without ADHD in the run up to diagnosis.

‘Our findings demonstrate the need for further research so we can identify children with ADHD earlier to get them effective help.’

Co-authors Professor Edmund Sonuga-Barke from the NIHR Maudsley Biomedical Research Centre, and Dr Johnny Downs, consultant child and adolescent psychiatrist at King’s College London, said the study provides a powerful reminder of both the physical and mental health difficulties that young people have to confront in the years leading up to an ADHD diagnosis.

‘At this point, we cannot be certain that earlier access to ADHD assessment and treatment would alleviate all these difficulties,’ they added.

But that the study does ‘highlight that young people who have suspected ADHD are already a vulnerable group and may benefit from coordinated multi-disciplinary care that can provide holistic support whilst they are waiting for specialist mental health services’.