ADHD News & Research

Study: Undertreatment of ADHD In Youth Far More Common Than Overtreatment

Four out of five youth diagnosed with ADHD were not being treated with medication, according to a meta-analysis studying the rate of ADHD pharmacological treatment in both diagnosed and undiagnosed individuals.

January 20, 2021

Just 19% of American youth diagnosed with ADHD are receiving medication treatment, according to a review and meta-analysis published in The Journal of Attention Disorders.1 Findings from the study suggest that, for every overtreated or improperly treated American youth, there are three more undertreated youths with ADHD.

The study rose from a debate over whether pharmacological treatment for youths with ADHD is overused or underused in the U.S. Researchers screened more than 25,000 potentially relevant studies, and retained 36 studies of 104,305 individuals. Using the 18 studies that met the main analysis criteria (that diagnosis was established using DSM criteria or validated rating scales, and not parental report), researchers identified three groups:

  1. Youth with ADHD who were receiving medication treatment
  2. Youth with ADHD who were not receiving medication treatment
  3. Youth without ADHD who were receiving medication treatment

Across the studies, pharmacological treatment rates were 19.1 % and 0.9 % in school-age children/adolescents with and without ADHD, respectively. Essentially, more than 80% of youth diagnosed with ADHD were not being treated with medication.

In an A.D.D. Resource Center blog post on the study, David Rabiner, Ph.D. reflects that “only a minority of children and teens with ADHD receive medication treatment for the condition,” and it is,“reasonable to conclude that undertreatment is substantially more common than overtreatment. Given concerns that ADHD medication is frequently prescribed to youth without ADHD, finding that this is relatively uncommon (under 1%) is reassuring.”2

1 Massuti et al. Assessing under-treatment and over-treatment of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis. Neuroscience and Behavioral Reviews, 128, 64-73. (2021). https://www.sciencedirect.com/science/article/abs/pii/S0149763421002396

2 Rabiner, David. The Over and Under Use of ADHD Medication Treatment. The A.D.D. Resource Center. (Jan. 2022). https://www.addrc.org/the-over-and-under-use-of-adhd-medication-treatment/

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