Australians with ADHD may be missing out on diagnosis and treatment

Neelima Choahan

18/09/2018 11:49:05 AM

The use of ADHD medication is increasing, but some patients are still not receiving the treatment they need, new research shows.

Adults with untreated ADHD ‘are much more likely to be involved in accidents, either as a pedestrian or as a driver of a vehicle, because of their impulsive behaviour,’ Professor David Coghill said.
Adults with untreated ADHD ‘are much more likely to be involved in accidents, either as a pedestrian or as a driver of a vehicle, because of their impulsive behaviour,’ Professor David Coghill said.

Many Australians living with attention deficit hyperactivity disorder – or ADHD – may be missing out on proper diagnosis and treatment, according to a new global survey.
Published in The Lancet Psychiatry, the study of 154 million people examined trends in the use of medication for the disorder in children, adolescents and adults across 14 countries, including the US, UK, Japan and Australia.
The research showed that despite increases in medication use for ADHD between 2001–15, prescription rates are still far below diagnosis rates in most countries, suggesting some patients may not be receiving the treatment they need. 
Professor David Coghill, who is Chair of University of Melbourne Developmental Mental Health, interpreted the global and Australian data. He told newsGP that although the rate of prescription is increasing in Australia, the data suggests children and adults are being under-diagnosed.
‘Around 5% of children have ADHD and we know that doesn’t vary hugely between different countries,’ Professor Coghill said. ‘[But] in Australia, the rate of prescription of medication, even though it has increased considerably over the years, is still only [up to] 1.74% of children.

‘Between one in three and one and four children are being treated in Australia [for ADHD].’
Those figures are worse for adults.
‘Around 2.5% of adults have ADHD; currently 0.2% are being treated,’ Professor Coghill said. ‘So around one in 10 adults with ADHD are being recognised and treated.
‘The increase in Australia in prescribing medicines for adults with ADHD is 4–10% each year.
‘So we have increased from a very low rate of treatment in Australia to a moderately low rate of treatment.’

david-text.jpgProfessor David Coghill believes healthcare professionals should consider the possibility of ADHD when they see patients who are having difficulties paying attention and concentrating, and with impulsivity.
While use of ADHD medications in children and adolescents, aged 3–18 years, has gone up in all countries, the data showed the number of people using medication ranged from 0.3% in France to 6.7% in the US in 2010.
Use of these drugs was less common in adults, ranging from 0.003% in Japan to 1.5% among privately insured individuals in the US in 2010.
Professor Coghill said the study suggests that ADHD might be over-diagnosed in the US, but under-diagnosed in other countries, including Australia.
When left untreated ADHD can have serious and far-reaching consequences for adults.
‘Those who are diagnosed with ADHD in adulthood, where it hasn’t been diagnosed in childhood, have a four times higher rate of mortality than those without ADHD,’ Professor Coghill said.
‘Adults with ADHD that are untreated are much more likely to have problems with substance misuse, they are more likely to smoke and drink as well as take illegal drugs.
‘They are much more likely to be involved in accidents, either as a pedestrian or as a driver of a vehicle, because of their impulsive behaviour.
‘They are much more likely to be involved in criminal activity. They have more family breakups, so they are more likely to be divorced, to have difficulties in their family relationships.’
Professor Coghill said adults with ADHD also often have poor peer relationships and poor work records, and are at an increased risk for all other mental health problems.
‘If you have someone with a chronic mental health problem and they are not responding to treatment, think about, “Could this be ADHD as part of this picture that I am seeing?”’ he said.
‘The message for all of us, but particularly for those in general practice, is that we should think about ADHD when we see patients who are having difficulties in paying attention, concentrating and with  impulsivity, and we should be asking questions about ADHD in order to increase the  rate of treatment.’

ADHD The Lancet Psychiatry University of Melbourne


Login to comment

Edward   25/09/2018 2:14:25 AM

it's really not good

Anon   25/10/2020 8:11:46 AM

Yes we are.
Drs and psychologists should consider this disorder more and actually inform their patients of the possibility. So they don't go years undiagnosed and live sh*##y lives, always thinking, 'just after this hurdle...' 'once this bout of depression is gone, i can....' 'i'll just ride this anxiety out a little longer, then i can get on with my life'. Because that way of living every month/week/day takes a huge toll on your mental health, productivity and happiness in general.

Tom   1/03/2021 5:52:23 PM

Everyone should also be aware that methamphetamine is in schedule 8 prescription legal for ADHD! It is the strongest medication available for ADHD! When taken responsibly it beats all other medications!

cato   9/04/2021 6:01:42 PM

Try getting diagnosed. Its months to wait for a psychiatrist appointment (and forget preferring a kindly woman doc, you be lucky to get anybody at all), and vast sums to pay when you finally get hold of one. I haven't managed yet. Apparently also if you are diagnosed as a child then meds are on PBS for your entire life, but diagnosed as an adult, you can pay full price.

Ali   30/04/2021 7:45:03 AM

It's a crises for so many people around the world
The world is not adhd friendly
And because of inhumane World health organization the only type of stimulant licensed in middle east is methylphenidate and one form only "concerta"
And everybody knows each health system should have both types of stimulants available as patients not responding equally to meds

Judi   30/04/2021 12:31:18 PM

I'm trying to see a psychiatrist in Adelaide. I've been assessed by a psychologist & completed various tests for her, but I can't get in to see a psychiatrist. Apparently those who treat adult ADHD (particularly in women) are very few & far between, & either won't deal with DVA, or aren't accepting new patients. Telehealth services also aren't very easy to get into either. I've been trying for over 12mths now. It's depressing & offputting not being able to even get in to see anyone, much less find out if you should be on medication.