Author says rising diagnoses reflect better understanding of neurodivergence, as researchers warn many people with ADHD are still going undiagnosed.
Best-selling author Matt Haig has pushed back against claims ADHD and autism are being overdiagnosed, arguing rising diagnosis rates reflect better awareness of neurodivergence rather than an increase in the number of people with the conditions.
Haig, who has ADHD and autism, made the comments after the publication of a government-commissioned review into rising diagnosis rates. The review was launched 10 months ago by former health secretary Wes Streeting amid concerns young people were being over-diagnosed and ‘written off’.
More than 560,000 people are waiting for an ADHD assessment in England, while over 250,000 are waiting for an autism one. The figures have raised concerns the country could be moving from underdiagnosis towards overdiagnosis or misdiagnosis.
Writing on Instagram, Haig said: ‘The government wanted a report into neurodiversity to prove it is overdiagnosed and it proved the opposite.
‘The government-backed review shows that the prevalence of ADHD and autism in the population has remained largely the same over decades. The only change has been in terms of awareness and understanding.
‘Correct diagnosis would ease social problems, from addiction to mental illness to prison rates. Only the most narrow-minded politician would think diagnosing fewer people would save money.’
Within 24 hours, research was being presented at the European neuroscience conference which seems to fully support Haig’s view.
‘It is now being recognised’
At the event, which took place in Munich, Professor Anita Thapar of Cardiff University presented evidence showing ADHD diagnosis rates across Europe do, in fact, reflect better awareness of the condition.
She said: ‘The rise in cases of ADHD across Europe appears mainly due to a change in awareness and diagnosis. Indeed, there is growing evidence that ADHD is still under-diagnosed in some countries.
‘My overview of the ADHD situation brings together several recent strands of evidence. Yes, ADHD diagnoses have risen across Europe, but this seems to be due to changes in diagnostic criteria, improved awareness and research evidence on ADHD and its risks, rather than to an epidemic of ADHD.
‘It is now being recognised, whereas in the past it wasn’t. You sometimes see this with medical conditions, for example conditions like high lipid levels and hypertension and their risks were not widely recognised in the 1960s. The same for ADHD.’
Thapar, who chaired the NHS England ADHD taskforce, claimed women, girls and adults were increasingly being diagnosed after years in which their symptoms had gone unnoticed. Changes to diagnostic criteria and growing research into ADHD had also contributed to the rise.
An estimated 5-7% of children and 2-3% of adults across Europe have ADHD, although diagnosis rates vary widely between countries. The figures suggest a lot of people with the condition may still be missing out on assessment and treatment.
Prescriptions on the rise
The number of people receiving ADHD medication has also increased. A recent study found medication use rose in Belgium, Germany, the Netherlands, Spain and the UK between 2010 and 2023.
In the UK, the proportion of people receiving medication more than tripled, from 0.12% to 0.39%, with a sharp increase among adult women.
Thapar acknowledged concerns about possible misdiagnosis but said there was limited evidence to establish how widespread the problem was. The number of people diagnosed remained below estimates of how many were likely to have ADHD, suggesting many were still going without treatment.
She cautioned against treating ADHD diagnosis as a simple yes-or-no decision, saying the point at which doctors diagnose or treat a condition can change as medical understanding develops.
Professor Barbara Franke of Radboud University in the Netherlands said: ‘For years, ADHD researchers have done their best to raise the awareness that ADHD is underdiagnosed in females and adults in general.
‘Over the last years, this knowledge finally takes hold in the population, but with such speed that it feels like an epidemic. Despite the relatively high prevalence and the burden associated with it, however, funding for research into ADHD – from its aetiology to its treatment – is surprisingly hard to find, and ADHD unfortunately still remains one of the most under-researched conditions in medicine. I sincerely hope that we can change that, too.’
Image: Peter Burdon/UnSplash
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