TY - JOUR T1 - Prescribing for ADHD in primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 170 LP - 171 DO - 10.3399/bjgp18X695357 VL - 68 IS - 669 AU - Ahmed Rashid AU - Nadia Llanwarne AU - Richard Lehman Y1 - 2018/04/01 UR - http://bjgp.org/content/68/669/170.abstract N2 - Attention deficit hyperactivity disorder (ADHD) is the name given to a condition characterised by inattention, hyperactivity, and impulsivity. Although there are many historical descriptions of these behaviours in children,1 definitions of ADHD as a disease emerged in the 1980s, when the practice of classifying mental disorders became popular and the DSM-III and ICD-9 diagnostic systems shifted the scientific focus on mental illness from aetiological debates to finding practical and reliable disease descriptions.The term ADHD, drawn from the DSM-III, was initially used only in North America. In Europe, the term ‘hyperkinetic disorder’ was used and was initially reserved only for the most severe cases. The broader definition afforded by the DSM eventually led to a corresponding rise in diagnosis rates in Europe, although they were still dwarfed by the much higher rates seen in the US. This historic diversion in practice has been partly explained by differing diagnostic criteria, but also by the power of the pharmaceutical industry, advocacy groups, and the internet.2 A comprehensive 2015 meta-analysis included 175 ADHD prevalence studies and suggested an overall pooled estimate of 7.2%, although few included studies were from outside of Europe and North America.3Prescribing rates are naturally closely linked to prevalence and have also received much attention. A 2016 study explored prescribing patterns of ADHD drugs in children in the UK using primary care records, finding a dramatic increase in use from 1992 until around 2008, with stable levels of use since then.4 Indeed, ADHD drug use in children aged <16 years increased a staggering 34-fold overall in that 16-year period. The steadying of prevalence in … ER -