GPs may have a crucial role in earlier diagnosis of ADHD in young people
By Michael Doris MB BS
Children and young people with attention deficit hyper activity disorder (ADHD) are twice as likely to present to their GP in the two years preceding their diagnosis compared with controls without such a diagnosis, according to a population-based matched case-control study published in the Archives of Diseases in Childhood. Researchers said this frequent contact with GPs might present an opportunity for earlier diagnosis of ADHD.
The researchers noted recent literature highlighting the challenges faced by GPs in diagnosing ADHD in children and young people, often resulting in a delayed or missed diagnosis and an impedance of access to effective treatment.
Using English primary care electronic health records with linked hospital records from 1 January 1998 to 31 December 2015, the researchers selected the records of 8127 children and young people aged 4 to 17 years with ADHD and those of 40,136 controls without ADHD, matched by age, sex and general practice. Participants had at least two years of medical records in their primary care practice before their diagnosis, or index date for controls.
In the two years preceding a diagnosis of ADHD, children and young people were found to attend health services twice as often as controls of the same age. Rates of attendance were higher across nearly all reasons for presentation. The strongest association for presentation to GPs was in the category of ‘mental and behavioural disorders’; however, other common reasons for presentation included physical complaints, such as asthma and eczema, as well as symptoms related to pathology in the eyes, ears, nose, throat and mouth.
The higher rates of presentation might present an opportunity for earlier diagnosis, the researchers said, calling for further research into the development and testing of interventions that would equip GPs with the means to identify ADHD earlier to facilitate prompt referral and diagnosis.
Commenting on the study, Associate Professor Alasdair Vance, Consultant Psychiatrist and Head of Academic Child Psychiatry at the University of Melbourne, said ‘ADHD is a common condition associated with slower rates of normal development across neurological, cognitive, emotional, behavioural and interpersonal domains. It is best managed by holistic care focused on skills development in all these domains.’
Also an adjunct academic at New York University and Shanghai Jiao Tong University, Associate Professor Vance said this study confirmed the known association of ADHD with other medical disorders, in particular dermatitis and asthma.
‘A key future direction is ensuring protective resilience factors are maximised and risks minimised across all these domains of young people’s functioning,’ he added.