ATTENTION deficit disorder (ADD), also often referred to as attention-deficit/hyperactivity disorder (ADHD)1
is a developmental behaviour condition characterised by inappropriate hyperactivity, impulsiveness and inattention.1-5
Cosgrove, in 1997, pointed out that in clear contrast to North America, ‘research on ADHD and its treatment has been largely ignored by British academic child psychiatry.’5
The diagnosis is made on a clinical basis, often together with a variety of standardised behaviour-screening tests.3
Hundreds of articles related to ADD have appeared over the past decades, primarily in psychiatric journals published in North America.3
In the United States (US), patients with ADD have been treated with psychostimulant drugs, particularly methylphenidate and dexamphetamine, for over 50 years.2
Reported prevalences of ADD in the US have varied from 4% to 26%,3
depending on the population studied and criteria for diagnosis. Until recently ADD has received less attention in the United Kingdom (UK), although a comprehensive review of the subject was published recently by Thapar and Thapar.6
Indeed, treatment with psychostimulants, particularly methylphenidate, was rare in the UK until the mid-1990s.7
ADD has a number of characteristics that are similar to those of autism, a condition which has been diagnosed with increasing frequency in the last decade in the UK8
and in other countries.9,10
Both conditions reflect behavioural disorders and occur primarily in boys. Both also appear to have some genetic component, but the causes of the conditions are essentially unknown.3
On the other hand, the behavioural manifestations of the two conditions are entirely dissimilar and there is specific drug treatment for ADD, but not for autism. Also, whereas the age of onset for symptoms leading to a diagnosis of autism reaches its peak at between the ages of 2–4 years,8-10
the diagnosis of ADD tends to be made from 5 years and reaches a peak in children aged 8–10 years.3
The criteria for diagnosis of ADD are controversial and not well defined.6
Many comorbid conditions; for example, depression, anxiety, and learning disabilities, have been associated with this condition.3
It is not the intent of this paper to address the comorbidity issues, but primarily to provide estimates of incidence and prevalence of treated ADD in the UK for the years 1996–2001. The study was based on the UK general practice research database (GPRD). The completeness and accuracy of the GPRD, which is closely reflective of the population of the UK, has been repeatedly demonstrated in areas including that for the estimation of incidence rates of illnesses.8,11-13
HOW THIS FITS IN
What do we know?
Little prior information has been published on the incidence of attention deficit disorder (ADD) in the United Kingdom.
What does this paper add?
We have reviewed information present in the general practice research database to measure the incidence of drug-treated ADD from 1996–2001. The results provide the age distribution of cases and the incidence during these years.