Scientific Breakthrough or Manufactured Epidemic? Why Adult ADHD Diagnoses Are Rising?

The number of adults diagnosed with ADHD is growing worldwide. This is due to several reasons: increased awareness of the disorder, more people identifying with the symptoms on social media, and changes in diagnostic criteria, which were previously limited to children. Today, many adults rely on personal accounts to seek help, but experts warn that diagnosis should be made carefully by professionals, as many symptoms can be confused with other problems, such as anxiety or stress.

Attention Deficit Hyperactivity Disorder (ADHD), often associated with restless and distractible children, has been increasingly diagnosed in adults as well. Recent research shows that the number of adults receiving this diagnosis is growing significantly worldwide.

While previous estimates suggested that approximately 2.5% of adults may have ADHD, more recent studies suggest that this number could reach 6.75%, representing more than 366 million people. This increase has caught the attention of the scientific community, which is now seeking to better understand the causes behind this phenomenon.

One of the main reasons for the increase in adult diagnoses is increased awareness of ADHD. Health professionals are more aware of the signs of the condition, and information campaigns have helped reduce stigma. But there's also a new and important factor: the role of social media.

Platforms like TikTok, Instagram, and YouTube have become spaces where users share personal stories, explain symptoms, and describe their daily lives with ADHD. This has led many people to identify with these stories and seek medical help, believing they may also have the disorder.

ADHD was originally described with a focus on children. The diagnosis began to be recognized in medicine in the early 20th century, and in 1968, it was officially included in the psychiatry manual (DSM) as a childhood disorder.

At that time, the symptoms were quite specific: physical restlessness, difficulty sitting still, impulsivity, and distractibility, often observed by parents and teachers. However, over time, the diagnostic criteria have become broader and adapted to different age groups.

In adults, diagnosis has undergone a major shift. Because the visible behavioral signs of childhood are often no longer apparent in adulthood, diagnosis has come to be based on the patient's own subjective descriptions, that is, on what the person feels or believes they feel.

Diagnosing ADHD in adults can be especially challenging, as its symptoms, such as inattention, procrastination, organizational difficulties, and mental fatigue, often overlap with other common adult conditions, such as chronic stress, burnout, anxiety, depression, or sleep deprivation.

In many cases, adults with exhausting routines, multiple demands, or emotional imbalance may present symptoms that resemble ADHD without actually having the disorder. Furthermore, factors such as excessive technology use, poor diet, and lack of physical activity can also negatively impact attention and executive functioning.

Therefore, a careful and multidimensional clinical evaluation is essential, avoiding hasty diagnoses based solely on subjective complaints. This has created what experts call the "subjectivization" of criteria: the focus has shifted from observable behaviors to the person's internal experiences.

This new model poses some challenges. First, it relies on the person's memory of what they were like in childhood, which can be inaccurate or influenced by other factors. Second, assessment often relies solely on self-report questionnaires, without interviews with family members or professionals, nor does it check for other disorders.

Furthermore, many clinical studies investigating ADHD lack a thorough assessment of participants' overall mental health, which can lead to misdiagnosis. This means there is a real risk that many people are being diagnosed with ADHD without careful verification.

Research shows that in the most important scientific studies on ADHD in adults, the diagnostic methods used vary widely. In a review of 292 studies, researchers found that more than half of the studies did not even involve a psychiatrist or psychologist to confirm the diagnosis.

In many cases, patients themselves completed online forms or were evaluated by professionals without specialized training. Furthermore, many of these studies included people with other psychiatric disorders that may have symptoms similar to ADHD, such as anxiety or depression.

This lack of standardization and rigor in diagnoses raises concerns. If scientific studies are not certain that participants actually have ADHD, the results may not translate correctly to medical practice.

This can lead to ineffective or even misguided treatments. Because many of these studies influence clinical decisions, such as which medications to use or which health policies to implement, ensuring a correct diagnosis is crucial.

In summary, diagnosing ADHD in adults involves many challenges. The criteria are still based on models developed for children, recall of symptoms in childhood is uncertain, tests used for adults have not been well validated, and information from close relatives is often lacking.

To improve the quality of diagnosis and ensure that patients receive appropriate treatment, experts recommend that only qualified professionals, such as trained psychiatrists or psychologists, perform this assessment, using thorough clinical interviews and differentiating ADHD from other mental health problems.

READ MORE:

Diagnosing ADHD in adults in randomized controlled studies: a scoping review. 

Igor Studart, Mads Gram Henriksen, and Julie Nordgaard

European Psychiatry. 2025; 68(1): e 64 

doi:10.1192/j.eurpsy.2025.2447

Abstract: 

The diagnosis of ADHD in adults is on the rise. Applying the ADHD diagnosis, which originally was described in children, to adults has involved a “subjectivization” of some of the diagnostic criteria, i.e., some behavioral features (signs) in children have become experiences (symptoms) in adults. These issues raise the question of how ADHD is best diagnosed in adults? Thus, we examined how ADHD is diagnosed in adults in research. A review of how ADHD is diagnosed in adults in randomized controlled studies (RCTs). We include 292 RCTs. We found substantial variation and no consensus about the diagnostic method. More than half of the studies did not seem to include an assessment of general psychopathology, and only in 35% of studies was the ADHD diagnosis allocated by psychiatrists or psychologist. More than half of the studies included patients with psychiatric comorbidity. These findings raise concerns about the validity of the ADHD diagnosis in many of the included RCTs. It is worrying that securing a reasonably accurate diagnosis is not prioritized in more than half of the studies. If neither clinicians nor researchers can rely on the basic fact the patients in scientific studies diagnostically resemble the patients they are facing, scientific studies risk losing their clinical relevance. Since RCTs can lead to changes in clinical practice, they must be conducted carefully. To advance research on adult ADHD, the quality of the diagnostic assessment must be prioritized, requiring comprehensive differential diagnosis by a skilled psychiatrist or psychologist.