Temporal trends in primary care-recorded psychiatric diagnoses and psychotropic medication prescribing among children and young people in the UK: a population-based study.

Abstract

Despite growing concerns about young people's mental health, it remains unclear how rates of psychiatric diagnoses and psychotropic medication prescribing have changed. To investigate temporal trends in UK primary care-recorded incidence of (1) psychiatric diagnoses: attention deficit hyperactivity disorders (ADHD), autism spectrum conditions, anxiety disorders, depression, substance misuse, and personality disorders, and (2) psychotropic medication prescribing, in individuals aged 1-24 years. This was a population-based study using primary care data from the Clinical Practice Research Datalink. The monthly incidence of each outcome from January 2010 to March 2022 were calculated. Negative binomial regression was used to predict expected incidence rates when the COVID-19 pandemic began in March 2020, based on antecedent trends. Observed and predicted (that is, expected) rates were compared. In the 2 years following March 2020, the incidence of ADHD diagnoses in females was 24.7% (95% confidence interval = 11.9 to 38.9%) greater than the expected incidence rate predicted from the trends before the pandemic. The increase in ADHD diagnoses occurred more commonly for females aged 20-24 years, followed by those aged 17-19 years, as well as among females from less deprived areas. Similar trends were observed for ADHD medications. Observed rates of other outcomes, including common mental illnesses, were below or close to the expected levels, with the differentials between observed and expected rates being greater for males than females. Increased ADHD awareness may partly explain the study's findings. However, the fall in other diagnoses may reflect barriers to accessing health services at the height of the pandemic. Early identification and timely treatment of mental health difficulties and neurodevelopmental conditions are crucial.