Electronic Screens Use is factor in the increase prevalence of ADHD

Ask any pediatrician and they will likely tell you they are seeing many more kids who have ADHD than ever before in their career. More adults have ADHD than ever before as well.

Most MDs know the incidence of ADHD is rising. We all know this increase is in part also due to increased electronic screen time. Trying to sit and contemplate, pray, study, and especially pray something like a rosary is very hard in one who has just seen hours and hours of tv and video games.

Yet the authors below list all the many factors involved in ADHD except increased electronic screen time. That is a travesty as it points to a possibility that the researchers may clueless to this factor.

Do all pediatricians ask about electronic screen time usage to all their patients? They should. Excessive screen time is a factor in ADHD in adults and kids as well as chronic eye pain syndromes in adults and now kids.


Original Investigation 
August 31, 2018

Twenty-Year Trends in Diagnosed Attention-Deficit/Hyperactivity Disorder Among US Children and Adolescents, 1997-2016

JAMA Network Open. 2018;1(4):e181471. doi:10.1001/jamanetworkopen.2018.1471

Key Points
Question  What are the long-term trends in prevalence of attention-deficit/hyperactivity disorder among US children and adolescents over the past 2 decades?
Findings  In this study of data from 186 457 children and adolescents aged 4 to 17 years from the National Health Interview Survey, a nationwide, population-based, cross-sectional survey conducted annually from 1997 to 2016, the estimated prevalence of diagnosed attention-deficit/hyperactivity disorder in US children and adolescents increased from 6.1% in 1997-1998 to 10.2% in 2015-2016.
Meaning  Among US children and adolescents, the estimated prevalence of diagnosed attention-deficit/hyperactivity disorder increased significantly between 1997 and 2016.

Importance  Attention-deficit/hyperactivity disorder (ADHD) is common in US children and adolescents. It is important to understand the most recent prevalence of ADHD and its long-term trends over the past decades.
Objective  To estimate the prevalence of diagnosed ADHD and 20-year trends from 1997 to 2016 among US children and adolescents using nationally representative data.
Design, Setting, and Participants  In this population-based, cross-sectional survey study (National Health Interview Survey), surveys were conducted annually from 1997 to 2016. A total of 186 457 children and adolescents aged 4 to 17 years from 1997 to 2016 were included in this analysis. Data were collected through in-person household interviews with a parent or guardian. The data analysis was performed in January 2018.
Main Outcomes and Measures  Attention-deficit/hyperactivity disorder diagnosed by a physician or other health care professional.
Results  Among the included 186 457 children and adolescents (96 017 boys [51.5%], 51 350 Hispanic [27.5%], 91 374 non-Hispanic white [49.0%], 28 808 non-Hispanic black [15.5%], 14 925 non-Hispanic other race [8.0%]), 14 704 children and adolescents (7.9%; 10 536 boys [71.7%], 2497 Hispanic [17.0%], 9010 non-Hispanic white [61.3%], 2328 non-Hispanic black [15.8%], and 869 non-Hispanic other race [5.9%]) were reported to have ever been diagnosed with ADHD. The weighted prevalence of diagnosed ADHD was 10.2% (95% CI, 9.6%-10.8%) in 2015-2016. There were significant sex and racial/ethnic disparities in the prevalence of diagnosed ADHD. The prevalence was 14.0% (95% CI, 13.1%-15.0%) in boys and 6.3% (95% CI, 5.6%-7.0%) in girls, 6.1% (95% CI, 5.2%-7.0%) in Hispanic individuals, 12.0% (95% CI, 11.1%-12.9%) in non-Hispanic white individuals, and 12.8% (95% CI, 11.0%-14.5%) in non-Hispanic black individuals. Over the 20-year period, the estimated prevalence of diagnosed ADHD in US children and adolescents increased from 6.1% in 1997-1998 to 10.2% in 2015-2016 (P for trend <.001). All subgroups by age, sex, race/ethnicity, family income, and geographic regions showed a significant increase in the prevalence from 1997-1998 to 2015-2016.
Conclusions and Relevance  This study’s findings suggest that among US children and adolescents, the estimated prevalence of diagnosed ADHD increased significantly between 1997-1998 and 2015-2016. This study suggests that additional research is needed to better understand the cause of this apparent rise in prevalence.

Nonetiologic factors may partly explain the apparent increase in the prevalence of diagnosed ADHD in this study. Over the past 20 years, there have been expanded continuing medical education efforts about ADHD that enhanced physicians’ sensitivity to the diagnosis of ADHD. Changes in diagnostic criteria may also contribute to the increased number of children being diagnosed with ADHD.7 In particular, changes in the Diagnostic and Statistical Manual of Mental Disorders criteria that established the predominately inattentive presentation of ADHD led to significantly increased diagnosis in girls, who often fail to demonstrate classic hyperactive symptoms. In addition, increased public awareness, improved access to health services, and improved referral from primary care and communities to specialty mental health services may increase the likelihood of ADHD being identified on screening and diagnosis.9 Increased rates of diagnosed ADHD among black and Hispanic youths might reflect increased access to care and decreased stigma in those communities for receiving an ADHD diagnosis. The execution of the Affordable Care Act may also have increased access to care in lower socioeconomic status and minority groups. There is a common perception that ADHD is overdiagnosed in the United States, but this perception was not supported by scientific evidence based on review of prevalence studies and research on the diagnostic process.27
It remains to be understood how much of the observed apparent increase in diagnosed ADHD was attributed to etiologic factors; ADHD has a genetic component with an estimated heritability of 70% to 80%.21 In addition to genetic risk factors, environmental risk factors are believed to contribute to the development of ADHD.1,28 Prenatal and perinatal risk factors, including preterm birth, low birth weight, maternal cigarette smoking, and maternal use of certain medications or illicit substances during pregnancy, have been associated with ADHD risk.2931 Attachment-related factors in early infancy have also been associated with ADHD in childhood.3234 Environmental contamination, such as lead, organophosphate pesticides, and polychlorinated biphenyls exposure, during prenatal and/or postnatal periods is a possible risk factor for ADHD.30 In addition, nutritional deficiencies (eg, zinc, magnesium, and polyunsaturated fatty acids) may also be implicated in the development of ADHD.1 The contributions of these nongenetic and genetic risk factors to the etiologic source of ADHD, both separately and jointly, warrant further 
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