Evaluating the evidence for and against the overdiagnosis of ADHD.

Objective: According to the DSM-IV TR, approximately 3 to 7% of school-age children meet the criteria for ADHD. However, there is a common conception that ADHD is overdiagnosed. The purpose of this article is to evaluate the evidence for and against overdiagnosis.

Method: Recent prevalence studies and research on factors affecting diagnostic accuracy were reviewed. For ADHD to be overdiagnosed, the rate of false positives (i.e., children inappropriately diagnosed with ADHD) must substantially exceed the number of false negatives (children with ADHD who are not identified or diagnosed).

Results And Conclusion: Based on the review of prevalence studies and research on the diagnostic process, there does not appear to be sufficient justification for the conclusion that ADHD is systematically overdiagnosed. Yet, this conclusion is generally not reflected in public perceptions or media coverage of ADHD. Potential explanations for the persistence of the belief in the overdiagnosis of ADHD are offered.