Demographic and Genetic Predictors of ADHD Diagnoses and Medications in Electronic Health Records

Background The rise in stimulant prescriptions, which are commonly prescribed for attention-deficit/hyperactivity disorder (ADHD), has raised concerns due to their high potential for abuse. Methods This study utilized data from the Penn Medicine BioBank (PMBB) to investigate prescription stimulant use by identifying: (1) individuals with an International Classification of Diseases (ICD) code for ADHD, (2) individuals prescribed a stimulant, (3) individuals with both an ICD code for ADHD and a stimulant prescription, (4) individuals without an ICD code for ADHD but with a stimulant prescription, and (5) a control group. We assessed differences in demographics, medication type, and dosages amongst these groups. For participants with available genetic data, we calculated polygenic scores (PGS) for ADHD and used regression models to examine whether PGS for ADHD is associated with ADHD diagnosis and stimulant medication use. Results Demographic differences between the five groups were identified. Individuals with an ADHD diagnosis were more likely to be younger, female, and White, compared to the control group. Individuals with ICD codes for ADHD were prescribed significantly higher average doses of stimulants compared to those without ADHD. PGS for ADHD was significantly associated with the likelihood of receiving an ADHD diagnosis, using a stimulant, using a stimulant in the absence of an ADHD diagnosis, and receiving a lower dosage of a stimulant. Conclusions Findings from this research will contribute to discussions surrounding the role of genetic predisposition and demographic disparities in ADHD diagnosis and treatment.