{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:17:20Z","timestamp":1794003440863,"version":"4.8.0"},"reference-count":43,"publisher":"BMJ","issue":"11","funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1104136"],"award-info":[{"award-number":["1104136"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1113532"],"award-info":[{"award-number":["1113532"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,10,11]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Worldwide, attention deficit hyperactivity disorder (ADHD) diagnosis rates in children and adolescents have been increasing consistently over the past decades, fuelling a debate about the underlying reasons for this trend. While many hypothesise that a substantial number of these additional cases are overdiagnosed, to date there has been no comprehensive evaluation of evidence for or against this hypothesis. Thus, with this scoping review we aim to synthesise published evidence on the topic in order to investigate whether existing literature is consistent with the occurrence of overdiagnosis and\/or overtreatment of ADHD in children and adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>The proposed scoping review will be conducted in the context of a framework of five questions, developed specifically to identify areas in medicine with the potential for overdiagnosis and overtreatment. The review will adhere to the Joanna Briggs Methodology for Scoping Reviews. We will search Medline, Embase, PsycINFO and the Cochrane Library electronic databases for primary studies published in English from 1979 onwards. We will also conduct forward and backward citation searches of included articles. Data from studies that meet our predefined exclusion and inclusion criteria will be charted into a standardised extraction template with results mapped to our predetermined five-question framework in the form of a table and summarised in narrative form.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The proposed study is a scoping review of the existing literature and as such does not require ethics approval. We intend to disseminate the results from the scoping review through publication in a peer-reviewed journal and through conference presentations. Further, we will use the findings from our scoping review to inform future research to fill key evidence gaps identified by this review.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-032327","type":"journal-article","created":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T14:00:08Z","timestamp":1573135208000},"page":"e032327","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Evidence of potential overdiagnosis and overtreatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents: protocol for a scoping review"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4105-0402","authenticated-orcid":false,"given":"Luise","family":"Kazda","sequence":"first","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0137-3218","authenticated-orcid":false,"given":"Katy","family":"Bell","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2165-5917","authenticated-orcid":false,"given":"Rae","family":"Thomas","sequence":"additional","affiliation":[{"name":"Institute of Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"McGeechan","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Barratt","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,11,7]]},"reference":[{"key":"2025121601400997000_9.11.e032327.1","doi-asserted-by":"crossref","DOI":"10.7326\/M18-2645","article-title":"Recognizing the potential for overdiagnosis: are high-sensitivity cardiac troponin assays an example?","volume":"170","author":"Bell","year":"2019","journal-title":"Ann Intern Med"},{"key":"2025121601400997000_9.11.e032327.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaac.2013.09.001"},{"key":"2025121601400997000_9.11.e032327.3","doi-asserted-by":"crossref","unstructured":"Xu G , Strathearn L , Liu B , et al . Twenty-Year trends in diagnosed attention-deficit\/hyperactivity disorder among US children and adolescents, 1997-2016. JAMA Netw Open 2018;1.doi:10.1001\/jamanetworkopen.2018.1471","DOI":"10.1001\/jamanetworkopen.2018.1471"},{"key":"2025121601400997000_9.11.e032327.4","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1111\/jcpp.12882","article-title":"Has the attention deficit hyperactivity disorder phenotype become more common in children between 2004 and 2014? Trends over 10 years from a Swedish general population sample","volume":"59","author":"Rydell","year":"2018","journal-title":"J Child Psychol Psychiatr"},{"key":"2025121601400997000_9.11.e032327.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-012-0501-1"},{"key":"2025121601400997000_9.11.e032327.6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/1087054714554617","article-title":"Prevalence, patient characteristics, and pharmacological treatment of children, adolescents, and adults diagnosed with ADHD in Sweden","volume":"22","author":"Giacobini","year":"2018","journal-title":"J Atten Disord"},{"key":"2025121601400997000_9.11.e032327.7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1778"},{"key":"2025121601400997000_9.11.e032327.8","doi-asserted-by":"publisher","DOI":"10.1037\/a0026582"},{"key":"2025121601400997000_9.11.e032327.9","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e318257c4b6"},{"key":"2025121601400997000_9.11.e032327.10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2011.04176.x"},{"key":"2025121601400997000_9.11.e032327.11","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.h867","article-title":"Overdiagnosis in mammography screening: a 45 year journey from shadowy idea to acknowledged reality","volume":"350","author":"Barratt","year":"2015","journal-title":"BMJ"},{"key":"2025121601400997000_9.11.e032327.12","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq099"},{"key":"2025121601400997000_9.11.e032327.13","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.f6172","article-title":"Attention-deficit\/hyperactivity disorder: are we helping or harming?","volume":"347","author":"Thomas","year":"2013","journal-title":"BMJ"},{"key":"2025121601400997000_9.11.e032327.14","doi-asserted-by":"crossref","DOI":"10.1186\/s13034-016-0140-5","article-title":"Overdiagnosis of mental disorders in children and adolescents (in developed countries)","volume":"11","author":"Merten","year":"2017","journal-title":"Child Adolesc Psychiatry Ment Health"},{"key":"2025121601400997000_9.11.e032327.15","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.jaac.2014.10.014","article-title":"The impact of case definition on attention-deficit\/hyperactivity disorder prevalence estimates in community-based samples of school-aged children","volume":"54","author":"McKeown","year":"2015","journal-title":"J Am Acad Child Psy"},{"key":"2025121601400997000_9.11.e032327.16","doi-asserted-by":"publisher","DOI":"10.1136\/ebmed-2017-110886"},{"key":"2025121601400997000_9.11.e032327.17","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12556"},{"key":"2025121601400997000_9.11.e032327.18","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/1087054715586571","article-title":"Is ADHD really increasing in youth?","volume":"22","author":"Safer","year":"2018","journal-title":"J Atten Disord"},{"key":"2025121601400997000_9.11.e032327.19","doi-asserted-by":"crossref","unstructured":"Morrow R . 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