Majority of GPs Think Adult ADHD Is Overdiagnosed, Pulse Survey Suggests

Seven in 10 GPs who responded to a Pulse survey said they think adult ADHD is overdiagnosed, including nearly half who said it is very overdiagnosed. The finding has reignited debate about rising referral rates, but the survey itself measures GP opinion among its respondents — it does not establish whether ADHD is being overdiagnosed nationally.

The survey, published by Pulse on 18 September 2026, is a snapshot of views from GPs who chose to respond, not a random sample of all UK GPs. Understanding what it did and did not measure is important for interpreting the current discussion around adult ADHD diagnosis in the UK.

What Did the Pulse Survey Find?

Pulse, a news publication for UK GPs, ran an online survey between 13 April and 7 May 2026. It was promoted through the Pulse Today website and email newsletters, with a £500 voucher prize draw offered as an incentive. The survey was unweighted and Pulse explicitly stated it did not claim the survey was scientific.

In total, 829 GPs responded.

Respondents were asked two main questions:

1. Roughly what percentage of patients you refer to adult ADHD services receive a positive diagnosis once they are seen?

Pulse applied midpoint analysis to banded responses and reported an average estimate of 81.3%. The distribution was:

2. Do you think adult ADHD is very underdiagnosed, slightly underdiagnosed, diagnosed about right, slightly overdiagnosed, very overdiagnosed, or don’t know?

Combined, those who answered slightly overdiagnosed or very overdiagnosed account for 583 of 829 respondents, or 70.3% of those who responded. Pulse reported this as seven in 10 GPs in its survey thinking adult ADHD is overdiagnosed, which accurately reflects the responding group, not all UK GPs.

What Does the 81.3% Diagnosis Figure Actually Mean?

The 81.3% figure is often the most misunderstood part of this discussion. It does not mean 81.3% of adults have ADHD, nor does it mean 81.3% of people in the general population who suspect they have ADHD would be diagnosed if assessed.

It represents GPs’ estimates of diagnostic yield among patients they themselves had already selected for referral.

Referral creates a strong selection effect. GPs do not refer everyone who mentions concentration problems. They take a history, consider differential diagnoses, and, as several respondents told Pulse, are aware of long waiting lists. That means the group sent for specialist assessment is already filtered to include people GPs think are more likely to meet diagnostic criteria.

Under NICE guidance on ADHD diagnosis and management (NG87), diagnosis in adults should be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in ADHD, based on a full clinical and psychosocial assessment, developmental history, and evidence that symptoms cause at least moderate impairment in multiple settings. Rating scales alone should not be used to make a diagnosis.

If GPs are setting a high threshold before referring, a high positive rate at the specialist clinic would be expected even if diagnostic accuracy is good. Conversely, a high positive rate cannot by itself prove overdiagnosis or underdiagnosis in the wider population, because the denominator — all adults who were not referred — is missing.

Why Are Some GPs Concerned About ADHD Overdiagnosis?

Pulse reported comments from responding GPs who were concerned about current pathways. These concerns were attributed to individual respondents and not presented as verified audit data.

Some respondents said they perceived assessments as potentially superficial, particularly when referral routes were via some private providers. One Dorset-based GP told Pulse: “Occasionally NHS services do not make a positive diagnosis, but I don’t think I have ever seen a private provider not give a positive diagnosis.” Another GP in Devon told Pulse: “ADHD seems to be considered a more socially acceptable diagnosis than, for example, PTSD. I am stunned by how superficial some assessments are, and how little reference is made to some patient’s significant history of trauma or adverse childhood experiences.”

Other concerns raised included symptom overlap between ADHD and other conditions such as anxiety, depression, trauma-related difficulties and mood disorders; the impact of separate single-condition pathways that focus on ADHD alone rather than a holistic mental health assessment; and pressure on services that may influence referral behaviour.

These are important experiences to report, but anecdotes about private versus NHS pathways are not representative national data, and Pulse did not present them as such.

Why Some Experts Say Rising ADHD Diagnoses Do Not Automatically Mean Overdiagnosis

Pulse also reported counter-perspectives.

Dr Katie Bramall, chair of the BMA GP committee UK and who has described being diagnosed with ADHD via the NHS herself, said she was not surprised by a diagnostic yield above 80%. She argued that the lengthy process — from recognizing symptoms to completing forms and waiting for assessment — means only those who feel more strongly affected or more knowledgeable may persist to the point of assessment.

Dr Bramall also argued that rising diagnoses may reflect improved recognition rather than overdiagnosis. She told Pulse that when she qualified in 2003, training on ADHD often focused on the disruptive primary school-aged boy, whereas understanding has since broadened to include how ADHD can present in adults and in women and girls, including links with other conditions.

Henry Shelford, chief executive of ADHD UK, told Pulse: “GPs know how long the waits are and many are setting the bar high to avoid making the queue worse. That is a rational response to a system without the capacity it needs.” He added that patients with ADHD rely on GPs for access to NHS assessment.

Both arguments point to the same issue: diagnostic yield among referred patients depends heavily on who is referred and who completes the pathway, not just on diagnostic accuracy.

ADHD Diagnosis Is More Complex Than a Positive or Negative Test

According to NHS information on ADHD diagnosis and NICE NG87, ADHD is not diagnosed by a blood test or brain scan. Assessment involves a detailed clinical history, including developmental history, evidence of inattention and/or hyperactivity-impulsivity that has been present since childhood, persistence across time, impairment in more than one setting, and consideration of other explanations for symptoms.

Symptoms that can overlap with ADHD include anxiety, depression, sleep difficulties, effects of trauma or chronic stress, substance use, and other neurodevelopmental or mental health conditions. This does not mean those conditions cause ADHD or that ADHD does not exist. It means assessment needs to consider differential diagnosis, which is why NICE recommends assessment by a specialist with expertise in ADHD.

Online screening questionnaires can help someone decide whether to seek professional advice, but they cannot diagnose ADHD on their own.

Why Adult ADHD May Be Diagnosed More Often Today

UK and international data show increases in adult ADHD referrals and diagnoses over the past decade. Researchers and clinicians have suggested several possible explanations, which may coexist:

• Greater public awareness of adult ADHD
• Improved recognition of how ADHD can present in adulthood, not just childhood
• Greater recognition among women and girls, who were historically less likely to be identified because diagnostic stereotypes focused on hyperactive behaviour in boys
• Changes in referral behaviour and expanded access, including NHS Right to Choose pathways in England
• Changes in service availability and recording
• Possible changes in underlying prevalence of symptoms or impairment, which remains uncertain
• Possible diagnostic expansion or substitution in some settings

Rising numbers alone cannot distinguish between better recognition of previously missed cases and overdiagnosis. That distinction requires population-level studies using consistent criteria over time, not just referral counts.

ADHD Prescribing Has Also Increased

Pulse reported that between July 2025 and June 2026, the total number of CNS stimulants and other ADHD medicines prescribed in England increased by 29% compared with the previous 12 months, with an average of 238,000 patients per month prescribed these medicines, according to NHS Business Services Authority (NHS BSA) data cited in the article.

More recent NHS BSA annual figures published in September 2026 show a broader trend. NHS BSA reported that 4.2 million ADHD prescription items were supplied to 427,000 patients in England in 2025/26, a rise from the previous year. Adult patients accounted for around 267,000 of those patients, a 40% increase from 190,000 in 2024/25.

Prescribing data shows how many items were prescribed and dispensed in primary care in England, and how many identified patients received them. It does not show whether each prescription was clinically appropriate, nor does it show clinical outcomes. Increases may reflect more people being diagnosed and treated, longer duration of treatment, changes in shared-care arrangements between specialists and GPs, and improved recording, as well as changes in need.

In the quarter April to June 2026, Pulse reported NHS spending on these medicines at £56 million, up from £50 million in the previous quarter. Spending figures are influenced by both volume and drug prices, including shortages and brand switches, so they should not be read as a direct measure of clinical appropriateness.

What Does the Government Review Say?

The debate takes place alongside an independent review commissioned by the Department of Health and Social Care. In December 2024, then Health Secretary Wes Streeting commissioned an independent review into mental health conditions, ADHD and autism, led by Professor Peter Fonagy, clinical psychologist at University College London.

The interim report, first published 31 March 2026 and updated to an accessible HTML version on 10 June 2026, said it had found sharply rising diagnoses and referrals for ADHD and autism that did not appear to be explained by changes in population prevalence. It described services as under “significant and sustained pressure” and said the status quo was “unlikely to be sustainable or fair.”

The interim report focused on children and young people aged 5 to 24 for some analyses and said there are institutional incentives that make a formal diagnosis a gateway to support at school and work. It did not conclude that ADHD is fake or that all increases represent overdiagnosis. It set out gaps and questions for the next phase of the review, which is examining prevalence, needs, support models and service design. The final report was expected shortly after the interim report, according to a Government spokesperson quoted by Pulse.

What the Pulse Survey Can—and Cannot—Tell Us

The Pulse survey provides useful information about what a group of responding GPs think and what they report experiencing.

Strengths: It captured 829 responses in a short period, asked directly about referral-to-diagnosis estimates, and included free-text comments that illustrate concerns about assessment pathways and service capacity.

Limitations: It was not a random or weighted sample. Recruitment was through Pulse channels, participation was voluntary, and a prize draw may have influenced who responded. Respondents may differ systematically from GPs who did not respond. Estimates of diagnostic rates were based on GP recall, not linked audit data from specialist services. Most importantly, it measured perceptions and reported experiences, not independent verification of whether individual diagnoses were correct.

For that reason, the survey can highlight that many responding GPs are concerned about adult ADHD overdiagnosis and perceive high diagnostic rates among referred patients. It cannot determine the national prevalence of ADHD, the national rate of accurate versus inaccurate diagnoses, or whether ADHD is overdiagnosed in the general adult population.

What This Means for People Seeking an ADHD Assessment

For people who are wondering whether they might have ADHD, the debate can be confusing. Concern about overdiagnosis among GPs does not mean ADHD does not exist in adults, nor that someone should not seek help.

NHS guidance suggests speaking to a GP about symptoms, how long they have been present, and how they affect daily life at work, education or home. If appropriate, a GP can refer for specialist assessment through local NHS pathways or, in England, through NHS Right to Choose. Waiting times are long in many areas, which is itself a significant barrier.

People awaiting assessment should not self-diagnose based on social media or screening tools alone, and should seek support for distress or functional difficulties regardless of diagnostic status. If symptoms are related to anxiety, depression, trauma, sleep problems or other health issues, those also warrant assessment and support.

The Bigger Question: Are ADHD Diagnoses Rising Because of Better Recognition, Overdiagnosis, or Both?

ADHD prevalence estimates vary by method. NICE notes that ADHD affects around 3-5% of children and around 2% of adults globally, but figures depend on criteria and population studied. Some population studies suggest many adults with ADHD remain undiagnosed, while other researchers have raised concerns about diagnostic expansion when assessments do not fully consider developmental history and impairment.

Both concerns can be true in different parts of the system: improved recognition of ADHD in women and adults may have increased appropriate diagnoses, while service pressures, rapid expansion of private assessment routes, and limited access to holistic mental health assessments may increase risk of less thorough assessment in some cases. The Pulse survey alone cannot weigh these factors.

What would help answer the question is population-level research with consistent diagnostic methods over time, linked data on assessment quality and outcomes, and evidence on whether treatment leads to sustained benefit — evidence that is still developing.

The Bottom Line

Pulse’s survey of 829 GPs found substantial concern about adult ADHD overdiagnosis among those who responded, with 70.3% saying it is slightly or very overdiagnosed, and 49.5% saying very overdiagnosed. Respondents estimated on average that 81.3% of patients they refer to adult ADHD services ultimately receive a positive diagnosis.

That 81.3% figure is an estimate of diagnostic yield in a selected, referred population, not a measure of ADHD prevalence or national overdiagnosis. Because GPs act as gatekeepers and many only refer people they already consider likely to meet criteria, a high yield is not surprising and does not by itself prove overdiagnosis.

Rising adult ADHD diagnoses and prescribing in England are documented in NHS data, but they have multiple plausible explanations, including better recognition, greater awareness, changes in referral pathways and service capacity, as well as possible overdiagnosis in some settings. The Government-commissioned Fonagy review’s interim report highlighted rising demand that does not appear to be explained by population prevalence alone and described services as under significant pressure.

Distinguishing access, recognition, diagnostic accuracy and service capacity — rather than treating a survey of GP opinion as proof — will be central to a fair and evidence-based discussion about adult ADHD diagnosis in the UK.

Frequently Asked Questions

Is ADHD overdiagnosed in adults?

There is no consensus national figure that proves ADHD is overdiagnosed or underdiagnosed in adults in the UK. The Pulse survey shows many responding GPs are concerned about overdiagnosis, but it measures opinion, not diagnostic accuracy. Evidence shows referrals and diagnoses have risen, which may reflect better recognition, changes in access, and possibly overdiagnosis in some settings. More rigorous population research is needed.

What did the Pulse GP survey find about ADHD?

Of 829 GPs who responded between April and May 2026, 410 said adult ADHD is very overdiagnosed and 173 said slightly overdiagnosed, totaling 70.3% of respondents. Respondents estimated that on average 81.3% of patients they referred to adult ADHD services received a positive diagnosis. The survey was unweighted and based on Pulse readership.

Does an 81% ADHD diagnosis rate mean ADHD is overdiagnosed?

No. The 81.3% figure is GPs’ estimated rate of positive diagnosis among patients already selected for referral. People referred are not representative of the general population. A high rate in this selected group may reflect careful referral thresholds and people dropping out before assessment, not necessarily inaccurate diagnoses.

Why are more adults being diagnosed with ADHD?

Possible reasons include greater public and professional awareness, broader understanding of how ADHD presents in adults and in women and girls, increased help-seeking, changes in NHS referral routes such as Right to Choose in England, and changes in diagnostic practice. Research is ongoing into how much each factor contributes.

How is adult ADHD diagnosed in the UK?

Under NICE NG87 recommendations on diagnosis, ADHD should be diagnosed by a specialist psychiatrist, paediatrician or other appropriately qualified professional with expertise in ADHD, based on a full clinical and psychosocial assessment, developmental history, and evidence of symptoms and impairment in multiple settings. Rating scales alone should not determine diagnosis.

Can anxiety and trauma cause symptoms similar to ADHD?

Several conditions can cause difficulties with attention, restlessness or impulsivity, including anxiety, depression, trauma-related conditions, sleep problems and mood disorders. These conditions do not cause ADHD, but symptom overlap can make assessment complex. That is why a comprehensive developmental history and consideration of differential diagnoses is recommended.

Are ADHD prescriptions increasing in the UK?

Yes, according to NHS Business Services Authority medicines data for England. In 2025/26, 4.2 million ADHD medicine items were supplied to 427,000 patients, including about 267,000 adults, a 40% rise in adult patients from the previous year. Prescribing volume alone does not show whether prescribing is appropriate.

Should someone who thinks they have ADHD seek an assessment?

If you are concerned about persistent difficulties with inattention, hyperactivity or impulsivity that affect daily life, speak to your GP or other appropriate healthcare professional. They can discuss symptoms, impact, and possible referral options. Support for distress and functioning can be important whether or not ADHD is diagnosed.

Samuel Kemp

Dr. Samuel Kemp is a Consultant Physician at the Royal Brompton Hospital with specialist expertise in respiratory medicine, including lung cancer, COPD, and advanced interventional bronchoscopy.