According to data from the National Institute for Health Development (TAI), the number of ADHD diagnoses has surged in recent years. In 2020, 2,345 children aged 14 or younger were diagnosed with the condition; by 2024, that number had risen to 3,690 — a 57 percent increase.

The growth in diagnoses among adults has been even more dramatic: in 2020, ADHD was diagnosed in 1,112 people aged 15 and older, while by 2024 the number had skyrocketed to 9,121 — more than eight times higher. TAI is still compiling data for 2025.

A comparison of recent years reveals that six years ago, adult men were diagnosed with ADHD more than twice as often as women. However, that ratio has shifted over time and by 2023, the number of newly diagnosed female patients had surpassed that of men.

In the year before last, a little over 4,000 men and just over 5,000 women had received an ADHD diagnosis. Among children, doctors diagnosed nearly 2,800 boys and slightly more than 900 girls with the condition.

The Health Insurance Fund's spending on ADHD medications has also increased over the years. In 2020, covering subsidies for 2,689 children cost more than €566,000. A year later, with 3,163 children receiving support, the cost rose to over €680,000.

Adults became eligible for subsidized ADHD medications in 2023, which led to a rise in Health Insurance Fund expenditures. By the end of 2023, a total of 8,839 children and adults had received medication with the subsidy, costing the Health Insurance Fund nearly €1.39 million.

Last year, 17,236 patients in Estonia received ADHD medications, with the Health Insurance Fund spending €3.46 million. However, these figures are not final, as not all treatment invoices from the past year have been submitted yet.

Qualifying for discount requires meeting several criteria

Sander Rajamäe, senior specialist at the Health Insurance Fund, told ERR that in order for an adult to receive a 75-percent subsidy for methylphenidate — the medication used to treat ADHD — the condition must be moderate to severe, affect multiple aspects of life and there must be evidence the disorder was present during childhood.

That final requirement has caused some confusion, as some psychiatrists have interpreted it to mean that in order to prescribe the subsidized medication, the doctor must also speak with the patient's parent to obtain an assessment of their childhood behavior.

However, Rajamäe clarified that this is not the case. According to treatment guidelines, a psychiatrist must confirm a first-time adult ADHD diagnosis and the diagnosis should be based on a clinical interview that explores symptoms present both in childhood and adulthood, supplemented by additional assessment tools when needed.

"Adults may find it difficult to recall childhood symptoms and challenges typically associated with ADHD, so it may be helpful to involve close relatives in the diagnostic process to clarify the information," Rajamäe said. "Evidence-based cognitive function testing can provide useful differential diagnostic insight, but it is not a prerequisite for confirming an ADHD diagnosis," he emphasized.

He added that the treatment guidelines should be understood to mean that while relatives may be involved in gathering information for diagnostic purposes, the final decision rests with the physician.

"If, for any reason, it's not possible to obtain relevant information from the patient's relatives, then the data collected from the clinical interview with the patient must be used. Neither the criteria for subsidized methylphenidate nor the treatment guidelines state that confirmation of childhood ADHD symptoms must come solely from a parent," Rajamäe said.

He encouraged patients who may have received different information from their psychiatrist to contact the Health Insurance Fund with their concerns.

ERR's science portal has previously reported that ADHD is a relatively new diagnosis and its underlying causes have primarily been studied in children. However, the number of ADHD diagnoses among adults has been rising rapidly worldwide.

Last fall, Kelli Lehto, associate professor of neuropsychiatric genomics at the University of Tartu, received a €1.5 million ERC grant to study the causes and mechanisms of adult ADHD over the next five years. Her research will use genetic data alongside environmental and lifestyle information, including data on smartphone usage.

According to the World Health Organization, ADHD affects approximately 8 percent of children under the age of 18, occurring several times more frequently in boys than in girls. The disorder typically begins in early childhood and usually persists throughout the school years, continuing into adulthood in about one-third to one-half of cases.

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