Thursday 27 June 2013

ADHD Overdiagnosis and Overmedication- The Risks and Pitfalls



The CDC’s report  (2011-2012 National Survey of Children’s Health) has raised some worrying aspects about the problem of overdiagnosis of ADHD and also as a consequence, overmedication. Over 76,000 parents were interviewed by phone.


The New York Times did not wait for the CDC to sum up its findings but went ahead and published all this data. The figure of 11% ( I in 5) of school children being diagnosed with ADHD represents a sharp rise over the last forty years or so.  These concerns have been raised before. Some famous examples are Hillary Clinton’s press conference in 2000. 

But are these gloomy predictions really true?  Perhaps ADHD really is increasing and there is a need for more and more medication. That is worrying.

It could be that there is growing awareness of the problem or as the New York Times states, there is far too much mislabelling of our children who may not have ADHD at all.  There are so many childhood conditions that mimic ADHD that this really should be taken into consideration more often.

The publication of the DSM V edition has broadened the areas of definition of ADHD which may mean that more and more children are going to fall into the net. There are fears that this redefining of the criteria and the extension of the age limits may actually lead to even more over diagnosis of ADHD.

There is also the question as to whether ADHD is being under reported in the case of inattentive children (especially girls) who tend to go unnoticed.

To sum up. The main concerns are:-
1.      There is far too much willingness to seek an ADHD diagnosis because parents and teachers want children to behave better
2.      They also want children to do better academically and they are not concerned about the ethics of giving medication as a study aid!
3.      Meds are shared among class mates and are taken by those students who are perfectly normal
4.      The health risks associated with such  misuse and abuse of the meds are considerable.
5.      Normal childhood behavior such as being fidgety and restless is part of childhood but is now being regarded as pathological. (This is the view of Dr. Jerome Groopman of the Harvard Medical School). He is the author of the book. ‘How Doctors Think’.

Finally, we should be wary of getting a fast diagnosis for our child who may have ADHD. There may simply be parenting issues. According to Dr. James Swanson, professor of psychiatry at Florida International University, the possibility that one in five high school kids has ADHD is grossly exaggerated. The real problem is with the misuse of the ADHD meds and he believes that these meds are given freely to schoolmates and he says that this could be as high as 30%.