Reasons Why ADHD Might Be Being Overdiagnosed

How Many Young People Are Diagnosed With ADHD?

Statistics reveal around 1 in 7 young people in the United States currently receives a diagnosis of ADHD (the majority of whom are male)) and it is has been argued by many that a large proportion of these diagnoses are incorrect ; in fact, it is quite possible that the number of incorrect diagnoses outweigh the correct ones.

Overdiagnosis ?

The extremely strong suspicion that ADHD is being overdiagnosed in young people in the United Stated is underlined by the fact that The American Psychiatric Association estimates the true number of ADHD sufferers to be around 5% (i.e. a mere third of those who are being diagnosed with the condition – see above) and this figure is generally endorsed as a realistic estimate ny most experts in the field.

Explosion of Diagnoses :

Also, it should be taken into consideration that there has been an absolute explosion in relation to the diagnosis of ADHD in the recent past ; for example, in 1990 only about 1% of young people, at most, had been diagnosed with ADHD.

In the UK, prescriptions of retalin have doubled for children and adolescents between 2003 and 2008 (and, in relation to adults, they have quadrupled).

So, if we accept the ADHD is indeed being overdiagnosed in young people, what are the possible reasons for this unfortunate occurrence?

Possible Explanations For Over-Diagnosis Of ADHD:

PROFITS :

One reason that is frequently put forward is that the organizations profiting from selling the drugs that are used to treat ADHD are funding studies, running aggressive campaigns (including campaigns endorsed by celebrities) and hiring physicians who will increase their sales and, of course, their profits.

RATIONALIZATION TO GAIN CONTROL :

It is also argued in some quarters that diagnosing a young person with ADHD so that he or she can then be medicated with drugs that have a ‘subduing’ effect may be, at least in part, motivated by a wish of some (e.g. over-stressed teachers) to control disruptive students rather than by a sole inclination to act in the young person’s best interests. Indeed, such motivation may, in some cases, be operating on an unconscious level with the concept of the young person having a genuine clinical need for the medication serving as a convenient rationalization.

‘PATHOLOGIZING BOYHOOD’ :

Indeed, some researchers have even suggested that the diagnosis of ADHD,and the subsequent administration of medication purpotedly to treat it, represents a cultural intolerance of boys deriving from a perception that their high levels of energy and aggressive tendencies make them hard to keep under discipline. In fact, as long ago as the 1970s, the drug retalin was being described by some as the ‘bahvior drug’ and, more recently, terms like ‘pathologizing boyhood’ and ‘medicating boyhood’ have been suggested in relation to the perceived inappropriate use of the drug (Kindton and Thompson, 1999 :Raising Cain: Protecting the Emotional Life of Boys ).

‘MILD’ AND ‘MODERATE’ CASES :

A very large proportion of children (estimated at around 85 per cent) are diagnosed with ‘mild’ or ‘moderate’ symptoms of ADHD. It is argued that in such cases where symptoms are not severe and dramatically pronounced, the diagnosis is subject to being overly influenced by subjective opinion.

FAKING / PERFORMANCE ENHANCEMENT :

Some individuals may fake ADHD symptoms so that they can gain a prescription for ADHD medication in the hope that it will improve their powers of concentration and attention in a way that helps them to achieve better academic grades. In other words, they treat such medication as ‘performance-enhacing drugs.’

INDIVIDUALS YOUNG FOR THEIR GRADE :

One study conducted in the 1990s (Watson) found that young students who were young for their grade in school were 20 times more likely to receive a diagnosis of ADHD than those who were not in this category (although there was some initial dispute, subsequently resolved, over her findings).

Another study, conducted by Ford-Jones, PhD, found that children born in December (the youngest in their grade) were more likely to receive a diagnosis of ADHD than those born in December (the oldest in their grade).

DEPRESSION MISDIAGNOSED AS ADHD?

It is possible that depression is sometimes misdiagnosed as ADHD because of the symptoms the two conditions share in common such as disrupted sleep, irritable mood and problems relating to focus, concentration and attention.

ANXIETY MISDIAGNOSED AS ADHD?

Similarly, it is possible that anxiety is sometimes misdiagnosed as ADHD because of the symptoms the two conditions share in common such as irritable mood, problems relating to focus, concentration and attention, restlessness and difficulties relating to interpersonal relationships due to social anxiety.

PTSD MISDIAGNOSED AS ADHD? :

See my previously published article : Childhood Trauma : Is PTSD Being Misdiagnosed as ADHD?

WHAT ABOUT THE CORRECT DIAGNOSES?

It is important to stress, that despite controversy regarding the appropriateness, or otherwise, of many diagnoses of ADHD, it is widely accepted amongst the medical community that a significant quantity of ADHD diagnoses are clinically justifiable and that sometimes the prescribed medication that follows such a diagnoses is beneficial to the individual to whom it is administered.

NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE (NICE) GUIDELINES FOR TREATMENT OF ADHD :

The UK guidelines (PDF, 217Kb) 

N.B. ALWAYS SEEK APPROPRIATE, EXPERT, PROFESSIONAL ADVICE BEFORE STARTING OR STOPPING MEDICATIONS.

 

RESOURCES :

 

Improve Impulse Control

MANAGE ADHD

 

 

 

 

 

 

 

 

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 

 

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About David Hosier BSc Hons; MSc; PGDE(FAHE)

Psychologist, researcher and educationalist.

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