Study Says ADHD May Be Over-Diagnosed in Children : Medicine: Condition is estimated to occur in up to 5% of youngsters nationwide but is found being treated among about 8% in one area.
Doctors may be over-diagnosing some groups of children with attention deficit-hyperactivity disorder and overprescribing drugs to treat the condition, according to a new study published Wednesday.
Researchers examined about 30,000 grade-school children in two districts in southeastern Virginia and found that pupils took drugs for ADHD in school at two to three times the expected rate, according to the study in the American Journal of Public Health.
ADHD is characterized by impulsive behavior and difficulty in paying attention and keeping still. About 90% of patients take Ritalin, a mild central nervous system stimulant believed to calm hyperactivity by helping the brain disregard distracting stimuli.
ADHD has been estimated to affect 3% to 5% of school-age children nationwide, with less than 3% actually receiving medication, said Gretchen LeFever, a pediatric psychologist and lead author of the study.
By comparison, her research found that 8% to 10% of children in second through fifth grades routinely took ADHD medication in school during the 1995-96 school year.
“It’s hard to believe this many children have the specific brain-related problem called ADHD,” said LeFever, assistant professor of pediatrics and psychiatry at the Center for Pediatric Research.
The center is a joint program of Eastern Virginia Medical School and Children’s Hospital of the King’s Daughters.
LeFever said there probably are regions across the country with similar trends, indicating more research is needed.
“That’s a very high rate of ADHD, by anyone’s estimate,” said psychologist Nadine M. Lambert of UC Berkeley, a longtime ADHD researcher who was not involved in the current study.
In the study, researchers reviewed records of pupils enrolled in the second through fifth grades in Portsmouth and Virginia Beach. They chose those two cities because they were the most diverse in southeastern Virginia, LeFever said. Portsmouth is a small, urban, poor, mostly black district, while Virginia Beach is larger, wealthy and mostly white.
Researchers also found that ADHD medication was used by three times as many boys as girls and twice as many whites as blacks.
The use of the medication increased as children aged. By the fifth grade, 19% to 20% of white boys received ADHD drugs.
Dr. Louis H. McCormick, a faculty member in the family medicine department at Louisiana State University Medical School, said the study confirms what he has long suspected in his own 20-year practice: that kids are being over-diagnosed with ADHD.
The problem is that other conditions, such as anxiety or depression, can mimic the symptoms of ADHD, said McCormick, a family doctor in Franklin, La., who has given seminars on ADHD. He also is a member of the American Academy of Family Physicians.
“We don’t have a blood test to evaluate ADHD. ADHD is an educated guess,” McCormick said. “You need better data from all 50 states to really get a handle on the prevalence.”
