We often hear that there is an overdiagnosis of ADHD in children. That children are treated and medicated because of something society has inflicted on them. Factors such as immaturity and age can play a role when it comes to getting a diagnosis, and we have to make sure that children get the best living conditions. But should we stop diagnosing and treating ADHD for that reason? Many studies indicate that not treating ADHD produces poor results. One in four patients in treatment for substance abuse disorders has ADHD, usually untreated. In particular, the incidence of ADHD is high among amphetamine users, where perhaps 35 per cent have an ADHD diagnosis. Their amphetamine use must be seen as an attempt to self-medicate. Perhaps as many as half of inmates have an ADHD diagnosis. There is also a clear over-representation of ADHD among the unemployed and those on disability benefits. We believe we are on safe professional ground when we claim that many would have avoided a prison sentence if they had received the ADHD diagnosis in time. The same applies to substance abuse and unemployment. We have not addressed the problem and provided the help we know works. The best documented treatment is still medication, but it must always be combined with other measures. There have also been studies that point to very different practices with regard to diagnosing ADHD. An investigation by researchers at Haukeland University Hospital showed that diagnostic practice varied by a factor of 10 between different centres, and that it is probably the attitudes of professionals that determine whether the child receives an ADHD diagnosis. This large variation has been interpreted as overdiagnosis. But can we be so sure? Could it not just as well be an expression that we are under-processing in some places? Does the fear of overdiagnosing prevent some children from receiving treatment they could benefit from? Many people have an opinion about ADHD. These are opinions such as “that we are treating too many”, “it cannot be the intention that so many should be medicated” or “we cannot medicalise normal behaviour”. This is perhaps an expression of a legitimate concern and hopefully we can do something about the societal structures that make it easier to live with ADHD symptoms. But such societal changes take time, and we cannot allow individuals to go untreated based on the idea that it is society that has something wrong with it. Not when we know that treatment is useful and that the result of a lack of diagnosis and treatment is negative, also in the long term. Not just a little, but very negative. Then we are dangerously close to letting individuals suffer for our own moralism. Of course, there are good examples of children with ADHD who have managed reasonably well, even if they have not received treatment for their disorder. But we cannot let the debate be dominated by these examples. All too often the debate is controlled by people who either do not have ADHD or by those who have managed despite not having received treatment. How often have we heard the phrase “Today I would probably get some kind of diagnosis”. It gives an indirect hint that we are too quick to put a label on unwanted behaviour. Our prisons, treatment facilities and drug scenes are full of people who can tell a completely different story. It is often the story of a sad life, with a lack of diagnosis and treatment. We must use our knowledge for the benefit of the patients. Also read:
ttn-69
We under-treat ADHD – Speech
