Why Are ADHD Diagnoses On the Rise Across the Globe ?

Attention deficit hyperactivity disorder (ADHD) is not contagious, yet the diagnosis and treatment of this behavioral condition is spreading like a plague - surging as much as tenfold in some countries.

The spread of ADHD is an economic and cultural plague, not necessarily a medical one, according to Brandeis professor Peter Conrad. In a recent paper in the journal Social Science and Medicine, Conrad and co-author Meredith Bergey examined the growth of ADHD diagnoses in the UK, Germany, France, Italy and Brazil.

Until recently, North America had by far the most ADHD diagnoses and the United States consumed 90 percent of all Ritalin, a common drug used to treat ADHD. ADHD diagnoses continue to grow in the US, but Americans now account for only 75 of Ritalin consumption.

Conrad and Bergey identify five trends leading to the growth in ADHD diagnoses. Drug companies are extremely effective lobbyists, and have convinced some countries to relax marketing restrictions on stimulants. Pyschoanalytic treatment with talk therapy, which is more expensive and time-consuming, is giving way to increased treatment of ADHD with drugs. More European and South American doctors are adopting the American-based Diagnostic and Statistical Manual (DSM) standards, which are broad and have a relatively low threshold for diagnosing ADHD. ADHD advocacy groups work together with drug companies to promote pharmaceutical treatments. Finally, the easy availability of information about ADHD and self-diagnosis via the internet empowers consumers to ask their doctors for prescription treatment.

According to the study, in the U.K., diagnosis of the disorder in school-age children grew from less than one percent in the 1990s to about five percent today. In Germany, prescription ADHD drugs rose from 10 million daily doses in 1998 to 53 million in 2008.

Growth in Italy and France has not been as rapid, in part due to those countries' more restrictive pharmaceutical drug laws. However, even those nations are becoming more lax, says Conrad. In Brazil, a rising number of ADHD advocacy groups, many with close ties to the pharmaceutical industry, are raising awareness of the disorder and leading to an increase in diagnoses.

"There is no pharmacological magic bullet," says Conrad. No drug can account for nonmedical factors that may contribute to behavior. A fidgety student may be responding to the one-size-fits-all compulsory education system, Conrad says, not a flaw in his brain chemistry.

"I think we may look back on this time in 50 years and ask, what did we do to these kids?" Conrad says.

 


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