One in 10 U.S. Kids Diagnosed With ADHD: Report

But many children who get diagnosis may not really have the condition, experts say

By Robert Preidt

Monday, April 1, 2013

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MONDAY, April 1 (HealthDay News) -- About 11 percent of school-age children in the United States -- and 19 percent of high-school-age boys -- have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), according to U.S. Centers for Disease Control and Prevention data.
The figures show that about 6.4 million children aged 4 to 17 have been diagnosed with ADHD at some point in their lives, a 16 percent rise since 2007 and a 53 percent increase over the past decade, The New York Times reported Sunday.
Also, about two-thirds of kids with a current diagnosis of ADHD take prescription drugs such as Adderall or Ritalin, which can improve the lives of patients, but may also lead to addiction, anxiety and even psychosis, the report said.
The data could add to growing concern among many doctors that the ADHD diagnosis and its drug treatments are overused in American children, according to The Times.
For its story about ADHD rates, the newspaper analyzed raw data from a wider CDC study of children's health issues. It included more than 76,000 parents nationwide who were interviewed from February 2011 to June 2012.
"Those are astronomical numbers. I'm floored," Dr. William Graf, a pediatric neurologist in New Haven, Conn., and a professor at the Yale School of Medicine, told The Times.
"Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy," he added.
Another expert agreed. "The marked increase in the number of youth diagnosed with ADHD is undoubtedly due to a multitude of factors. Regrettably, the results from this study do not allow us to identify a single cause, and one has to resist the temptation to lay blame on any one single factor," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at the Steven & Alexandra Cohen Children's Medical Center of New York, in New Hyde Park.
He added, "To the extent that problems with inattention, impulsivity, and restlessness can vary wildly in severity, it is likely that the increased number of children and adolescents diagnosed with ADHD reflects a greater number of youth with mild problems being diagnosed and treated."
The data showed that 15 percent of school-age boys and 7 percent of girls had received an ADHD diagnosis. Among teens aged 14 to 17, about 19 percent of boys and 10 percent of girls had been diagnosed with ADHD. About 10 percent of high school boys currently take ADHD medications, The Times reported.
ADHD diagnosis rates in states vary widely. For example, about 23 percent of school-age boys in Southern states -- such as Arkansas, Kentucky, Louisiana, South Carolina and Tennessee -- were diagnosed with ADHD, compared with fewer than 10 percent in Colorado and Nevada.
Historically, ADHD has been estimated to affect 3 percent to 7 percent of children. There is no definitive test for the disorder. Diagnosis is based on extensive interviews with children, parents and teachers, and ruling out other causes, The Times reported.
"These data highlight the importance of obtaining an accurate diagnosis of ADHD in children, adolescents and adults with ADHD. The diagnosis of ADHD needs to be established through careful clinical interview -- there are no shortcuts," said Dr. Lenard Adler, a professor of child and adolescent psychiatry at NYU School of Medicine.
The rising rates of ADHD diagnosis and medication use are due to several factors, according to experts. Some doctors are too quick to diagnose any complaints about inattention as ADHD, drug company advertising emphasizes how medication can substantially improve a child's life, and some parents pressure doctors to do something about their children's bad behavior and poor grades.
For his part, Adler, who is also director of the adult ADHD program at NYU Langone Medical Center, pointed out the importance of treating actual ADHD.
"The consequences, if ADHD is present, but untreated in young adults, are significant in that the risk for substance abuse, cigarette smoking, motor vehicle accidents, divorce or separation and under-performance on the job or in school are substantially elevated," Adler said.
Appropriate treatment "can include medication and psychosocial treatments, and should be established in careful cooperation of the patient, family and physician," he added. "Stimulant medications can be highly effective treatments with appropriate monitoring for improvement of symptoms of ADHD and for potential side effects."

SOURCES: Andrew Adesman, M.D., chief, developmental and behavioral pediatrics at Steven & Alexandra Cohen Children's Medical Center of New York, New Hyde Park; Lenard Adler, M.D., professor of psychiatry, child and adolescent psychiatry, NYU School of Medicine, and director, adult ADHD program, NYU Langone Medical Center, New York City; March 31, 2013, The New York Times

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