Hyperactive Prescribing?

ADHD Drugs

Ryan D’Agostino worries ADHD is being over-diagnosed:

Falsely diagnosing a psychiatric disorder in a boy’s developing brain is a terrifying prospect.

You don’t have to be a parent to understand that. And yet it apparently happens all the time. “Kids who don’t meet our criteria for our ADHD research studies have the diagnosis—and are being treated for it,” says Dr. Steven Cuffe, chairman of the psychiatry department at the University of Florida College of Medicine, Jacksonville and vice-chair of the child and adolescent psychiatry steering committee for the American Board of Psychiatry and Neurology.

The ADHD clinical-practice guidelines published by the American Academy of Pediatrics—the document doctors are supposed to follow when diagnosing a disorder—state only that doctors should determine whether a patient’s symptoms are in line with the definition of ADHD in the DSM. To do this accurately requires days or even weeks of work, including multiple interviews with the child and his parents and reports from teachers, plus significant observation. And yet a 2011 study by the American Academy of Pediatrics found that one third of pediatrician visits last less than ten minutes. (Visits for the specific purpose of a psychosocial evaluation are around twenty minutes.) “A proper, well-done assessment cannot be done in ten or fifteen minutes,” says Ruth Hughes, a psychologist who is the CEO of Children and Adults with ADHD (CHADD), an advocacy group.

Only one significant study has ever been done to try to determine how many kids have been misdiagnosed with ADHD, and it was done more than twenty years ago.