ADHD diagnosis, more marketing than medicine? Attention Deficit Hyperactivity Disorder

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A global surge in ADHD diagnosis, more marketing than medicine?

You can't catch attention deficit hyperactivity disorder (ADHD). Yet the diagnosis and treatment of this behavioral condition is spreading like a contagion -- surging as much as tenfold in some countries.

Call it an economic and cultural plague, but not necessarily a medical one, says Brandeis professor Peter Conrad.

Conrad and Bergey attribute ADHD's growth to five trends. 

• Drug companies are effective lobbyists, and have spurred some countries to relax marketing restrictions on stimulants.

• Psychoanalytic treatment with talk therapy is giving way to biological psychiatry -- treating psychological problems with drugs. 

• More European and South American psychologists and psychiatrists are adopting the American-based Diagnostic and Statistical Manual (DSM) standards, which are broader and have a lower threshold for diagnosing ADHD. 

• Vocal ADHD advocacy groups work closely with drug companies to promote pharmaceutical treatment. 

• Lastly, the easy availability of ADHD information and self-diagnosis via the Internet empowers consumers to ask for prescription treatment.

"... checklists turn all kinds of different behaviors into medical problems," Conrad says. "The checklists don't distinguish what is part of the human condition and what is a disease." 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.

"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. ADHD continues a long history of medicalizing behaviors, Conrad says. "I think we may look back on this time in 50 years and ask, what did we do to these kids?" Conrad says.
Brandeis University. Social Science and Medicine

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