ADHD: Misunderstood Again?!

This New York Times article just doesn't get ADHD. ADDitude responds to media misconceptions about attention deficit.
Speak Up, Please | posted by Andrew Gilbert, M.D.

Despite substantial growth in our understanding of ADHD, questions about its validity endure and are highlighted in major newspapers.

The New York Times ran an article about physicians allegedly trying to battle inequality by providing children with bogus ADHD diagnoses in order to justify their stimulant prescriptions. It's a timely article in that ADHD Awareness Week is upon us, and it speaks to the continued need for greater education about ADHD and other psychiatric disorders in the general population and even within the medical community.

It was unfortunate to read a physician in the article referring to ADHD as "made up" and "an excuse." In 1998 the American Medical Association’s Council on Scientific Affairs reported that "ADHD is one of the best-researched disorders in medicine, and the overall data on its validity are far more compelling than for many medical conditions."

Nearly 15 years later, despite substantial growth in our understanding of this neurobiological condition, questions about its validity endure and are highlighted in major newspapers. Should we change ADHD Awareness Week to ADHD Awareness Month? Year? Decade? What will it take?

Medications are one of several tools that can effectively treat ADHD, when it is properly diagnosed, in children and adolescents; there is substantial evidence that medications can be safely and effectively used when working closely with an experienced treatment provider.

In any community, irrespective of socioeconomic status, patients may not fit neatly into medical diagnostic categories and yet may benefit from effective treatments for their symptoms — this is the real world of health care (and is certainly not unique to psychiatry).

While diagnostic ambiguity does not "excuse" the deliberate misdiagnosis described in the article, communities with limited access to quality health care and education are more susceptible to inadequate clinical care. This is a persistent and complex problem that demands attention from our health care and public policy leaders.

The article clearly speaks to the need for more child and adolescent psychiatrists, as we are a small but growing community of physicians with expertise in diagnosing and treating ADHD and other psychiatric disorders in children and adolescents.

Meanwhile, we continue to depend upon outstanding organizations such as CHADD (chadd.org and ADHDAwarenessWeek.org) and the American Academy of Child and Adolescent Psychiatry (aacap.org) to promote awareness and provide community and political outreach.

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