The symptoms—distractibility, impulsivity, and hyperactivity—are consistent with the normal behavior of young children. But where do we draw the line between developmentally normal behavior and medical disorder? That's a crucial question because diagnosis rates among very young children are on the rise, and many kids are being medicated.
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The number of U.S. preschoolers diagnosed with attention-deficit hyperactivity disorder (ADHD) jumped 56 percent between –08 and –12, according . Thomas Power from director of the Center for Management of ADHD at Children’s Hospital of Philadelphia and US NEWS writes, recent findings that 11 percent of children have attention-deficit hyperactivity disorder raise legitimate concerns about over diagnosis, leading to questions about possible overuse of medication. This is a concern particularly in affluent communities, since rural and. The Mayo Clinic study that reported the shocking statistic in found that behind antibiotics, doctors prescribe opioids and antidepressants more than any other type of drug.
Psychiatric medicines are quite effective when correctly prescribed for clearcut disorders. But Americans are taking too much medicine, often casually and unnecessarily prescribed by the wrong people for the wrong reasons, and causing lots of needless harm.
The really bad news is that the bulk of psychiatry is no longer done by psychiatrists. Psychiatric medicines are most often prescribed by primary care doctors who are always busy and usually under trained in psychiatry.
And their diagnostic and treatment decisions are heavily influenced by drug company advertising aimed directly at patients combined with aggressive marketing campaigns aimed at doctors. The result is massive overprescription of medicine for off label, untested, and inappropriate indications.
Drug companies have more unregulated freedom in the U. Their success is measured in returns to shareholders, not benefits to patients.
Antipsychotics often cause large weight gains increasing the risks of diabetes, heart disease, and shortened life expectancy.
Almost equally concerning is that eleven percent of U. Perversely, only a third of severely depressed people get the medicine they so desperately need, while many taking antidepressants do not need them at all and receive no more than placebo effect.
We seem to be creating a brave new world in which everyone will take a psychiatric medicine, and some will take two or three or even more. Psychiatric diagnosis and treatment is particularly subject to fads and undue drug company influence because judgments are still based on subjective data that cannot be confirmed or disproved by laboratory tests.
The pride of psychiatry is the enormous neuroscience base accumulated in the past thirty years, but the brain is the most complicated organ in the known universe and reveals its many secrets only very slowly.
We have learned a great deal about normal brain functioning -- but still know very little about what causes the mental disorders. This enormous leap from basic brain science to clinical psychiatry will take decades to bridge in very small steps. In the meantime, decisions about diagnosis and treatment are only as good as the people making them -- and too often they are made after brief and cursory evaluations that ignore best diagnostic and treatment practices.
I am a psychiatrist and was chair of the group that prepared DSM-IV -- the manual that currently guides psychiatric diagnosis. Sad to say, DSM-IV is often used carelessly or not at all especially in primary care -- resulting in a great deal of mislabeling and unnecessary treatment.
The overdiagnosis of mental disorders has recently gotten out of hand with faddish false epidemics of childhood bipolar disorder increased by forty foldautism increased by twenty foldand attention deficit doubled.
One quarter of the general population would now qualify for a diagnosis in any given year, more than half lifetime.
The next edition of the diagnostic manual DSM 5 is in preparation now and will become official in Unless its ambitions are trimmed dramatically, DSM 5 will promote the misdiagnosis of tens of millions of people and an even greater misuse of potentially harmful medication.
It proposes to introduce many new diagnoses and broaden the criteria for existing ones. The people working on DSM 5 mean well, are not drug company shills, and genuinely believe their suggestions will help patients. The problem is that they are researchers who have worked in ivory tower settings with little experience in how the diagnostic manual is often misunderstood and misused in actual practice.
A suggestion that might be fine in their own hands can cause disaster if misapplied by a less expert primary care doctor. As researchers they are much less worried than I am that their proposals are largely untested. This is dead wrong and dangerously reckless. DSM 5 will have a dramatic effect on peoples lives and everything in it must be certified safe and scientifically sound.
Final decisions on DSM 5 will be made soon. I will post a series of blogs highlighting its worst proposals and updating the efforts to shoot them down before they can become official.
Public health will be adversely affected by DSM 5 -- the public should become informed and have its say before it is too late.Ritalin can almost be a lifesaver for children like Jarryd.
But, with two and a half million prescriptions for the drug written last year, many people are wondering if ADHD is being over diagnosed. May 23, · "We couldn't exist without him being medicated," said Rob Gorski, Gavin's father.
"We struggled with it at first. Nobody wants to medicate their kids, but it comes to a quality of life issue. That's a crucial question because diagnosis rates among very young children are on the rise, and many kids are being medicated.
According to historical health data collected in the United States, the percentage of 2-toyear-olds diagnosed with ADHD increased by 50% between and (Danielson et al ). Jun 06, · A common interpretation: children with behavioral or emotional problems are being overmedicated by psychiatrists too busy to provide therapy, at the request of parents too busy to provide a healthy home environment.
The controversial subject of medicating children with attention-deficit hyperactivity disorder (ADHD) was the focus of several APA Annual Convention sessions.
Among them, Div. 53 (Society of Clinical Child and Adolescent Psychology) sponsored a panel discussion for leading clinicians and. Thomas Power from director of the Center for Management of ADHD at Children’s Hospital of Philadelphia and US NEWS writes, recent findings that 11 percent of children have attention-deficit hyperactivity disorder raise legitimate concerns about over diagnosis, leading to questions about possible overuse of medication.
This is a concern particularly in affluent communities, since rural and.