ADHD overdiagnosed in children?

Attention deficit hyperactivity disorder (ADHD) may be over-diagnosed, new research has suggested. Published in the Journal of Consulting and Clinical Psychology, the findings are likely to lend more backing to a notion that has long been suspected by many.

According to investigators from Ruhr-Universitat Bochum (RUB) and the University of Basel - home to more than 300 professors - both child and adult psychiatrists and psychotherapists often fail to adhere to recognised criteria when considering the condition, choosing instead to stick to unclear rules of thumb.

It was also demonstrated that boys are more regularly misdiagnosed than their female counterparts in this regard.

RUB Professors Silvia Schneider and Jurgen Margraf noted: "In spite of the strong public interest, only very few empirical studies have addressed this issue."

The duo explained current research has done little to properly delve into misdiagnoses of the condition, adding therapists should adhere to defined and established guidance rather than relying on intuition.

Paul Mawer, Chartered Psychologist, commented: "I feel that a diagnosis of ADHD should only be made if school parents and the professionals all agree on the child's behaviour.

"A variety of behavioural techniques should be used over a period of time before any diagnosis is made. If medication is prescribed a double blind method should be used to ensure that it is being effective and not serving to alter people's perceptions of the child's behaviour.

"Questionnaires used to help diagnose ADHD should also be examined to see if they can be improved in anyway."

It was my understanding that diagnosis is only given if inattention and/or hyperactivity and impulsive behaviour is present ACROSS settings. I would hope that professionals are aware of the differences between a child demonstrating the signs of ADHD and other difficulties. The issue of diagnosis is, as ever, highly complex especially as research has demonstrated that ADHD is a highly heritable condition and therefore any child with ADHD has a parent with ADHD who would find it difficult to control their own attention levels, hyperactivity and impulsiveness in the management of their child's behaviour. I am also aware of the fact that many teachers do not fully understand ADHD believing it to be a condition rendering children totally incapable of focusing or sitting still or worse, don't believe that it exists and apply pressure to the child to just work harder or focus more.

In my practice I have come across a number of adults who have unrecognised ADHD, who have been diagnosed with personality disorders or believe that they simply have an anger management problem which they have failed to control. Had they been diagnosed they (and their families) would have had the opportunity to develop acceptance of their difference and perhaps access to appropriate drug treatments (which are amongst the most effective psychiatric drugs available).

In sum, although I agree with Paul Mawer and the sensible suggestions of the article, my concern is that the lay person will only pay attention to ADHD as an "overdiagnosed" problem and conclude that this is evidence to question the validity of the condition. This will only serve to reinforce the stigma that people with ADHD already suffer i.e. that they just need to learn to behave in a more socially acceptable manner.

I also believe ADHD can be overly diagnosed in children.
I agree with Paul Mawer, the decision of a diagnosis would be better if the school parents and other professionals agree with the behaviour and diagnosis. ADHD can be confused with a lot of other psychological problems, and I don't believe an initial assessment from a professional is enough to really diagnose the condition.

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