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According to a study released Friday, the number of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) has reached more than 10%, a significant increase over the past 20 years.
The increase was more pronounced among minority groups, suggesting that better access to health insurance and mental health treatments through the Affordable Care Act could have played a role. role in this increase. The diagnosis rate during this period doubled among girls, but was still much lower than among boys.
But the researchers say that they have found no evidence to confirm frequent complaints that the disease is overdiagnosed or misdiagnosed.
The United States has far more cases of ADHD than other developed countries, which researchers say has led some to believe that children overdiagnose Americans. Dr. Wei Bao, the lead author of the study, said in an interview that a review of studies around the world does not support it.
Overdiagnosis not the main problem
"I do not think overdiagnosis is the main problem," he said.
Nevertheless, these doubts persist. Dr. Stephen Hinshaw, who co-authored a book in 2014 titled "The Explosion of ADHD: Myths, Drugs, Money, and Pressure for Performance," compared ADHD to depression. In an interview he stated that neither of the two diseases has unambiguous biological markers, so it is difficult to determine whether a patient is actually suffering from this disease without undergoing lengthy psychological assessments. Symptoms of ADHD can include inattention, restless behavior and impulsivity.
"This is probably not a real epidemic of ADHD," said Hinshaw, a professor of psychology at the University of California-Berkeley and professor of
In interpreting their results, however, the authors of the study associated the highest numbers with a better understanding of the condition by physicians and the public, with new diagnostic standards and better access to health insurance.
Through the ACA, "some low-income families have better access to services and referrals," said Bao, an assistant professor of epidemiology at the College of Public Health of the University of Toronto. 39; Iowa.
The study, published in JAMA Network, used data from the National Health Interview Survey, an annual federal survey conducted among approximately 35,000 households. He found a steady increase in diagnoses among children from about 6% between 1997 and 1998 to more than 10% between 2015 and 2016.
Advances in medical technology
According to the study, advances in medical technology could also have contributed to this increase. Twenty years ago, premature or low birth weight babies had more difficulty surviving. These factors increase the risk of diagnosing ADHD.
The study also suggests that fewer stigmas about mental health care in minority communities can also lead to more people being diagnosed with ADHD.
According to the study, in the late 1990s, 7.2% of non-Hispanic white children, 4.7% of non-Hispanic black children and 3.6 Hispanic children had been diagnosed with ADHD.
In 2016, it was 12% of white children, 12.8% of blacks and 6.1% of Hispanics.
Over the past few decades, Hinshaw has stated that there is a broader vision of who can develop ADHD. It is no longer considered a disease that affects only middle-class white boys, as eating disorders are no longer perceived as affecting only middle-class white girls.
However, he cautioned against overdosing ADHD in communities where behavioral problems could be the result of social or environmental factors such as overcrowded classrooms.
Climbing at the girls'
The study found that ADHD rates among girls had increased from 3 to over 6% during the study period. He stated that this was partly the result of a change in the way the condition is classified. For years, ADHD involved hyperactive children. But in recent years, the American Psychiatric Association has added to its guide to mental health issues that the diagnosis should also include some inattentive children, Bao said. This has increased the number of girls, he explained, because it seems that they are more likely to be in this second subtype.
"If we compare these two factors, you can easily imagine that people will easily recognize hyperactivity," he said.
This was true for Ruth Hay, a 25-year-old student and New York cook who now lives in Jerusalem. She was diagnosed with what was later called ADD in the summer between the second and third year.
Hay says his hyperactive tendencies are not as strong as some people. She is less likely to bounce into a room than she has to jump into her chair, she said.
Yet despite his early diagnosis, Hay said no one had ever told him about other symptoms. For example, she said, she suffers from executive dysfunction, which makes her unable to perform tasks, regardless of her desire or desire.
"I grew up being called lazy in times when I was not," said Hay. "If you look at a list of all the different symptoms of ADHD, I have them all to one degree or another, but the only ones to have ever discussed with me were that you might be less focused and more agitated."
"I do not know how my brain would be if I did not have it," she added. "I do not know if I would always be me, but all that has been for me is a handicap."
The coverage of children's health problems by the KHN is partly supported by Heising-Simons Foundation.
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