ADHD Update 2015

Knowledge about ADHD over time has come from research primarily from school age boys, with recent interest in girls. The third group is children who are inattentive but not hyperactive. There remains a predominance of boys over girls. Frequency in ethnic groups is highest in African American children and lowest in Hispanic children. About 10% of children overall have ADHD, with differences in ethnic groups. This raises the question of how much of this is involves socioeconomic, identification, and treatment questions. Are these children receiving both the medical and educational services they need? Poor populations have less available services with the right resources unavailable.

A recent study from Johns Hopkins found that ADHD children are 12 times more likely to do binge-eating, and have an association with premature death, suicide and other psychiatric diagnoses. ADHD coexists with other conditions and disabilities and is often difficult to diagnose accurately. Mood disorders, depression, risk taking, and impulsivity are frequent coexisting conditions and often lead to bad outcomes. A diagnosis of ADHD is a red flag, or a tip of the iceberg, indicating that there are a range of problems below the surface. These must be recognized by the primary care provider because there is more than an isolated behavior involved. Insurance status and ethnicity are key variables. (Summary: ADHD: 2015’s Most Important Research, Cudder, Lipkin, Findling, Medscape, 7/21/15)

Unfortunately, ADHD diagnoses are rising in numbers, though support lags in its research. It is little understood in several parts of the world, debates about medication and diagnosis playing out from Northern and Eastern Europe, to the Middle East and South America, Germany and England. As in America, countries are concerned about the role of pharmaceutical companies who push drug treatment. Parents struggle because of the suffering of their children and cannot find the medical, social or educational supports they need. They feel stigmatized because of their children’s ADHD. If they give medication they are called “bad moms”. If they don’t use medication the children go from crisis to crisis. Tbilisi, Georgia outlaws medication for children and Germany does not accept the ADHD diagnosis. Some have sent their children to Utah for help as their only option in trying to save their lives. (ADHD Rises, but Support Lags, Katherine Ellison, The New York Times, 11/10/15).