“How Our Compulsion for Diagnosis May Be Harming Children”

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A team of American pediatric physicians has published an article in the journal Pediatrics examining the many ways in which medical overdiagnosis may be harming children. “Overdiagnosis is defined as the identification of an abnormality where detection will not benefit the patient,” they write. They specifically discuss ADHD as one of many problematic and questionable diagnoses.

“Unlike misdiagnosis, the finding is accurate; the condition detected may be precisely the condition that was meant to be detected,” they write. “The notion that an accurate diagnosis could be anything but beneficial runs counter to the conventional wisdom that the more that is known about a patient, the better. Unfortunately, not only do overdiagnosed patients fail to benefit from their diagnosis, they may also be harmed.”

The authors lament that the phenomenon of overdiagnosis has been little studied in children, but examine numerous areas of concern from food allergies and gastroesophageal reflux to hypercholesterolemia and tonsillectomy, and discuss harms such as physical effects of tests and unnecessary treatments, psychological effects of anxiety and stigma, and financial strain on families.

They also explore some of the reasons for overdiagnosis, such as industry influences. “The 2012 attention-deficit/hyperactivity disorder (ADHD) guideline panel included 9 members, 5 of whom had industry ties to manufacturers of widely used medications for ADHD. Based on this committee’s recommendations, the definition of ADHD was broadened to include children 4 to 18 years old (previously 6–12 years old). Although it is unclear how many new diagnoses of ADHD this expansion created, diagnostic creep has resulted in the prescription of stimulants to 10,000 toddlers aged 2 and 3 years old.”

“Substantial proportions of children may not benefit from commonly pursued pediatric diagnoses,” they conclude. “In some cases, overdiagnosis is necessary to ensure larger gains for the children who do benefit from the diagnosis. However, for many diagnostic tests, the ratio of benefit to harm resulting from the diagnosis is incompletely understood.”

(Abstract) (Full text) Overdiagnosis: How Our Compulsion for Diagnosis May Be Harming Children (Coon, Eric R. et al. Pediatrics. Published online October 6, 2014. doi: 10.1542/peds.2014-1778)

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3 COMMENTS

  1. I hate this. There is a compulsion to diagnosis. Then once the diagnosis has been made, the purpose of that diagnosis is usually to get a person on drugs that have been approved for that condition. The only reason there is a consequence to this is because the push is to get people on drugs, which damages and makes condition worse. If they didn’t have a condition before, they will after the drug is administered, type stuff, which necessitates more drugs even if it doesn’t cure the side effects or damage.

    There is another consequence in that legal affairs and life outcomes can be negatively impacted. Because you may be discredited, left out from activities, or never receive help for problems that have been labeled a mental illness.

    Drugs prevent employment, engagement, and usefulness after that, as the person is essentially chemically lobotomized, which makes the people in charge of that, those who set the system up, very rich indeed..

    http://www.obamasweapon.com/

    • It reminds me of when back in the day left-handed people were “diagnosed”, labelled and subjected to harmful treatment (forced use of right hand). Today’s ADHD diagnosis is much like that but the “treatment” is more disastrous.