Study Confirms Overdiagnosis of ADHD in Children and Teens

Medical researchers present evidence that ADHD is overdiagnosed in children and teens, which can lead to significant harm.

Peter Simons
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A new study has found that ADHD is overdiagnosed in children and adolescents. Growing diagnoses in those with mild symptoms may lead to children being exposed to the harms of stimulant medication without any benefit.

“Convincing evidence was found that ADHD is overdiagnosed in children and adolescents,” the researchers conclude. “For individuals with milder symptoms, in particular, the harms associated with an ADHD diagnosis may often outweigh the benefits.”

The researchers were led by Luise Kazda at the University of Sydney, Australia, and published in JAMA Network Open.

The researchers acknowledge that there are many ways in which the ADHD diagnosis is problematic. The expansion of the diagnostic category in the DSM 5 has increased the potential for overdiagnosis (for children who meet fewer criteria, for instance). They also note that behaviors that were once considered normal for children have been increasingly medicalized and considered evidence of “illness.”

However, their current study focuses just on the idea of overdiagnosis—expanding diagnosis to children who will derive no benefit from it but who may be harmed.

The researchers note that overdiagnosis of cancer is well-known in the research literature. A framework for assessing overdiagnosis in other conditions (such as heart conditions) grew out of this, and the researchers applied that framework to the current study.

To meet the criteria for overdiagnosis based on this framework, five conditions must be met:

  1. Potential for increased diagnosis;
  2. The diagnosis has increased;
  3. The newly diagnosed have mild or “subclinical” symptoms;
  4. The newly diagnosed receive treatment; and
  5. The harms of diagnosis and treatment may outweigh the benefits.

The researchers examined 334 studies, each provided data on at least one of the five conditions. They found that all five conditions were supported by the research.

Because there is no biological test for ADHD, and the diagnosis is applied subjectively across age, gender, race, and socioeconomic status, there is room for the diagnosis to expand. Additionally, as the diagnostic criteria are loosened, rates of ADHD have increased. The researchers confirmed that a large proportion of the new cases are on the “mild” end of the spectrum. Rates of stimulant treatment for ADHD have also increased, including those with “mild” or “subclinical” ADHD.

According to the researchers, there was also significant evidence of harm after diagnosis. They write, “In 22 studies, a biomedical view of difficulties was shown to be associated with disempowerment.” Additionally, the diagnosis “can also deflect from other underlying individual, social, or systemic problems.”

The researchers found that receiving an ADHD diagnosis also increases stigmatization: “The diagnosis can create an identity that enhances prejudice and judgment, which are associated with even greater feelings of isolation, exclusion, and shame.”

The researchers also found that treatment, particularly stimulant medication, was ineffective and potentially harmful, especially for those children with “mild” or “subclinical” ADHD.

“Only 3 studies reported long-term follow-up beyond active treatment, finding no difference in symptoms between youths who were treated and those who were untreated in later life, and another study found no difference in symptoms after a 48-hour washout period. In terms of harms, active treatment was commonly associated with mild and moderate adverse events and high discontinuation rates.”

The researchers write that clinicians, parents, and teachers should be mindful of the potential for overdiagnosis. Especially for children with “mild” or “subclinical” ADHD, the harms of diagnosis and medication likely outweigh any potential benefits. They recommend a watch-and-wait approach to milder cases—similar to that recommended for some low-risk cancers, which are also plagued by overdiagnosis.

The researchers write:

“Our findings have implications for these individuals, who may be harmed by overdiagnosis and the adverse effects of medication during childhood, adolescence, and even adulthood. These findings are also relevant to the growing number of adults being newly diagnosed with ADHD and may be applicable to other conditions, such as autism.”

 

 

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Kazda, L., Bell, K., Thomas, R., McGeechan, K., Sims, R., & Barratt, A. (2021). Overdiagnosis of attention-deficit/hyperactivity disorder in children and adolescents: A systematic scoping review. JAMA Netw Open, 4(4), e215335. doi:10.1001/jamanetworkopen.2021.5335 (Link)

4 COMMENTS

  1. The subjective opinion on how kids should behave and feel while adults info dump them 7 hours a day can’t be under or over diagnosed. It’s purely an opinionated label. It would be like over diagnosing how many people have brown hair because blond hair is “superior”

    If a parent told their kid every day they were were mentally inferior and forced fed them meth they’d go to jail, unless of course a psychiatrist also tells the kid he/she is inferior and needs to be addicted to meth. Maybe some day society will recognize that telling young kids they are mentally defective, with diseased brains based on adults wanting the kids to sit down and shut up while being lectured 7 hours a day is harmful to everyone.

  2. The school social worker in my child’s school seemed to believe that all children who get in the top 100% of their state standardized tests, merely because their schools are “not equipped to deal with these children,” need to be drugged. Thankfully the science teacher and principal of my child’s school had sane bones in their bodies. But a psychologist I spoke to about this problem later agreed with that satanic social worker.

    The reality is, our society really has a problem of the overmedicating, by the psychological, social worker, and psychiatric industries, of our children. Largely due to the scientific fraud based psychological and psychiatric industries’ desire, to maintain their scientifically debunked DSM “bible” system.

  3. And? So what if someone decided to label certain kids as disordered because they can’t follow the protocol.
    What then?
    This government seems to think it is okay to then drug them. They say it is okay to not be able to provide consent.
    The FDA says so. Psychiatrists, school principals, psychologists, teachers, all seem to deeply believe that kids should be drugged. They see this as an absolutely normal undertaking.

    And better yet, if they see nothing really out of the ordinary after the drugging, all is okay in their minds. And if it’s not okay, they think more drugs are needed.

    It never dawns on them that perhaps the shit they dealt to kids will follow someone. Perhaps not themselves, but someone will reap the rewards of drugged kids.

    Denmark dropped it’s drugging of non consenting adults by a whopping 40%, so what is different in Denmark? Are they more insightful?

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