Attention Deficit Hyperactivity Disorder (ADHD) - Research Paper Example

Is Attention Deficit Hyperactive Disorder Overdiagnosed? Introduction Attention deficit hyperactive disorder is one of the most controversial psychiatric diseases. It has been riddled with controversy primarily because of increasing numbers of children with ADHD which some practitioners and concerned parents believe to be a product of the misdiagnosis of the disorder. There are currently over 5 million children in the United States who have been diagnosed with this disorder, and most of them are immediately prescribed with psychostimulant drugs (HEALL, 2000). Some practitioners and parents insist that the natural rambunctiousness of children is often mistaken for ADHD and due to parents’ and teachers’ inability to handle these children, they immediately think that there must be something wrong with their child. The use of psychostimulants on children is also creating a lot of controversy with increased risk of heart attacks, high blood pressure, strokes, death, and other cardiovascular diseases seen in patients (Defective Drugs, 2009). However, no firm evidence has been seen linking the use of ADHD to these risks. Nevertheless, side effects such as heart attacks, increased blood pressure, stroke, sudden death, psychosis, dependence, and visual problems are known to be serious side effects in the ADHD intake (Defective Drugs, 2009). Advocates of the ADHD diagnosis however point out that the disease is a legitimate diagnosis in children; after these children are given psychostimulants they learn to function better in the classroom and in their interaction with other children. They claim that Ritalin use actually helps the children to eventually realize their true potential. With these contrasting points to this issue, this paper shall now evaluate and assess researches on the overdiagnosis of ADHD and the subsequent use of Ritalin on patients. It shall assess evidence and researches in the hope of reaching an accurate and research-based decision or conclusion on this issue. Discussion/Research In a 2007 study, Sciutto and Eisenberg attempted to evaluate the evidence for and against the overdiagnosis of ADHD. In their study they reviewed different prevailing studies and researches on the factors which affect diagnostic accuracy. For the authors, their determining criterion for an overdiagnosis of ADHD is the rate of false positives which must substantially exceed the number of false negatives (Sciutto and Eisenberg, 2007). Their study was able to reveal that the contention for the overdiagnosis of ADHD is not sufficient and these diagnoses are not generally affected by public perceptions and by the media reports on ADHD. Most of the studies were able to reveal that substantial evidence for the persistence of the disorder has been offered (Sciutto and Eisenberg, 2007). A research brief by the Kronkosky Charitable Foundation (2006), points out that since the 1990s, there was a noticeable increase in stimulant use among children in the United States. The research points out that parents seem to easily accept the diagnosis of ADHD because they would much rather have the psychostimulant drug suppress the child’s hyperactive behavior than try to manage the child’s symptoms through stimulation and increased attention. Some communities exhibit no increase in the use of Ritalin and the diagnosis of ADHD, however, other communities registered with high numbers of Ritalin use and ADHD diagnosis (Kronkosky Charitable Foundation, 2006). Reports have also suggested that the overdiagnosis of the disorder in some schools is actually being rewarded by the Individuals with Disabilities Education Act, (IDEA) which distributes funds to these school districts according to the number of children with disabilities (Kronkosky Charitable Foundation, 2006). The study concluded that ADHD has been brought on by debilitating symptoms which can actually be managed through behavioral techniques which would eventually help in managing hyperactivity as a characteristic, not a disorder among children. The research however, further recommends that more studies be undertaken on the subject matter in order to definitively establish accurate and appropriate conclusions. Psychiatrist Mota-Castillo (2007), in a paper published with the Psychiatric Times, discussed his encounter with ADHD and his stance on the issue of its overdiagnosis. He narrated an incident where a patient was diagnosed by another psychiatrist with ADHD and given mixed amphetamine salts for it. The patient later experience hallucinations and began hearing voices; the patient also experienced symptoms which were consistent with a psychotic disorder – which was also within the patient’s family history. The psychiatrist later gave the patient quietiapine and discontinued the amphetamine salts. Later, the patient’s symptoms worsened. She was hospitalized with a diagnosis of ADHD, but was later sent home with a regimen of quetiapine. This showed the first’s doctor’s possible cognizance of an alternative diagnosis for the patient (Mota-Castillo, 2007). Mota-Castillo (2007) went on to point out that there are so many practices in the medical field which contribute to the over or the wrong diagnosis of ADHD. These factors include: mental health professionals’ failure to obtain a complete and accurate family history; cultural and linguistic barriers, failure to communicate with clinicians who knew the patient well; and misconstruing behaviors as causative explanations. In this patient’s case, the initial health care professionals did not look thoroughly into the patient’s family history which indicated schizophrenic relatives and some with bipolar disorder. They also did not communicate well with the patient and her family who only spoke Spanish. The practitioners did not also take into account that hyperactivity is a symptom which can also be seen in neuropsychiatric disorders (Mota-Castillo, 2007). Considering the patient’s history and symptoms, the possibility of a misdiagnosis of ADHD is actually quite strong. Fisher (2007) discusses several factors which may contribute to the wrong or the over diagnosis of ADHD, and by her initial analysis alone, there is already a strong support for an over diagnosis of ADHD. First and foremost, she points out that traumatic head injuries can often lead to manifestations which very much mimic the symptoms for ADHD. Sleep disorders is also another diagnosis close to ADHD. Sleep disorders disrupt the brain’s proper functioning and also affects the heart (Fisher, 2007). Restless legs syndrome is also yet another possible diagnosis which may be mistaken for ADHD. Fisher also points out that the symptom of hyperactivity often distracts from a true and accurate diagnosis of ADHD. Hyperactivity is actually only one of the symptoms of the disease and the other symptoms, when present, would actually help support an ADHD diagnosis (Fisher, 2007). In a compilation of studies made by the Children and Adults with Attention Deficit Disorder (Ross, 2007), one of their psychiatrists pointed out that two studies have revealed that ADHD is actually underdiagnosed as a disorder. These studies compared national estimated prevalence rate of ADHD and point out that ADHD is not diagnosed enough in children. However, psychiatrist Ross is quick to point out that the analysis of these studies has not taken into consideration the variations in the utilization of medication (2007). Ross points out that in the US, medication for ADHD is actually prescribed at more than the expected rates; and in other countries, not a single individual is on ADHD medication (2007). MaGill-Lewis (2005) emphasizes that ADHD in children when untreated can later progress into the child’s adolescence and adulthood. And in adults, the behavior or disorder is even much more difficult to diagnose, and yet it substantially disrupts the life of the adult. She points out that in adults, this disorder is not diagnosed enough (MacGill-Lewis, 2005). She also emphasizes that this disorder is associated with other co-morbid conditions which makes this disease difficult to diagnose. Nevertheless, MacGill-Lewis (2007) claims that this disorder is not diagnosed enough. Medical journals in the past ten years indicate that ADHD is not an overdiagnosed disorder, and the more it is ignored, the more that it is likely to create problems for the child and eventually, the adult (MacGill-Lewis, 2005). Conclusion Based on the researches presented above, I do believe that ADHD is an overdiagnosed disorder. In the past ten years, diagnosis for this disease registered at alarming rates. This increase is a strange occurrence because it begs the question: what triggered this sudden increase in ADHD cases? One of the studies above pointed out that many parents and teachers have found it difficult to deal with children’s normal rambunctiousness. I agree with this premise because on a deeper analysis, most parents these days are both working and barely have time to care for their children. Teachers are also often overwhelmed with the increasing number of students they have to handle every year. With those above factors, it is easy enough for the harried parent or teacher to want some sort of ‘help’ in handling and controlling children’s natural hyperactive behavior. The fact that psychostimulants can ‘calm’ these children down is an all too enticing prospect to parents and teachers; and so, they easily accept an ADHD diagnosis for the child. Moreover, part of the diagnostic testing for ADHD is self-reporting from parents and/or teachers. These factor, when combined with the teacher’s or parent’s frustration can lead to a wrong diagnosis of ADHD and the overprescription of Ritalin or psychostimulants. I agree with the paper and analysis laid out by Mota-Castillo when he sets forth different factors which can lead to a wrong diagnosis of ADHD. These factors are easily overlooked by psychiatrists and other mental health professionals who do not have the adequate and appropriate tools to make an accurate diagnosis of ADHD. Works Cited Attention Deficit Hyperactivity Disorder (ADHD) (January 2006). Kronkosky Charitable Foundation. Retrieved 23 November 2009 from http://www.kronkosky.org/research/Research_Briefs/Attention%20Deficit%20Hyperactivity%20Disorder%20%28ADHD%29%20January%202006.pdf Fisher, B. (2007) Attention deficit disorder: practical coping mechanisms. New York: Informa Health Care MacGill-Lewis, J. (24 October 2005) ADHD: Not just for kids. Modern Medicine Network Drug Topics. Retrieved 23 November 2009 from http://drugtopics.modernmedicine.com/drugtopics/article/articleDetail.jsp?id=187942&sk=&date=&&pageID=1 Mota-Castillo, M. (1 July 2007) The Crisis of Overdiagnosed ADHD in Children. Psychiatric Times, volume 24, no. 6. Retrieved 23 November 2009 from http://www.psychiatrictimes.com/display/article/10168/53786?verify=0 Ritalin Side Effects (2009). Defective Drugs. Retrieved 23 November 2009 from http://www.adrugrecall.com/ritalin/side-effects.html Ross, C. (June 2007) CHADD and Public Attitudes About ADHD. Psychiatric Services, volume 58, number 6. Retrieved 23 November 2009 from http://ps.psychiatryonline.org/cgi/reprint/58/6/876.pdf Sciutto, M. and Eisenberg, M. (2007) Evaluating the Evidence For and Against the Overdiagnosis of ADHD. Journal of Attention Disorders, volume 11, no. 2, pp. 106-113 US Congress Told of ADHD Overdiagnosis in Schools (2000) Health Education Alliance for Life and Longevity. Retrieved 23 November 2009 from http://www.heall.com/holistic_psychology/adhd.html Read More