Attention Deficit Hyperactivity Disorder Overdiagnosed, Especially in Boys

Health & Wellness on 04.02.12
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If you know a child diagnosed with attention deficit hyperactivity disorder, and you have thought to yourself "that boy doesn't have a psychological illness, that's just kids being kids," then you might be right. Scientists have proven that child and adolescent psychotherapists and psychiatrists tend to overdiagnose ADHD. Boys are mis-labeled with ADHD far more often than girls. Moreover, male therapists diagnose ADHD "substantially more frequently" than their female colleagues.

Leon has ADHD, Lea Doesn't 

Researchers at the Ruhr-Universität Bochum (RUB) and University of Basel created vignettes describing four children, and then assigned the fictional children to either the male or female sex, creating a total of 8 cases. Only one out of four represented a child with all the characteristics required for a proper diagnosis of attention deficit hyperactivity disorder.

The researchers found that 16.7% of the therapists participating in the survey assigned a diagnosis of ADHD to the children in the three cases which did not satisfy the criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM–IV) and International Classification of Diseases (10th rev.; ICD–10).

Because all characteristics in each pair of case studies were identical -- except the gender of the child -- it was easy to judge whether the therapists were prejudiced in their diagnosis. The study found that when a case representing a boy was twice as likely to be mis-diagnosed as having ADHD.

Remarkable Lack of Research

In the press release on the study, Prof. Dr. Silvia Schneider (RUB) and Dr. Katrin Bruchmüller (University of Basel) point out that: “In spite of the strong public interest, only very few empirical studies have addressed this issue.”

Of course, if a child really does suffer from a treatable condition, it is important to identify that and provide the necessary support. But it is equally important not to mis-label children as suffering from conditions that may affect their social and educational outcomes in addition to entailing expensive and distracting unnecessary treatments.

What Can You Do?

If you want to make sure your child is getting a correct diagnosis, discuss with your doctors about whether they are using standardized diagnostic instruments, such as diagnostic interviews. This is the path advocated by the researchers to "avoid a misdiagnosis of ADHD and premature treatment."

You should also consider getting a second opinion. While doctors may not like to be double-checked, you have a right as a patient to ask questions until you are comfortable that you are getting the right answers.

The study, Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis, by Prof. Dr. Silvia Schneider and Prof. Dr. Jürgen Margraf (both from RUB) and Dr. Katrin Bruchmüller (University of Basel) appears in the American periodical “Journal of Consulting and Clinical Psychology”.


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