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Debunking Myths About ADHD – is it Over-diagnosed And Overtreated?

ADHD Is it overdiagnosed and overtreated

ADHD mostly receives negative press coverage relative to other neurodivergent conditions. A common belief among the general public is that doctors tend to over-diagnose ADHD, especially following the global pandemic. While we tend to disagree with this widely held opinion, a 2021 meta-analysisi reported evidence of overdiagnosis of ADHD in both children and adolescents. This study stated that what looks like an overdiagnosis is more so a misdiagnosis of ADHD, where people with other conditions may be diagnosed with ADHD.

ADHD is a neurodevelopmental condition in which your brain works differently from the majority of society. It is estimated that about 8.7% of adolescentsii in the United States were diagnosed with ADHD in 2011. Of this percentage, ADHD severely impacts approximately half of the adolescents, who then find it difficult to be able to function normally. The concerns regarding its overdiagnosis arise from the fact that ADHD cases roughly doubled between 2005 and 2014, as shown by a 2017 study.iii

What is the Over-diagnosis of ADHD?

The term overdiagnosis in the medical dictionary is described as a frequent diagnosis of a certain condition, regardless of whether it meets the diagnostic criteria. The common way to reach a diagnosis for ADHD commonly adopted by doctors includes a multi-person interview approach. The child’s parents, guardians, caregivers, and teachers are required to give an account of the child’s behavior. The information gathered by the healthcare practitioner is then analyzed, followed by a diagnosis.

What Could Lead to Over-diagnosis of ADHD?

There are many factors, apart from misdiagnosis on the doctor’s end, which contribute to the overdiagnosis of ADHD in both children and adults. A few of them could be:

Inaccurate Results of The Multi-Person Interview Approach

As much as someone tries to avoid it, it is almost impossible to be free of bias. Since the multi-person interview approach to getting a diagnosis for ADHD involves speaking to the parents and other adults surrounding the individual, the results tend to be biased. In some cases, the parents may subconsciously have a certain belief or perception of how ADHD looks. The bias of the parents, in this case, may lead to ADHD being overdiagnosed in individuals.

Adhd Specialist

Assessment Based On Numerical Age

It is reported that clinicians often tend to assess children for an ADHD diagnosis strictly based on their numerical age. In this way, they end up giving positive diagnoses to younger children acting the same way as their fellow adult peers, without considering other factors. Similarly, children who are younger than their grade-level peers may be provided a misdiagnosis owing to their reduced emotional and intellectual development. This also results in ADHD being overdiagnosed in children of young age.

Ineffective Parenting

Ineffective or inadequate parenting commonly leads to behavioral changes in children, regardless of whether they have ADHD. When a child victim of neglectful parenting presents improper behavior, their symptoms might be misdiagnosed to be ADHD. However, this is not always the case. Children with ADHD are equally affected by bad parenting and tend to show erratic behavior. Their condition later gets diagnosed when they seek professional help.

Increased Awareness

Another reason for ADHD overdiagnoses could be the rate at which social media is helping spread awareness regarding this neurodivergent condition. With years of effort put into destigmatizing neurodivergence, more people have come to terms with it and are being open about their symptoms. With multiple search engines at your service, more people are aware of what ADHD is supposed to look like and rush to their doctor when they suspect they have this condition.

Improved Diagnostic Procedure

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is used to diagnose ADHD, among other conditions. The revision and improvement of the diagnostic criteria of DSM-5 reduce the chances of errors during diagnostic procedures. The revision of diagnostic criteria from DSM-4 to DSM-5 has, undoubtedly, lead to low diagnostic thresholds. Improved editions of the diagnostic tests warrant better results and may be responsible for the claim that ADHD is overdiagnosed.

Misdiagnosis

Individuals with borderline personality disorder (BPD – a mental illness) tend to present with impulsive behavior that may look very similar to ADHD at first glance. As an experienced clinician, one should know better and run thorough diagnostic tests to assess and provide the individual with a correct diagnosis. In some cases, confusion, impatience, or exhaustion owing to the inefficient healthcare system may cause your doctor to provide you with a misdiagnosis. This could also add to the belief that ADHD is overdiagnosed.

Is ADHD Over diagnosed Following COVID-19?

People with the attention-deficit hyperactive disorder (ADHD) must have noticed that they show optimal functioning rates when they stick to a routine. Since the global pandemic of COVID-19 vastly disrupted everyone’s routine, people finally started presenting with symptoms of ADHD.

While this does not mean that people ‘developed’ ADHD during the lockdown, they just started noticing their symptoms during that period of idleness. If you are diagnosed with ADHD at some point later in life, chances are you have always had it but the symptoms were never so prominent. The disruption or lack of routine threw off the ADHD-wired brains and people started presenting with symptoms similar to those of ADHD, hence the increase in diagnoses.

How is Over diagnosed ADHD affecting the population?

While Attention Deficit Hyperactive Disorder treatment is sufficient in greatly improving symptoms, its overtreatment like any other has its side effects. Some possible side effects of overdiagnosed ADHD and its overtreatment include:

  • Anxiety
  • Delay in growth
  • Increased blood pressure
  • Loss of appetite
  • Palpitation
  • Trouble falling or staying asleep

It is common for patients to feel anxious and uneasy when they get diagnosed with a certain condition. The same anxiety is seen in patients diagnosed with ADHD. Misdiagnosing ADHD in children or adolescents causes panic and unnecessary behavior changes. Since the individual in question would not have ADHD and was misdiagnosed, an otherwise successful treatment plan devised solely to deal with people with ADHD seems to be futile for healthy people.

In some cases, the patient or their loved ones fret over the potential long-term side effects of overdiagnosed ADHD, it may have adverse effects on their mental health. Such a person(s) is likely to develop anxiety or hypertensive disorders, to name a few.

What is to follow?

Researchers around the world continue working to find qualitative and statistical proof for overdiagnosis and overtreatment of ADHD. They work alongside experienced healthcare professionals to get to the roots of ADHD overdiagnoses or misdiagnoses and figure out ways of preventing that from happening in the future. Furthermore, research now extends further towards analyzing the disparities in ADHD diagnosis among different genders, ethnicities, and races.

See Also: Caffeine Affect ADHD?

Conclusion

If you feel like you or someone you love might be presenting with ADHD symptoms, reach out to us today! At Family Medicine Austin, we provide diagnostic-based healthcare through a spectrum of services. Let us handle all your other medical concerns. Our healthcare professionals are renowned for being thorough in their diagnostic procedures, providing you with the best advice and treatment. We honor the trust you put in us and deliver the best care for you and your family.

Family Medicine Austin

Written by Jeannette

I am Jeannette, the medical writing specialist here at Family Medicine Austin. I have over five years of experience working with a range of medical and healthcare across the U.S.