Diagnosis of ADHD: Too often and often wrong

Diagnosis of ADHD: Too often and too often wrong

In the recent publication of the 2012 Barmer GEK medical report, ADHD (attention deficit disorder with hyperactivity) is mentioned as a "new childhood disease" that is on the rise and, on top of that, expensive. However, there can still be considerable doubt that ADHD is a specific, even "new" childhood disease. Research to date leaves the question of the specificity of a disease called ADHD still open. Rather, ADHD is a diagnostic pool of many very different other disorders. A little exaggerated, it can be said that ADHD without Ritalin has not existed for a long time, like the fashion diagnosis MCD (minimal cerebral dysfunction) at the time. And as for the increase in diagnosis: As early as 2000, it was found that more than half of the ADHD diagnoses in children did not meet the diagnosis guidelines and were therefore wrong. Almost 75 percent of children treated with methylphenidate had an incorrect diagnosis of ADHD (Angold 2000). In 2010, after examining the data from 12,000 children, Todd Elder reported that there are likely to be 1 million children in the United States with an incorrect diagnosis of ADHD.

And now, in Switzerland, it has been investigated whether specialists adhere to the official diagnostic guidelines when asked to diagnose ADHD in children. In contrast to the aforementioned studies, in which existing diagnoses were checked, the diagnosticians were asked directly about given case vignettes, which is certainly a particularly strict criterion. And yet here too 17% of the 1,000 diagnosticians involved made false diagnoses, in boys even twice as often as in girls, although the symptoms were the same. There is also a wild growth of ADHD diagnostics, the lack of reliability and objectivity of the diagnostic practice has been sufficiently proven. Some diagnosticians orientate themselves on their gut feeling, others still on methylphenidate as a diagnostic according to the motto: if it works, it is ADHD. ADHD is diagnosed far too often and too often. The diagnosis blinds us to psychological relationships. (Dipl.-Psych. Hans-Reinhard Schmidt
Psychological psychotherapist, conference ADHD)

Angold A, Erkanli A, Egger H.L, Costello E.J. (2000): Stimulant treatment for children: a community perspective. J Am Acad Child Adolesc Psychiatry. 2000 Aug; 39 (8): 975-84.
Bruchm├╝ller K, Margraf J, Schneider S. (2012): Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. J Consult Clin Psychol. 2012 Feb; 80 (1): 128-38.
Elder, T.E. (2010): The importance of relative standards in ADHD diagnoses: evidence based on exact birth dates. J Health Econ. 2010 Sep; 29 (5): 641-56.
Shimansky, H-Chr. (2012): http://www.schimansky-netz.eu/formulare/aussenfiltertest-bei-adhs.pdf Winkler, M. (2012): http://adhsspektrum.wordpress.com/2012/01/03/was-ist-adhs-und-was-nicht/

Image: Alfred Heiler / pixelio.de

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