Physicians say ADHD is not overdiagnosed

Overdiagnosis of attention-deficit/hyperactivity disorder (ADHD) and overprescription of drugs to treat the disorder is not widespread, according to a report by the American Medical Association?s Council of Scientific Affairs.

However, some physicians do misdiagnose ADHD because they fail to use established diagnostic criteria. And more patients may begin to abuse stimulants used to treat ADHD as drug companies produce more of the drugs and more patients begin using them, the report concludes.

The council, which evaluated the diagnosis and treatment of ADHD in response to public concern over the disorder, concluded that:

? Research has solidly established ADHD as a neuropsychiatric syndrome, and researchers have developed accurate diagnostic criteria. However, diagnosis is most accurate when conducted by clinicians familiar with childhood development and behavioral disorders.

? Studies suggest that 3 percent to 6 percent of school-aged children have ADHD. The number of children treated for the disorder falls at the lower end of this prevalence range, implying no overdiagnosis.

? Optimal treatment of ADHD should be tailored to each patient and generally includes pharmacotherapy along with psychoeducation, behavioral therapy , environmental changes and supportive psychotherapy for the child and parents. However, behavioral treatments are significantly underused in primary-care settings.

? There is little evidence that children with ADHD are abusing or sharing stimulants prescribed to treat their disorder. However, such problems may increase, and clinicians should be mindful of the risk.

The full report was published in the Journal of the American Medical Association (Vol. 279, No. 14, p. 1100?1107).

?B. Azar