View Full Version : NY Times: One in Five High School Age Boys diagnosed with ADHD


APSJ
04-01-13, 07:27 PM
Nearly one in five high school age boys in the United States and 11 percent of school-age children over all have received a medical diagnosis of attention deficit hyperactivity disorder, according to new data from the federal Centers for Disease Control and Prevention. http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern.html?pagewanted=all

I've generally been of the opinion that the 'overdiagnosis' issue was exaggerated, and while perhaps with some truth in certain areas and communities, balanced out by the underdiagnosis in others.

One in five, though, seems high, and to suggest that this may have changed.

Any thoughts?

Amtram
04-01-13, 07:50 PM
This is very concerning. If these numbers are factual, who is doing the diagnosing? My personal feeling is that too many people are getting psychiatric medications for many different conditions from physicians who should not be prescribing them. Not to paint the General Practitioner or Family Physician with the same broad brush, but they might be contributing to the problem of overdiagnosis/overtreatment of ADHD and other psychiatric issues.

I don't know whether the phone interview methodology is ideal, either, but I'd want to see a little more before coming right out and criticizing that - it just seems a bit dodgy on the surface.

Numbers that high, especially confined to that age group, definitely look wrong. Most other studies have shown that age-adjusted numbers are holding pretty steady at a reasonable rate, demonstrating that the claims of overdiagnosis are not well supported. This, on the other hand, is too disproportional not to raise some red flags.

dvdnvwls
04-01-13, 08:10 PM
1. The papers love a story that stops people in their tracks. They will do just about anything to be able to print one.

2. They have succeeded in doing that to me.

demuregeek
04-02-13, 12:48 AM
This is another NYT piece on ADHD by Alan Schwarz, whose other greatest hits have included:

<a href="http://www.nytimes.com/2012/06/10/education/seeking-academic-edge-teenagers-abuse-stimulants.html">Seeking Academic Edge, Teenagers Abuse Stimulants</a>
<a href="http://www.nytimes.com/2012/10/09/health/attention-disorder-or-not-children-prescribed-pills-to-help-in-school.html">Attention Disorder or Not, Children Prescribed Pills to Help in School</a>, and
<a href="http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html">Drowned in a Stream of Prescriptions</a>.

Fortune
04-02-13, 12:51 AM
http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern.html?pagewanted=all

I've generally been of the opinion that the 'overdiagnosis' issue was exaggerated, and while perhaps with some truth in certain areas and communities, balanced out by the underdiagnosis in others.

One in five, though, seems high, and to suggest that this may have changed.

Any thoughts?

I had the same thought. Everything I've read previously made it difficult to see overdiagnosis as a serious problem, but 1 in 5 boys is statistically ridiculous.

Fortune
04-02-13, 12:52 AM
This is another NYT piece on ADHD by Alan Schwarz, whose other greatest hits have included:

<a href="http://www.nytimes.com/2012/06/10/education/seeking-academic-edge-teenagers-abuse-stimulants.html">Seeking Academic Edge, Teenagers Abuse Stimulants</a>
<a href="http://www.nytimes.com/2012/10/09/health/attention-disorder-or-not-children-prescribed-pills-to-help-in-school.html">Attention Disorder or Not, Children Prescribed Pills to Help in School</a>, and
<a href="http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html">Drowned in a Stream of Prescriptions</a>.


He clearly has an agenda, but does this mean that the numbers are wrong?

Gina
04-02-13, 02:03 AM
http://www.nytimes.com/2013/04/01/health/more-diagnoses-of-hyperactivity-causing-concern.html?pagewanted=all

I've generally been of the opinion that the 'overdiagnosis' issue was exaggerated, and while perhaps with some truth in certain areas and communities, balanced out by the underdiagnosis in others.

One in five, though, seems high, and to suggest that this may have changed.

Any thoughts?

There are so many problems with that story (and the NYTimes' ongoing crusade against reasonable reporting about ADHD) that I don't know where to begin. I'm formulating a blog post, but it will take a bit.

For one thing, it's a phone survey and part of a much-larger effort by the CDC to query parents about children's health issues. ADHD was a tiny part of it. And the wording of the questionnaire was pretty darn vague. (There was even a follow-up note for the survey takers, to explain what ADHD is if the respondent didn't know -- it means they have trouble sitting still, etc.) Someone needs to explain to me why it was left to the NYTimes to compile the data. And was anyone from the CDC overseeing their methods? All very strange....

Also, look at rates in the South -- almost 23 percent in some Southern states! The South is throwing the national average, with the rest of the country coming in about as ADHD epidemiology rates would suggest. As I wrote to reporter Alan Schwarz, will someone please report on THAT story?

The NYTimes seems bound and determined to de-legitimize ADHD. A bonus: They get a tsumani of hits from the enraged ADHD community. I've stopped sharing links; it only encourage the jerks. Did you see the lurid lead photo of what looks like an illicit drug exchange? Gah, these people are shameless. I don't believe a darn thing I read in the NYTimes, given their track record on ADHD (and the run-up to the war).

Gina
04-02-13, 02:05 AM
This is another NYT piece on ADHD by Alan Schwarz, whose other greatest hits have included:

Seeking Academic Edge, Teenagers Abuse Stimulants (http://www.nytimes.com/2012/06/10/education/seeking-academic-edge-teenagers-abuse-stimulants.html)
Attention Disorder or Not, Children Prescribed Pills to Help in School (http://www.nytimes.com/2012/10/09/health/attention-disorder-or-not-children-prescribed-pills-to-help-in-school.html), and
Drowned in a Stream of Prescriptions (http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html).



You ought to see my e-mails to him. He's impervious. Never wrong. Doesn't know what he doesn't want to know.

sarahsweets
04-02-13, 04:29 AM
no one ever wanted to read something like:

"Adhd is underdiagnosed,undermedicated,overlooked in girls and misunderstood"

Its more exciting for morons to read and write:

"Adhd is over diagnosed, stimulants are over prescribed and doctors are perpetuating the myth of adhd in children"

Its like journalistic porn.

Amtram
04-02-13, 09:51 AM
Did I miss a link to the survey in the article? I would love to see the methodology. As I mentioned above, I'm dubious about the validity of phone surveys, and the author of the article clearly mentioned that it was done by the CDC to make it sound like this was solid evidence.

I was skeptical of the article in the first place, but since I tend to not see text at the tops and bottoms of things, I missed the author name, and didn't make the connection with the other sensationalistic pieces. I can search around for the actual CDC information, but I've got a busy schedule today, so if someone else already has it, would you please share? Pretty please?

Dizfriz
04-02-13, 10:11 AM
I have been long concerned about the CDC's surveys and the way the results are treated.

This is a survey, not a study. They ask parents if they were every told that their child was ADHD. Good information but hardly definitive. The problem is when the results are reported as fact on the prevalence of the disorder. That level of certainty is not justified in my opinion.

Here are some comments from Sanjay Gupta

CDC data shows increase in kids with ADHD

Data from a new CDC report, which was analyzed by "The New York Times," shows 11% of all school-age children have received an attention deficit hyperactivity disorder diagnosis at some point in their lives - a 16% increase since 2007.

Nearly one in five boys in high school has been diagnosed with ADHD, and nearly two-thirds of children with a current diagnosis of ADHD are taking medication for it, like Ritalin or Adderall.

In this segment with Wolf Blitzer, Dr. Sanjay Gupta explains that the self-reported survey may not accurately indicate the number of children with ADHD.

The crux of the issue is that medical records weren't used and no patients were directly examined. The method was to call parents and ask them questions about their children, which can be an unreliable way to gather scientific data.

Sanjay says that doesn't change the larger conclusion that the number of children with ADHD has gone up over the past few decades. It's still unclear to the medical community if the reason stems from more correct diagnosis of the disorder of from more people actually having ADHD. http://ac360.blogs.cnn.com/2013/04/01/cdc-data-shows-increase-in-kids-with-adhd/

The problem is not the survey, it is the way it will be used. Be ready for hysterical overblown reactions because it is going to come.

Dizfriz

Dizfriz
04-02-13, 11:09 AM
Another reasonably good article on the CDC study.

http://healthland.time.com/2013/04/02/understanding-the-rise-in-adhd-diagnoses-11-of-u-s-children-are-affected/?xid=rss-topstories&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+time%2Ftopstories+%28TIME%3A+ Top+Stories%29

While you are there, look at the comments. A couple are rather bizarre.

Dizfriz

Amtram
04-02-13, 01:32 PM
It is possible to love science and be skeptical of science journalism. In fact, I'd say loving science requires being skeptical in general, but especially of journalism! Thanks for the links, Dizfriz, I'll be reading after pain meds and naptime!

Fortune
04-02-13, 04:23 PM
Another reasonably good article on the CDC study.

http://healthland.time.com/2013/04/02/understanding-the-rise-in-adhd-diagnoses-11-of-u-s-children-are-affected/?xid=rss-topstories&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+time%2Ftopstories+%28TIME%3A+ Top+Stories%29

While you are there, look at the comments. A couple are rather bizarre.

Dizfriz

Woah, talk about conspiracy theory.

Thanks for the dose of perspective. I was skeptical, but I had not noticed that it was a phone survey.

Amtram
04-02-13, 05:26 PM
Yep. Looks just about as credible as what the Gerson clinics use for reporting their success with cancer.

Gina
04-03-13, 01:09 AM
Here is the CDC questionnaire:

http://www.cdc.gov/nchs/data/slaits/2011NSCHQuestionnaire.pdf

BTW, even the New York Daily News did a better job of sourcing the story, such as Dr. Xavier Castellanos.

Gina
04-03-13, 01:10 AM
Another reasonably good article on the CDC study.

http://healthland.time.com/2013/04/02/understanding-the-rise-in-adhd-diagnoses-11-of-u-s-children-are-affected/?xid=rss-topstories&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+time%2Ftopstories+%28TIME%3A+ Top+Stories%29

While you are there, look at the comments. A couple are rather bizarre.

Dizfriz

Hi Diz!

have you ever seen an ADHD story where there weren't a couple of "rather bizarre" comments? :-)

Dizfriz
04-03-13, 04:13 AM
Hi Diz!

have you ever seen an ADHD story where there weren't a couple of "rather bizarre" comments? :-)
The one blaming ADHD on circumcision for rewiring the brain was, I thought, especially interesting.

Dizfriz

demuregeek
04-03-13, 07:34 AM
The one blaming ADHD on circumcision for rewiring the brain was, I thought, especially interesting.


I only caught that one because of the reply "Oh? Then how do you explain *my* ADHD?" from a woman with ADHD. :giggle:

APSJ
04-03-13, 07:53 AM
So, here's the ADHD question from PDF posted above:

K2Q31_INTRO Now I am going to read you a list of conditions. For each condition, please tell me if a doctor or other health care provider ever told you that [S.C.] had the condition, even if [he/she] does not have the condition now.
INTERVIEWER INSTRUCTION: IF THE RESPONDENT HAS NEVER HEARD OF THE MEDICAL CONDITION OR DOES NOT KNOW WHAT THE CONDITION IS, THEN A DOCTOR OR OTHER HEALTH CARE PROVIDER PROBABLY HAS NOT TOLD THE RESPONDENT THAT THE S.C. HAS THE CONDITION. IF A DOCTOR OR OTHER HEALTH CARE PROVIDER HAS NOT TOLD THE RESPONDENT THAT THE S.C. HAS THE CONDITION, BUT THE RESPONDENT INSISTS THAT THE S.C. HAS THE CONDITION, WE STILL NEED TO CODE THE ANSWER AS “NO.”
IF AGE_NSCH < 24 MONTHS SKIP TO K2Q40A.
(READ IF NECESSARY: Has a doctor or other health care provider ever told you that [S.C.] had…)
K2Q31A Attention Deficit Disorder or Attention-Deficit/Hyperactivity Disorder, that is, ADD or ADHD?
HELP SCREEN: A child with Attention Deficit Disorder or Attention Deficit Hyperactive Disorder has problems paying attention or sitting still. It may cause the child to be easily distracted.It does seem strange that it indicates that if someone hasn't heard of the condition, their child probably hasn't been diagnosed with it, and that even if the parent thinks the child has it, the answer is no unless a medical provider has diagnosed, yet also seems to indicate the symptoms should be described if parent is unfamiliar with it.

That said, while I can see that this survey technique is problematic, from the question, it doesn't seem obvious to me that the problems would lead to overreporting rather than underreporting. After all, a strict definition of 'told SC has" by the surveyor or parent may mean a no response where a child does have adhd and it has been suggested by a medical provider, but not in a very definitive way.

In addition, given the significant likelihood that ADHD *is* underreported in many communities based on prior studies I've seen, and that people from those communities surveyed may be bringing the numbers down...I find this hard to dismiss easily.

Gina
04-03-13, 10:31 AM
The one blaming ADHD on circumcision for rewiring the brain was, I thought, especially interesting.

Dizfriz




lol! You're right! Amazingly, that IS a new one!

Gina
04-03-13, 10:32 AM
My favorite comment on the NYT story said: "In England, the treatment is family therapy." As if she was bragging and not complaining of the futility.

Amtram
04-03-13, 11:29 AM
To be fair, getting treatment in England is easier than in Eastern Europe or Asia. . .