View Full Version : Higher rates of ADHD diagnosis linked to drug company promotional activity


Kunga Dorji
11-27-14, 04:58 PM
This one is just too pathetic:

http://www.ibtimes.com/higher-rates-adhd-linked-drug-company-awareness-campaigns-advocacy-groups-1727751


The recent growth of reported ADHD diagnoses and prescriptions, especially in adults, isn’t simply due to an increase in the number of people who have the condition, writes Brandeis University social science professor Peter Conrad in a recent paper published in Social Science and Medicine.


www.brandeis.edu/departments/sociology/pdfs/ADHD.pdf (http://www.brandeis.edu/departments/sociology/pdfs/ADHD.pdf)

One major flaw in Professor Brandeis' contention is the high rate of undiagnosed ADHD in middle aged adults:

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0031500


According to this study, the rate of diagnosable ADHD in the sample population of middle aged Australian adults was 6.2%. (My estimate as an ADHD aware clinician who has ADHD himself is that that would be in the right ball park at least).


I doubt that the rate of diagnosed ADHD in this population is more than 0.5%-- it was about 0.2% a few years ago according to a survey done by the NSW health department.


So it is clear that in the middle aged population there is a great deal of undiagnosed ADHD. In this setting it is difficult to see whether there is any real increase at all in the last few years.


Actually I think there is- as the distribution of ADHD within the USA is not even- it clusters especially in very poor states with high rates of intrafamily trauma and also in Eastern seaboard states where kids live a more controlled and regulated life. It is lowest in more rural midwest states where children lead more active lives in more intact and healthy rural communities. Given Dr John Ratey's observations about the overlap of the neurology of attention and movement it is clear that healthy outdoor play is essential to normal brain development- and that todays latchkey kids who spend more time on line and less time playing in the street may well be at risk of abnormal brain development.


Speaking as a clinician who was diagnosed at age 46, I see many cases of ADHD. After my diagnosis I realised to my alarm that I had, unknowingly been seeing ADHD adults for years- they were coming in with alcohol abuse, with habitual overeating, with chronic pain syndromes, with metabolic syndrome with marital and child rearing difficulties and with refractory anxiety and depression.


ADHD causes serious difficulties for those of us who have it, until we master it. Stimulant medication is only a part of the treatment regimen but it is a vital part for many of us. (My own personal treatment regimen is firmly anchored in mindfulness and I now practice largely in mindfulness and have a qualification as a meditation teacher. I could not have got there without access to dexamphetamine).


If it is true that the drug companies are playing a role in increasing ADHD awareness, I can only congratulate them, as my profession (especially in Australia) has abdicated its responsibility to the community in its regressive and incompetent attitude to the diagnosis and management of ADHD.




While my ADHD was diagnosed at age 46, I had had a strong clinical suspicion that I had ADHD based on my reading. However I was scared to seek diagnosis. I was afraid of being labelled eccentric or taking supposedly “dangerous medications".


In the end I had to fire 2 psychiatrists before finding an individual competent to diagnose me, and that process took 2 years. By the time that process was done the damage to my marriage caused by my ADHD behaviours was irreparable.

People like Prof Conrad who focus on abstruse speculations about issues such as medicalisation cause real harms by scaring individuals away from seeking appropriate investigation and treatment and should be recognised for the menace that they are.

Flory
11-27-14, 05:16 PM
makes me so mad.

i even read in a textbook of my mums on psychiatric meds something similar...its shocking :(

Pilgrim
11-27-14, 06:55 PM
I had to go to 5 different Psyciatrists to get a diagnosis. I had to go to hospital about a skin condition that I didn't think was related to anything. I was overseen by a top immunologist and he saw a possible connection.

I spent less than 10 minutes with the doctor trained in this area. I went on medication and didn't look back.

I think your right, drug companies pushing these products isn't such a bad thing.

The medical profession have got to get there heads around this.
Conservative fools.

sarahsweets
11-27-14, 10:50 PM
This just proves that just because someone has extra letters behind their last name or the letters d&r they can still be an as+hole. Too bad the drug companies can't make a med to treat that condition.

SB_UK
12-02-14, 06:18 PM
Even though it's our everything we cannot definitively state that we have a mind - that the mind exists - that the mind is something to do with brain - and in conditions of mind - we're left wondering whether in the absence of hard proof in the existence of the mind - whether variations on a theme will ever be agreed on.

Perhaps it'll in the forseeable term be up for debate.

Becomes tiring though - you know persisting with this debate.

I wonder if we can simply just generate a nice world to live on - which shouldn't be too hard to justify - and then live happily ever after - in the process eliminating all of the stress which drives us into disorder.

I don't know that the mind will ever be grasped on that satisfying level which when achieved brings certainty.

Shifting back 10 years ago on site - the question came up - are we meant to understand (mind) ? or be able to use (mind) ? ... ... being able to use mind to generate a moral global landscape is more satisfying than understanding mind - but understanding mind - I don't think will be far behind a global accord settling on application.

The key problem we have is that whilst people are disagreeable - there won't ever be any way of reaching an accord.

We need people to be free to agree.

- which isn't the default state in competitive world - where to disagree and be victorious regardless of whether you're right is the goal.

-*-

So ... ... to all of the people who disagree on the nature of ADHD - I think the answer is simple.
When defined by the desire to disagree - in matters of mind - it's going to prove impossible to agree ... ... we need the mindset which accepts the optimal model - regardless of whether that optimal model is the one which one has placed one's 'chips' upon.

I don't think that many people will have chosen to place their chips wisely - if only because correct chip placement involves not playing the game at all.

Complete rejection of the genetic - pharmacological approach - all we need do to prevent disease is change global social structure into one in which human hierarchy is lost.

Stevuke79
12-03-14, 02:41 PM
I can't agree more with what you're saying here. I know we've disagreed a bit in the past, and I know that I'm often pretty sarcastic, so let me clarify that I'm 100% serious.

The funny thing is that the article has some decent points which are interesting enough to be worth knowing but not grabbing enough to get "clicks", especially when compared with something like:
Pharmaceutical Companies Drive Profits By Fueling a Dramatic Over/Misdiagnosis of ADHD".

Other than being false, it's a great headline because it fits with the demonization of corporations and their profits and scandalous theories about the overuse of prescription meds.

The suggestion of overdiagnosis is patently false. The truth in the article is that ADHD diagnosis is clustered and advocacy groups have spent a lot of money raising awareness in the hopes of getting more people diagnosed, and and they do this for their financial interests and not a sense of altruism. Both are interesting and worth knowing but not at all surprising - you could have guessed them both. I think citing the revenue numbers for a few drugs is disingenuous $594MM from Novartis's Ritalin and $375MM from Shire's adderall sound like big numbers, but as percentages they are 1% (out of 20 drugs) and 8% (out of 11 drugs) respectively. (Seriously, what could her point of been other than to mislead?)

As far as citing the CDC, I don't think the article is ill-intentioned. I think you see a lot of similar things when a journalist is looking at numbers that they don't fully understand. For instance, by the standards of DSM V ADHD has an expected incidence of 5%, where as there is a rate of diagnosis among children of 11%. By itself that doesn't imply overdiagnosis, unless you assume:
1. All or most doctors have updated their diagnostic procedures to concur with DSM5. We all know that's not true - plenty of doctors still use subtypes which (I'm pretty sure, but not 100% here and correct me if I'm wrong) don't exist in DSM5. As a more extreme example, plenty of doctors still use the term ADD which is from DSM3, and not the official term since the 80's.
2. That once DSM 5 came out, all or at least most doctors called their patients and subjected them to reevaluation.

What's sad is that most people will assume the CDC was suggesting overdiagnosis. I'll give the reporter the benefit of the doubt that she genuinely missed the intention of the info-graphic which was (bold and underlines added):
A historical view provides the necessary context to understand changes in what we know about ADHD, including estimates of the rates of ADHD across time, changes in diagnostic criteria, and medication treatment.
In other words expected incidence of ADHD has varied between 5% and 16% - and the reason is the ever changing diagnostic criteria.

This wouldn't bother me, except this is the kind of place most people get their information.

Kunga Dorji
12-03-14, 02:47 PM
Even though it's our everything we cannot definitively state that we have a mind - that the mind exists - that the mind is something to do with brain - and in conditions of mind - we're left wondering whether in the absence of hard proof in the existence of the mind - whether variations on a theme will ever be agreed on.

Perhaps it'll in the forseeable term be up for debate.




It is funny really, isn"t it?
The whole debate over "the existence mind" really is something that has an existence only in the minds of those involved in the debate!

There is a remarkable level of dumbness being exhibited by some contributors to the debate.

I would recommend you get onto the iTunes podcasts and pick up a free talk by my maim meditation teacher Alan Wallace, called "Scientific Materialism on its Deathbed". He presents some data published in peer reviewed medical journals re the persistence of mental activity after the cessation of brain activity in well monitored circumstances involving prolonged cardiac arrests in hospital (brain activity ceases within 30 seconds of a cardiac arrest, but survivors have reported events at least 3 minutes post arrest.

SB_UK
12-03-14, 04:25 PM
It is funny really, isn"t it?
The whole debate over "the existence mind" really is something that has an existence only in the minds of those involved in the debate!

There is a remarkable level of dumbness being exhibited by some contributors to the debate.

I would recommend you get onto the iTunes podcasts and pick up a free talk by my maim meditation teacher Alan Wallace, called "Scientific Materialism on its Deathbed". He presents some data published in peer reviewed medical journals re the persistence of mental activity after the cessation of brain activity in well monitored circumstances involving prolonged cardiac arrests in hospital (brain activity ceases within 30 seconds of a cardiac arrest, but survivors have reported events at least 3 minutes post arrest.

It's the human mind - it is predisposed to over-complicate.

But nothing's so complicated.

Sure - that doesn't mean that generating a benchtop nuclear fusion reactor is simple - but where materialist science falls down is why'd you need one in an insulated house with solar power ?

It would be nice to retire the mind and settle into the dream (preferably in the sun with a fluffy dog) ... ...

SB_UK
12-04-14, 05:28 PM
http://www.brainyquote.com/quotes/quotes/c/claudedebu204277.html

preferably in the sun

http://www.youtube.com/watch?v=VBlKYbFWZ-o&list=PL2QT-cDQgJmNnDVRUWcaGOReqhhVBpbxG (https://www.youtube.com/watch?v=VBlKYbFWZ-o&list=PL2QT-cDQgJmNnDVRUWcaGOReqhhVBpbxG)

simple minds

[morality]

SB_UK
12-04-14, 05:31 PM
Somewhere there is some place, that one million eyes can't see
And somewhere there is someone, who can see what I can see

Out beyond ideas of wrongdoing and rightdoing there is a field.
There is a field and I'll meet you there.

SB_UK
12-04-14, 05:42 PM
Extreme complication is contrary to art. [-above]

In the philosophy of science, simplicity is (... desired). [wikiP]

HADDaball
12-04-14, 06:28 PM
...
After my diagnosis I realised to my alarm that I had, unknowingly been seeing ADHD adults for years- they were coming in with alcohol abuse, with habitual overeating, with chronic pain syndromes, with metabolic syndrome with marital and child rearing difficulties and with refractory anxiety and depression.
...

Well put. Indeed they could be seen as secondary problems stemming from poor impulse control.

Although a more complete history from childhood would be needed to diagnose.

Kunga Dorji
12-07-14, 05:59 PM
Well put. Indeed they could be seen as secondary problems stemming from poor impulse control.

Although a more complete history from childhood would be needed to diagnose.


Often that history is not available, or cannot be corroborated- as so many of us have big blanks in our memory as a result of trauma-- and so many ADHD people are not on speaking terms with their parents.

So what do you do then- refuse to diagnose it?
I think not.
Often we have to rely on sketchy histories.

Another problem is that ADHD parents sometimes see ADHD behaviors as "normal".

Kunga Dorji
12-07-14, 06:01 PM
Extreme complication is contrary to art. [-above]

In the philosophy of science, simplicity is (... desired). [wikiP]


Given some of your posts in the past-- that quote is just too funny :)

anonymouslyadd
12-07-14, 06:02 PM
This just proves that just because someone has extra letters behind their last name or the letters d&r they can still be an as+hole. Too bad the drug companies can't make a med to treat that condition.
:goodpost:

anonymouslyadd
12-07-14, 06:11 PM
There's probably a hidden agenda behind many of these researchers, who believe it's unfair for "big pharma" to make profits. Do they ever think or realize that only one out of every 100 medication produced will actually make it to the market?

Also, pharmaceutical companies don't have just big executives. They have secretaries, a communications department and probably a facilities department, all of which have have families to support.

mbrandon
12-11-14, 09:01 PM
I just think that the more exposure, the more people think about it, the more that get diagnosed.

Remember those "adult add" commercials that were all over the place several years ago that show a woman struggling to keep it together in a meeting? I used to watch them and think "how does that make sense, wouldn't an adult already know they have add?"

HOW WOULD YOU KNOW YOU HAVE IT IF YOU DIDN'T KNOW ABOUT IT?

I'm such a dumb **** haha

InvitroCanibal
12-12-14, 01:40 AM
Who the hell let this man have a pen? Nothing is more toxic than a bad idea.

It seems the rate of idiotic professor's has increased several fold. I believe this is due to prejudice disguised as research. They may have a piece of paper but they have no clue what it's like to have a mental disorder.

Keep that in mind, they pretty much have nothing but there opinion, the numbers for adhd were projected to actually be 20 percent, but only 7.5 to 10 percent of the populous gets treatment. The rate increased because of awareness. It's estimated that only about 2.5 percent of adhd people are fakers.

I do believe the rate of head-up-assitis, is increasing among the educated buracrats, we should all be scared and angry.

meadd823
12-17-14, 04:31 AM
This just proves that just because someone has extra letters behind their last name or the letters d&r they can still be an as+hole. Too bad the drug companies can't make a med to treat that condition.


There is no cure for stupid . . . .:D

someothertime
12-17-14, 07:00 AM
When defined by the desire to disagree - in matters of mind - it's going to prove impossible to agree ... ... we need the mindset which accepts the optimal model - regardless of whether that optimal model is the one which one has placed one's 'chips' upon.

I don't think that many people will have chosen to place their chips wisely - if only because correct chip placement involves not playing the game at all.

Complete rejection of the genetic - pharmacological approach - all we need do to prevent disease is change global social structure into one in which human hierarchy is lost.

Fear being the most powerful human emotion feeds the narrow and biased elements of individuals and society.

An open, realist platform facilitates alleviation of fear... so it is openess and truth that is the key. When any platform favour's one view / prespective...... human potential suffers..... fears perpetuate.......

So, why is this a favourable fear? The Insider meets pharma me thinks ;)