Misdiagnosis of ADHD adults
Dr. David W. Goodman was video interviewed by Vox.com on misdiagnosis of ADHD as a counterpoint to Dr. Allen Francis, psychiatrist, who believes ADHD is overdiagnosed. The video is excellently edited and very engaging. While it is easy to say ADHD is overdiagnosed because of the extensive media coverage, it is not overdiagnosis. The basis for my opinion lies in the research facts: 4.5% of US adults ages 18-44 are believed to have ADHD, a diagnosis whose basis is the persistence of symptoms since childhood of which 75% were never diagnosed as children. Of the adults with ADHD in the U.S., only 25% have been treated in the last year. With the prevalence rate of ADHD internationally ranges from approximately 2-10%, appallingly few adults outside of the U.S. are identified and treated.
Setting aside those adults who are accurately diagnosed with a comprehensive evaluation, there are patients who are given the diagnosis of ADHD and don’t have it. Inadequate clinician training, little time spent obtaining the history, and strong patient demand for ADHD can lead to misdiagnosis. These patients who do not have ADHD should not be placed on stimulant medication. More often, primary care clinicians are prescribing short-acting stimulants which can be abused, misused, and sold/given away to friends/customers.
65% of all stimulants prescribed in the U.S. are prescribed primary care clinicians; 55% of all stimulants prescribed are short-acting; four international guidelines for the diagnosis and treatment of ADHD recommend long-acting stimulants as first line medication, not short-acting.
Well, that’s enough science for today. I provide this information so that if you are in a conversation about this topic, you are armed with meaningful data, beyond opinion.
As I have said before in my blogs, let science be the designated driver on the highway of opinions.