Tuesday, April 2nd, 2013
Over the past decade, diagnoses of attention deficit hyperactivity disorder (ADHD) have grown exponentially, with 11 percent of school age children–and 1 in 5 boys–having a diagnosis. The New York Times reports on the new numbers, which come from research by the Centers for Disease Control and Prevention:
The figures showed that an estimated 6.4 million children ages 4 through 17 had received an A.D.H.D. diagnosis at some point in their lives, a 16 percent increase since 2007 and a 53 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis.
“Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.”
And even more teenagers are likely to be prescribed medication in the near future because the American Psychiatric Association plans to change the definition of A.D.H.D. to allow more people to receive the diagnosis and treatment. A.D.H.D. is described by most experts as resulting from abnormal chemical levels in the brain that impair a person’s impulse control and attention skills.
While some doctors and patient advocates have welcomed rising diagnosis rates as evidence that the disorder is being better recognized and accepted, others said the new rates suggest that millions of children may be taking medication merely to calm behavior or to do better in school. Pills that are shared with or sold to classmates — diversion long tolerated in college settings and gaining traction in high-achieving high schools — are particularly dangerous, doctors say, because of their health risks when abused.
Image: ADHD, via Shutterstock
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Thursday, December 6th, 2012
A new diagnosis that would give the name “disruptive mood dysregulation disorder,” or DMDD, to severe and recurrent temper tantrums is the source of hot debate in the medical community in the wake of the announcement Monday of a number of changes to the manual psychiatrists use to diagnose mental health issues. The announcement also revealed the American Psychiatric Association’s decision to drop “Asperger’s disorder” as a diagnosis distinct from “autism spectrum disorder.”
The debate over DMDD relates to doctors’ concerns that it may be over-diagnosed in children who simply have a harder time learning to regulate their emotions. More from MyHealthNewsDaily:
“Although detailed criteria for the diagnosis have not been released, an APA statement said the condition could apply to “children who exhibit persistent irritability and frequent episodes of behavior outbursts three or more times a week for more than a year.” The addition is intended in part to reduce the number of kids misdiagnosed as having bipolar disorder, who may be treated with powerful drugs.
But some experts say the new condition was added to the manual too soon.
“I think it’s premature to put it in as a full diagnosis,” said Dr. David Axelson, an associate professor of psychiatry at University of Pittsburgh School of Medicine, referring the condition’s inclusion in the front of the manual with other well-accepted diagnoses, rather than in the appendix, which includes provisional diagnoses requiring further research.
Some are concerned that a label of disruptive mood dysregulation disorder would turn normal kid behavior into a medical condition.
But Axelson said the diagnosis requires severe and frequent behavior problems, and if properly applied, kids without a true mental condition would be unlikely to be diagnosed. In addition to frequent outbursts for more than a year, children need to be at least 6, but younger than teenagers, to be given the diagnosis, according to early versions of the criteria.
However, parents might overestimate how often their child behaves badly, because they focus on recent outbursts, and inaccurately reporting behavior to a mental health professional may lead to mislabeling, Axelson said.”
Image: Child having tantrum, via Shutterstock
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Monday, December 3rd, 2012
In a move that is sure to elicit strong opinions in parents of autistic children, the American Psychiatric Association has approved proposed changes to the new edition of the Diagnostic Statistical Manual (DSM) that will eliminate an independent diagnosis of “Asperger’s Disorder” and include Asperger’s kids within the diagnostic label of “autism spectrum disorder.” The Associated Press has more:
“One of the most hotly argued changes was how to define the various ranges of autism. Some advocates opposed the idea of dropping the specific diagnosis for Asperger’s disorder. People with that disorder often have high intelligence and vast knowledge on narrow subjects but lack social skills. Some who have the condition embrace their quirkiness and vow to continue to use the label.
And some Asperger’s families opposed any change, fearing their kids would lose a diagnosis and no longer be eligible for special services.
But the revision will not affect their education services, experts say.
The new manual adds the term “autism spectrum disorder,” which already is used by many experts in the field. Asperger’s disorder will be dropped and incorporated under that umbrella diagnosis. The new category will include kids with severe autism, who often don’t talk or interact, as well as those with milder forms.”
The Asperger’s changes are not the only ones that will appear in the new edition of the DSM, which will be published in May. Another major change is the addition of the diagnosis of DMDD, or disruptive mood dysregulation disorder, which will be given to children who have severe and recurrent temper tantrums.
The new edition is the 5th for the DSM. The last edition was published in 1994.
Image: Girl with psychiatrist, via Shutterstock
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