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Tuesday, November 26th, 2013
New research by the Centers for Disease Control and prevention reports that attention deficit hyperactivity disorder (ADHD) affects 11 percent of American children, spiking a staggering 43 percent since 2003 and growing by 2 million children since 2007. Researchers, far from being alarmed, are saying the finding shows that public awareness efforts and better diagnostic tools are helping families and doctors make an accurate number of diagnoses. More from CNN.com:
Today, 6.4 million children between the ages of 4 and 17 – 11% of kids in this age group – have received an ADHD diagnosis, according to the study, which is based on a survey of parents. That’s 2 million more children than in 2007.
The number of children using medications to treat ADHD is also rising. Since the last survey taken in 2007, there has been a 28% increase in children taking drugs to manage the disorder. More than 3.5 million children in the 4 to 17 age group, or 6%, are taking ADHD medications, the survey found.
These data are part of the CDC’s National Survey of Children’s Health, a national cross-sectional, randomized telephone survey. The survey is conducted every four years, and questions about ADHD diagnosis have been included since 2003. The latest data are from interviews conducted via telephone from February 2011 and June 2012, with 95,677 interviews completed and an overall response rate of 23%.
But while rising rates of ADHD diagnosis may be an alarming headline, Dr. John Walkup, director of child and adolescent psychiatry at Weill Cornell Medical College and New York-Presbyterian Hospital, found some positive news when looking at rates of prevalence and treatment. In his view, the data suggest that the increasing diagnosis rate of ADHD is getting closer to the true prevalence of ADHD, which is even higher.
“We’ve been working so hard for so long to improve treatment,” Walkup said. “If the prevalence rate is 9 to 11% and we’re getting 8% currently diagnosed, it suggests that the public advocacy for treatment is paying off.”
Image: ADHD buttons, via Shutterstock
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Thursday, November 7th, 2013
A new, broader definition of attention deficit hyperactivity disorder (ADHD) is leading to over-diagnosis and unnecessary medication of many children, a new report published in the British Medical Journal says. The rise also amounts to a $500 million bump in health care costs associated with ADHD in the U.S. alone. More from Reuters:
Less restrictive diagnostic criteria have contributed to a steep rise in diagnoses for the behavioral brain condition -particularly among children – the researchers said, and in the use of stimulant drugs to manage it.
The broader definition also “devalues the diagnosis in those with serious problems”, said Rae Thomas, a senior researcher at Australia’s Bond University who led an analysis of the problem and has published it in the British Medical Journal.
“The broadening of the diagnostic criteria is likely to increase what is already a significant concern about overdiagnosis,” he said. “It risks resulting in a diagnosis of ADHD being regarded with skepticism, to the harm of those with severe problems who unquestionably need sensitive, skilled specialist help and support.”
People with the ADHD are excessively restless, impulsive and easily distracted, and children with the condition often have trouble in school. It is most often diagnosed in children, mainly boys, but it is also known to persist into adulthood.
There is no cure, but the symptoms can be kept in check by a combination of behavioral therapy and medications such as Ritalin or a newer drug called Vyvanse.
Image: Hyper boy, via Shutterstock
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Tuesday, October 1st, 2013
The number of children who are being prescribed medications for mental health conditions including attention deficit hyperactivity disorder (ADHD) and anxiety is stabilizing, even as the number of children diagnosed with those disorders continues to rise. More from Time.com:
From the early 1990s to the early 2000s, the number of young children on psychotropic drugs, which include anti-depressants, stimulants, mood stabilizers and anti-anxiety agents, increased by two- to three- fold. Some drugs, including several ADHD medications, have been approved for use in children ages six to 12, while others have not studied long term in younger patients.
But in a new study published in the journal Pediatrics, researchers report that psychotropic drug treatments among children is stabilizing, according to data from a national sample of more than 43,000 kids between the ages of two and five. These drug prescriptions peaked between 2002 and 2005, and leveled off from 2006 to 2009.
While more refined guidelines for diagnosing mood and behavioral disorders among children may explain some of the change in medication use, more stringent warnings about the potential risks of psychotropic drugs on youngsters probably also played a role. In the mid-2000s, the Food and Drug Administration started adding its strictest black box warning to antidepressant medications, alerting doctors and patients to the serious risks these treatments could pose for children and adolescents. For those reasons, more pediatric groups advise doctors to start their youngest patients on behavioral therapies first, before relying on medications to treat their symptoms. “Our findings underscore the need to ensure that doctors of very young children who are diagnosing ADHD, the most common diagnosis, and prescribing stimulants, the most common kind of psychotropic medications, are using the most up-to-date and stringent diagnostic criteria and clinical practice guidelines,” the authors conclude.
However, some recent research showed that more than one in five specialists who diagnose and recommend treatment for preschoolers with ADHD turn to drug therapy first, either alone or in tandem with behavior therapy.
Image: Child with prescription bottle, via Shutterstock
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Tuesday, May 28th, 2013
Ibuprofen and acetaminophen, the two most commonly used pain relievers for infants and children, have had some parents worried after recent research had suggested that the medications may increase the risk of a child developing asthma. A new study, presented at a meeting of the American Thoracic Society, says the association is a misreading of the data. More from The New York Times:
The study, presented on Monday at a meeting of the American Thoracic Society in Philadelphia, found that children suffering from respiratory infections — which often lead to asthma — are simply more likely to be given over-the-counter pain relievers. These underlying respiratory infections and the fevers they cause, not the use of pain relievers, are responsible for the increased asthma risk, the authors argue.
“That’s essentially what we think is happening here,” said Dr. Augusto Litonjua, an assistant professor at Harvard Medical School and Brigham and Women’s Hospital. “We showed that children who took acetaminophen and ibuprofen in the first year of life had higher risks of developing asthma later on. But when we accounted for their concomitant respiratory infections, the effects were no longer significant.”
For the study, Dr. Litonjua and his colleagues examined data on nearly 1,200 women and their young children. The women were recruited early in pregnancy and were subsequently followed after giving birth. The researchers looked at how frequently the women used drugs like acetaminophen and ibuprofen, either for themselves or for their children. They investigated any diagnosis of asthma or wheezing symptoms, and they looked at respiratory infections, like pneumonia and bronchitis, that the children developed as infants and toddlers.
When they separated the children into groups, based on their exposure to analgesics in their first year of life, the researchers found that those with the highest exposure had a greater likelihood of developing asthma by age 7, a result consistent with earlier reports. But once they adjusted their findings to take into account the occurrence of very early respiratory infections, they found that the association between pain relievers and asthma diminished.
Much of the research linking pain relievers to asthma comes from observational studies, which are limited by a problem known as confounding by indication, in which the symptoms of an underlying disorder can be mistakenly considered a side effect of treatment.
Image: Infant receiving medicine, via Shutterstock
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Thursday, April 4th, 2013
Doctors are increasingly making the diagnosis of “GERD,” or gastroesophageal reflux disease, in infants, and the label may be prompting parents to medicate for infant issues that pediatricians would otherwise regard as normal, such as crying and spitting up.
A new report published in the journal Pediatrics argues that the use of the disease label is leading to the growing use of medication. “Labeling an otherwise healthy infant as having a “disease” increased parents’ interest in medicating their infant when they were told that medications are ineffective,” the article concludes. “These findings suggest that use of disease labels may promote overtreatment by causing people to believe that ineffective medications are both useful and necessary.”
Previous research has already established the growing number of medical interventions for GERD. One 2010 study by the Food and Drug Administration found that the prescription rate for a particular class of acid blockers increased 11-fold in the years between 2002 and 2009 for babies under age 1.
The new study, which was conducted as a survey of parents in a general pediatric clinic, attributes the rise to the use of the disease label GERD. From the survey’s abstract, “Parents who received a GERD diagnosis were interested in medicating their infant, even when they were told that the medications are likely ineffective. However, parents not given a disease label were interested in medication only when medication effectiveness was not discussed (and hence likely assumed).”
Image: Crying newborn baby, via Shutterstock
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