Essay on Attention Deficit Hyperactive Disorder

Attention deficit hyperactive disorder (ADHD) characterized as varying degrees of hyperactivity, impulsivity, and inattention leading to disruption of academic, social and emotional functioning. It is one of the most diagnosed mental illnesses among school going children aged 12 years and below. So much so that there is a growing concern on the accuracy of the diagnosis alongside the long-term medication given to patients and the side effects. Over the years, the number of newly diagnosed patients has increased. The Diagnostic and Statistical Manual of Mental Disorder is the key document of reference for a majority of psychiatrists and other medical practitioners where diagnosis and management of ADHD are outlined. There has been growing concern whereby when the DSM manual is updated, ADHD definition becomes more expansive. Signs and symptoms to look out for continue to increase with every version released. The current description of ADHD is the persistent pattern of hyperactivity and inattention that affects the daily functioning of an individual. A positive diagnosis in children requires at least 6 of symptoms outlined for 6 months while in adults 5 months.

Factors Contributing to the Misdiagnosis

Common errors that occur with the diagnosis of ADHD is describing a patient to having ADHD when really, they dont. Diagnosing it in the place of other mental illness such as bipolar disorder due to some similarity in the presentation and dismissing patients as not having ADHD yet they do have the disorder. It can be argued that the increase in the number of those diagnosed could be due to the increase in the number of false positive whereby those diagnosed with ADHD dont really have the disorder or a reduction in the number of false negatives where more of those with the disorder in the population are still not diagnosed.

Factor contributing to the over diagnosis of ADHD

There are a number of reasons why ADHD is over diagnosed. Some argue that over diagnosis is due to practitioners using limited assessments techniques. Only few of them use more than one source of reference for making diagnosis while the majority depend on one reference material. This is seen to contribute to the large number of false positive results. Some practitioners are more inclined to diagnose ADHD on the basis of the patients ethnic and social background compounded with the limited evaluation procedures. The liaison between practitioners and pharmaceutical industries can contribute to the over diagnosis of ADHD on the basis of supply induced demand where they create an unnecessary market for the drugs produce in order to make profit. The DSM also contributes to the over diagnosis as a result of blurred lines between the behaviours that warrant diagnosis and those that are non-diagnostic. ADHD organisations are seen to contribute to the increasing demand of seeking treatment CITATION Che16 \l 2057 (Cheng, 2016). The pressure for improved performance and accountability in schools drives teachers to referral of poor performing students for ADHD check-up and this may contribute to over diagnosis CITATION Bro09 \l 2057 (Molina, 2009).

Recommendations on reducing Misdiagnosis and over Diagnosis of ADHD

To reduce the incidence of misdiagnosis of ADHD, a proper evaluation should be carried out before initiation of treatment. In addition to the use of one handbook such as the DSM for diagnosis, a number of different other sources of reference for diagnosis should be used. Treatment should not be initiated unless all observations are made over adequate periods of time and the adequate evaluations are made. Those who are on medication already should undergo evaluations to rule out any side effects and determine the need to either continue or stop treatment. Strick policies can be put in place to ensure there is no supply induced demand where only legitimate cases warrant treatment and not making a prescription for the sake of financial gains. For the case of poor performers in school being dubbed as having the disorder to explain their academic standing, through investigations should be performed before initiation of treatment. Lastly, proper research on the disorder would go a long way especially in dispelling any uncertainty in the presentation of ADHD. With clearly defined protocols, diagnosis and management will be more accurate leading to an overall reduction in the incidences of misdiagnosis and over diagnosis.

Summary

ADHD is a commonly misdiagnosed condition due to inability to make adequate evaluation of those who are suspected to have it. The blurred lines between the symptoms to look out for and innocent hyperactivity and playfulness results to the misdiagnosis and unnecessary initiation of treatment. Pharmaceutical companies and ADHD organisation can influence the rate at which people seek treatment with some of the organisations causing the underestimation among parents with children suffering from ADHD.

References

Cheng, J. (2016). Arguments About Whether Overdiagnosis of ADHD is a Significant Problem. UCLA Center.

Molina, B. S. (2009). The MTA at 8 Years: Prospective Follow-up of Children Treated for Combined-Type ADHD in a Multisite Study. Journal of the American Academy of Child and Adolescent Psychiatry, 484-500.

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https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-adhd-the-basics/

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