Medicating Kids: Pediatric Mental Health Policy and the Tipping Point for ADHD and Stimulants

Abstract

Attention Deficit Hyperactivity Disorder (adhd) holds the distinction of being both the most extensively studied pediatric mental disorder and one of the most controversial. This is partly due to the fact that it is also the most commonly diagnosed mental disorder among minors. Currently, almost 8 percent of youth from the ages of four to seventen have a diagnosis of ADHD, and slightly more than 4 percent both have the diagnosis and are taking medication for the disorder. In other words, on average one in every ten to fifteen children in the United States has been diagnosed with the disorder and one in every twenty to twenty-five uses a stimulant medication—often Ritalin, Adderall, or Concertaas treatment. The biggest increase in youth diagnosed with ADHD and prescribed a stimulant drug occurred during the early 1990s, when the prevalence of physician visits for stimulant pharmacotherapy increased fivefold. This unprecedented increase in U.S. children using psychotropic medication triggered an intense public debate.

The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates

“…Fueled largely by increasing recognition of ADHD as a legitimate disorder within the medical community, prescriptions of psychostimulants to children diagnosed with ADHD rose by more than 700 percent in the U.S. between 1991 and 2005 (Mayes and Erkulwater, 2008). In 2006, the Centers for Disease Control and Prevention estimated that 4.5 million children under age 18 were diagnosed with ADHD, with roughly 2.5 million of these children regularly using prescription medication to treat their symptoms (Bloom and Cohen, 2007).…”

Surdiagnostic du TDAH au Québec: Impact de l’âge d’entrée à l’école, différences régionales et coûts sociaux et économiques

“…Plusieurs aspects du TDAH ont amené les chercheurs de différentes disciplines à s'interroger sur les effets et l'intensité de la médication prescrite, en particulier sur la très forte croissance (700 %) du nombre de prescriptions de psychostimulants entre 1991 et 2005 aux États-Unis (Mayes et Erkulwater, 2008). Peu d'informations sont disponibles sur les effets à long terme de la prise de ce type de médicaments par les plus jeunes, et les études des effets bénéfiques à long terme sur l'éducation et le travail sont insuffisantes.…”

American Pediatrics and the Transition from Mental Health to Illness Since the 1960s

“…At the same time, though, as Rick Mayes and Jennifer Erkulwater have pointed out with regard to ADHD, our system of heightened awareness, early treatment, and assumptions about disability that go along with mental illness can have profound effects on the children who are diagnosed-and on the policy decisions (and costs) down the line. 64 From a policy perspective, it is understandable that the problems in child mental health seem to be largely logistical. If most care should be provided by pediatricians, the problem to be solved would be the best ways to educate these primary-care providers to give better-quality care.…”