Doctors Warn Changes in DSM May Lead to Increase in ADHD Diagnoses
The American Psychiatric Association (APA) plans to revise their language on ADHD in the forthcoming issue of the Diagnostic and Statistical Manual of Mental Disorders in order to expand availability of treatment, according to The New York Times.
While the text has not been released, those involved in the discussions told the news outlet that the changes could lead to a higher rate of diagnosis among all ages.
These changes include emphasizing that ADHD is not only an adolescent disorder, but that adults who have trouble focusing on paperwork or find themselves repeatedly losing their cellphone may qualify.
Perhaps most fundamental of all, however, is the shift in rhetoric regarding the disorder itself: rather than causing "impairment" in a person's life, new descriptions are stating that it can merely "impact" it.
The news of these changes comes in the face of record high rates of diagnosis with an estimated 6.4 million children between 4 and 17 having been treated for symptoms at some point in their lives.
This represents a 16 percent increase since 2007 and more than a 50 percent increase in the last decade alone.
Of those who have been diagnosed, roughly two-thirds receive prescriptions for stimulants like Ritalin and Adderall.
With numbers so high, not everyone is convinced the drugs are being used for the right reasons.
"Those numbers are astronomical," pediatric neurologist and Yale professor Dr. William Graf told The New York Times. "Mild symptoms are being diagnosed so readily, which goes beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy."
Among the reasons doctors may be over-prescribing is parents.
"There's a tremendous push where if the kid's behavior is thought to be quote-unquote abnormal - if they're not sitting quietly at their desk - that's pathological, instead of just childhood," Dr. Jerome Groopman, a professor of medicine at Harvard Medical School, told the paper.
And the costs, researchers warn, are not only being transferred to insurance companies.
According to the CDC, those who are covered by Medicaid show the highest rates of diagnosis, including 14 percent for school-age children, which represents a one-third increase over the rest of the population.
In all, sales of ADHD stimulants have more than doubled from $9 billion in 2012 to $4 billion in 2007, according to IMS Health.