A rare parent today is not familiar with the abbreviation ADHD (attention deficit hyperactivity disorder), because a rare child, alas, now does not put such a “fashionable” diagnosis. Still, today’s children were simply uncontrollable twist and turn, attentively listen to the lessons that fall out of the blue… Of course, they need to be treated.
However, the world has spread the sensational news: German and American psychiatrists have called ADHD a myth and presented evidence that such a disorder simply does not exist, and children are treated in vain with psychotropic drugs.
Adults also suffer from ADHD (1-2%). These people tend to choose for themselves a very active, they have too much to do in the schedule, they are chatty, constantly busy, inconsistent, often leave work, divorce, quarrel with others, exceed the speed. According to American scientists, workaholics with ADHD tend to an unhealthy lifestyle (32-53% of them indulge in alcohol, and 15-21% — are delayed by marijuana). And to finish their description, it is worth saying that they often become criminals or victims of crimes. Doctors recommend hyperactive adults: keep a diary and record all the things there; more typing on the computer than writing by hand; record on tape important lectures and meetings and do not refuse help from others (including doctors).
Long-standing doubts of some experts seem to be confirmed by two articles that appeared in scientific periodicals. They are now popular existence of the syndrome, as well as methods and results of its diagnosis is questioned. The first article was written by German psychiatrists Sylvia Schneider and Jurgen Margraf from the Ruhr University of Bochum, as well as Dr. Catherine Bruchmüller from the University of Basel. The researchers found out what the doctors are guided by, offering a thousand children’s psychotherapists to diagnose and recommend treatment based on a personal file sent to them by mail with a detailed description of the symptoms. Options file developed 4. In the first, the invented symptoms fully corresponded to the 10 criteria of the “Manual on diagnosis and statistics of mental disorders” (DSM—IV) and the “international classifier of diseases”, on the basis of which children and adolescents today are diagnosed with ADHD. In the other three symptoms were blurred and satisfied the “classic” only partially. The result: in ambiguous cases, 16.7% of doctors still diagnosed children with ADHD.
The fact that some seemingly healthy virtual children found controversial mental disorder, of course, unpleasant. Along the way, it turned out and another piquant detail: with the same set of symptoms of fictional patients, they played a big role… fictional gender. ADHD in boys was diagnosed twice as often as in girls. The conclusion is disappointing: boys, even if their symptoms go beyond the ADHD criteria, are 2 times more likely to get the wrong diagnosis and treatment. Especially if you get to the male doctor (Yes, the study revealed such a curious feature).
German researchers the resulting picture is very alarming. Especially if we take into account that from 1989 to 2003 the number of children and adolescents diagnosed with ADHD increased in Germany by 381%, and the volume of costs for their treatment with psychostimulants increased during the same time by 9 times. By the way, such statistics are not conducted in Russia.
Another scientific work calls into question the very fact of the existence of ADHD-it was published by American neurophysiologist Damien Fair and psychiatrist Joel Nigg. The authors compared the cognitive abilities of two groups of adolescents — with the diagnosis of ADHD and without it — on a number of parameters: the ability to understand and remember information, to concentrate, to separate the information signal from the noise, etc.Despite the fact that children with the diagnosis as a whole did not differ, in some parameters, “sick” teenagers surpassed “healthy“.
And although there are not so many scientific studies devoted to ADHD, the number of diagnosed patients, as well as the cost of their treatment, is growing rapidly. The researchers suggest that the syndrome of hyperactivity and attention deficit is nothing more than the fruit of medical fashion, and very dangerous, as for the treatment of children using serious psychotropic drugs.
The diagnosis of ADHD is becoming more fashionable in Russia. Some pediatric neurologists claim that every 3rd child in our country is hyperactive. So, he has more chances to become a criminal, a drug addict, a gambling addict or a scum of society. In Russia, ADHD is rarely diagnosed correctly. And even less often – properly treated.
Old New Syndrome
Fashion is fashion, but the syndrome of hyperactivity and attention deficit in the world is known for more than a hundred years. And ironically it was opened by a German researcher and a predecessor of those who are now trying to debunk ADHD. As the most authoritative in Russia specialist in ADHD, Professor of the Russian state medical University Nikolai Zavadenko, tells, symptoms of ADHD were described in the middle of the XIX century by the German doctor Heinrich Hoffmann in the form… children’s poems. The most famous book of Dr. Hoffmann was the collection of poems ” Funny stories and funny pictures for children 3-6 years.” And one of the most famous poems in it — “Philip-fidget.” Until now, in Germany it is so, “Zappel-Philipp”, called hyperactive children.
In 1902, the English pediatrician sir George Frederick still described a group of impulsive, poorly assimilated children. And long tried to prove to colleagues that inattention and lag in development — different things. After another 66 years, the American Association of psychiatrists offered the first methods of diagnosis of ADHD. But in Russia this syndrome was talked about only in the second half of the 90-ies of the last century.
Today, however, our doctors are already aware of three types of ADHD: “inattentive”, “mixed” and “hyperactive-impulsive” (that is, without attention deficit). The most common (more than 65%) — mixed. The most rare (less than 10%) — hyperactive, with 90% of these children in a couple of years go to a mixed type. The rest of the children are inattentive (dreamy, absent-minded, shy and slow).
Some experts note that in our age of children “with a motor” — 90%. But major Russian and foreign scientists believe that this is a serious misconception. ADHD affects only 3-7% of children — about 2 million young. Most often these are boys (about three times more than girls).
On the one hand, the diagnosis of ADHD is not familiar to many neurologists and teachers. On the other — some experts are so zealous that they put ADHD to children who do not have it in sight. According to the data, every 3rd diagnosis of ADHD is a consequence of incompetence of specialists. No wonder: there are quite a few similar States — emotional disorders, organic brain damage, developmental delays and even the usual age-related crises or features of character.
Today, doctors and scientists in the world have decided on a list of clinical manifestations of ADHD. There’s 18. 9 describe the symptoms of impaired attention (the child is difficult to focus; he does not hear the speech addressed to him; can not finish the job; is not able to organize the execution of tasks; avoids or disavows from cases involving high mental stress; often loses things; easily distracted; forgetting). Other 9-symptoms of hyperactivity and impulsivity (baby fidgeting; talking too much; makes restless movements with his hands and feet; runs or gets up, when to sit, not quiet play; answers without hearing the question; sticks to the outside, intervenes in the conversation; don’t like to wait).
Usually these symptoms develop in a child under 7 years. But! The diagnosis can be made not earlier than 5-6 years (although we often “reward” them and two-year-old children). Part of the manifestations of ADHD may be inherent in any child, but if it is indeed a disease, they should be present in the aggregate, be pronounced, manifest in all situations (school, home, street) and persist for a minimum of 6 months.
In contrast to the recently published researchers, our experts cite other data: according to statistics, half of children diagnosed with ADHD have serious problems in adulthood. They often get into criminal stories, leave the house, easier to sit on the needle, stronger friends with the”green snake”. They are prone to unnecessary risk, face career difficulties. Foreign statistics are as follows: 32-40% of children with ADHD drop out of school, 50-70% have almost no friends, 30% are in an accident, and 20-30% even get pregnant in adolescence! They are 4-7 times more prone to injury than their peers. Experts from the center For social and forensic psychiatry. Serbian on the basis of their own research concluded that more than 90% of gamers who came to them for treatment, as a child suffered ADHD. There is even reason to believe that people with ADHD live less, because they are more likely to meet cardiovascular and cancer. In addition, hyperactive people have increased risks of depression and suicidal tendencies. With age, the symptoms may weaken, but do not disappear completely.
It is necessary to begin treatment with recommendations to parents-how to bring up such children, how to communicate with them. Parents should understand that the child has objective difficulties, and it is impossible to consider him a bully, a loser, a slacker…