NYT Dec.15,2013 Headlines:
The Selling of Attention Deficit Disorder
The Number of Diagnoses Soared Amid a 20-Year Drug Marketing Campaign
the article clik
Could this be a confusion of correlation with cause? (Other possible headlines: Soared amid 20 years of global warming, or increased use of hybird cars, or of increasing airline ticket prices).
However, it seems likely that the phrama companies’ advertising has indeed pushed and increased the diagnosis of the condition. To some extent, that would seem to be a good thing. However, when I read that 1 in 7 children (14.3%) are diagnosed, that seems pretty high; my impression from previous studies is that it’s about 8% in children and that half of those have significant persistence into adulthood (so 4% of adults; we are not rare).
I don’t find much in the article that is clearly wrong, and I agree that some of the advertising and physician promoting is quite questionable, but i do think the tone and slant is unduly negative. Also, I personally found the article too long for someone with ADD – we do better with short. (I confess that I have not carefully read it word by word.)
from the article:
“Few dispute that classic A.D.H.D, historically estimated to affect 5 percent of children, is a legitimate disability that impedes success at school, at work, and in personal life. Medication often assuages the severe impulsiveness and inability to concentrate, allowing a person’s underlying drive and intelligence to emerge.”
I would’ve said, instead of “to emerge”, “to be utilized for productive functioning”.
I am not aware of my doing any prescribing influenced by advertising (that doesn’t mean it’s never happened, of course).
I am influenced by :
1. my assessment of the patient
2. results of scientific clinical studies (of course, many of these are funded by the pharma companies, and are not always totally valid – see Tips o the Day clik clik
3. previous experience with other patients and medications
4. what other physicians tell me of their experience
5. included in assessing the patient: their preferences, their previous experiences, experience of close family member, medical conditions, other meds or substances they take, costs of meds, potential side effects of meds.
6. I started diagnosing ADD mainly after I discovered my own, and then began to recognize it in others, not after reading pharma ads. I regret the many I must’ve missed.
Bottom line: Maybe the advertising is really a big factor in the high prescribing, by increasing awareness of the disorder?
Many questions abound. overdiagnosis? abuse and addiction? effect on non ADD ADHDers?
More later.
doug
Its all a bit cloudy.
The article clik
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When I went in for a formal diagnosis the Psychologist I met with told me flat out after seeing me for less than 15 minutes that he didn’t believe I have ADD. Then he reviewed the tests given to me that day and brought me in later for more tests. He tried valiantly to hold on to his original beliefs, but eventually let the tests and other work show him the real diagnosis. (ADD) That said, I really didn’t want to go on drugs so have been trying to work with other methods like getting more exercise and using the tools in your book (that has been VERY helpful). The diagnosis has been very helpful in the sense of getting it that this is what is going on and then studying the literature about what I’m up against, but the push by the drug industry that we can’t spend the time with counseling or exercise or building habits, etc. but instead need to take this pill can be really frustrating.
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scott –
good to hear from you.
15 minutes does seem a little quick, as your story illustrates..
the meds can be very helpful, but Dr Dodson says their purpose is to help us focus enough to use strategies. some people can pull it together without them, and i sure agree, the meds are not a substitute for counseling, exercise , habits, etc.
thank you for commenting
doug
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Seems like everybody thinks they have ADD. But then my son went to a psychiatrist for help with his ADD and the guy said he didn’t have it. Really??? I lived with the kid for 20 years and I can tell you he absolutely has it. Some of the problem was that my son didn’t answer the questions honestly. He didn’t lie – he just didn’t have an accurate picture of himself. His wife needed to be there with him so she could answer for him. Then I’m guessing that psychiatrist would have changed his tune. Anyway, can you really make a diagnosis after one short meeting?
As far as all the children being diagnosed, seems to me (my opinion only) that many of those children are not disciplined at home and are just active. Kids are active!!! It doesn’t mean they have ADD.
I’m done now.
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Homey –
yes, we have trouble seeing ourselves. It is very helpful in diagnosing to hear from someone else who knows the person well, and especially knows of their childhood – mother’s, of course, are perfect! ( i dont necessarily mean that literally). occasionally it seems obvious that someone is ADD right off, but even then you need to be careful, as there are other things that can mimic it.
many kids are active indeed; not so many are hyperactive and that is different.
thank you for commenting
doug.
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