Cultural changes may explain global variation in ADHD rates

By Staff Writer

Despite a growing clinical understanding of attention deficit hyperactivity disorder (ADHD), patients face a wide range of diagnosis and treatment conditions depending where they live, a study shows.

Researchers already knew that ADHD rates vary significantly in different regions of the globe, but they had always ascribed that to differences in culture or national attributes.

Instead, the new research suggests that the difference is due largely to changing methodologies of science, according to a paper in the May issue of the American Psychiatric Association's journal Psychiatric Services.

Doctors widely agree that ADHD is a chronic neurodevelopmental disorder leading to impairment and requiring treatment such as therapeutic schools. Yet they can disagree about its diagnosis and treatment, which leads to differences in medical education and even payment systems.

Researchers looked at social attitudes about ADHD in nine countries and found that both treatment and diagnosis vary a great deal, even though ADHD prevalence may not. The study encompassed Australia, Brazil, Canada, China, Germany, Israel, the Netherlands, Norway and the United Kingdom.

Doctors in some countries view medication as a first-line treatment, while others use extensive psychosocial therapy first. Diagnosis rates may also vary because, for example, teachers in Israel have a tolerance for high activity levels in classrooms, while those in China expect children to remain still and quiet for long hours, the study found.