New Study on Adolescent ADHD
A study that was published in the Journal of the American Academy of Child and Adolescent Psychiatry, December 2007, is the largest study of adolescent ADHD to date. The study first began in 1986 and followed children through adolescence in Finland.
Some of the results of the study:
- About one half of the children diagnosed with ADHD exhibited cognitive deficiencies.
- The prevalence rate of adolescent ADHD was approximately 8.5%.
- Approximately two thirds of the children originally diagnosed with ADHD continued to show symptoms in adolescence.
- ADHD symptoms manifest themselves differently at different ages, impulsiveness and hyperactivity decrease and inattention continues.
- ADHD has a higher rate of co-existing psychiatric conditions, such as depression, anxiety, oppositional defiant disorder and conduct disorders.
Many of the findings of the study confirmed what researchers believed based on other studies. For example, the involvement of the dopamine pathways in the brain was reinforced with two genes regulating dopamine (labeled DBH and DRD2) associated with ADHD in Finland as well
There were, however, some questions raised based on the results of the study. One was regarding the long-term efficacy of the use of medication to treat symptoms of ADHD. It is apparent from other studies, as well as this one, that medication helps to treat symptoms in the short-term. Long-term improvements were not necessarily noted in the study. According to the data, adolescents with ADHD in Finland showed similar difficulties, similar symptoms, similar academic problems and similar co-morbid rates as in the United States. However, in Finland, medication is rarely used as a treatment method. Therefore, is medication helping to improve symptoms in teenagers?
Susan Smalley, a psychiatric professor at UCLA, headed this study. According to Smalley, "We know medication is very effective in the short-term. But the study raises important questions concerning the long-term efficacy of ADHD treatment. Here we have two different cultures and two different approaches to treatment, yet at the time of adolescence, there are few difference in the presentation and problems associated with ADHD."
Smalley accepts that ADHD is a valid diagnosis and that similar prevalence is seen around the world. The researchers, however, believe that "ADHD is an extreme on a normal continuum of behavior that varies in the population, much like height, weight or IQ. It's diagnosis, and thus prevalence, is defined by where health professionals ‘draw the line' on this continuum..."
Susan Smalley suggests that rather than broadening diagnostic classifications, more research go into the environmental factors contributing to impairment.
After reading about this study, I found the concept that teenagers in a country that does not use medication as a treatment to have the same symptoms overall as teenagers in the United States, where medication is used more frequently to be intriguing. I do however; have questions that were not answered in the literature about the study:
What teenagers in the U.S. were the teenagers in Finland compared to?
Were these teenagers that were not taking medication or were they compared to teenagers that had been receiving treatment, medication and behavior modification?
It is not that I am trying to defend the use of medication as the only treatment for ADHD, nor am I trying to knock down the results of years of study. I greatly respect the researchers and am pleased to know that this diagnosis is continually being researched in order to provide answers to the many people impacted by ADHD in their lives. However, the study referred to the problems teens with ADHD have in this country as being, in my opinion, classic ADHD symptoms. These symptoms are the reason that parents seek treatment and use medication when they feel there is no other choice. As a parent, I know I have seen my son improve on medication, and I know other parents that feel the same way. Did this study compare teens in Finland simply to the "classic ADHD symptoms" or are they referring to specific teens that have received treatment?
The last question I have is what does the parents and doctors in Finland do for treatment? What methods are used? I could not find those answers.