ADHD epidemic? Not

[Anonymous]

Who has ADHD?

Just under 8 percent of US children ages 4 to 17 had been diagnosed with attention-deficit hyperactivy disorder in 2003, and more than half of them are being treated with drugs, the US Centers for Disease Control and Prevention says.

Boys are more than twice as likely to be diagnosed with ADHD than girls, especially boys from poorer families, the CDC said. The 2003 survey is the first comprehensive analysis of how many US children have the disorder, the CDC said in its MOrbidity and Mortality Weekly Report.

[Anonymous]

http://www.cdc.gov/mmwr/

In light of the impact of mental illness on public health worldwide, MMWR is launching a series of reports on mental health in the United States. This week?s issue includes a report on attention-deficit/hyperactivity disorder in children.

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The Role of Public Health in Mental Health Promotion

Mental illness contributes a substantial burden of disease worldwide. Globally, approximately 450 million persons suffer from mental disorders (1), and one fourth of the world's population will develop a mental or behavioral disorder at some point during their lives (2). Mental disorders account for approximately 25% of disability in the United States, Canada, and Western Europe and are a leading cause of premature death (1,3). In the United States, approximately 22% of the U.S. adult population has one or more diagnosable mental disorders in a given year (3). The estimated lifetime prevalences for mental disorders among the U.S. adult population are approximately 29% for anxiety disorders, 25% for impulse-control disorders, 21% for mood disorders, 15% for substance-use disorders, and 46% for any of these disorders (4). In addition, an estimated one in 10 children in the United States has a mental disorder that causes some level of impairment (5). The effects of mental illness are evident across the life span, among all ethnic, racial, and cultural groups, and among persons of every socioeconomic level (6). Moreover, mental illness costs the United States an estimated $150 billion annually, excluding the costs of research (7).

Mental health is integral to overall health and well-being and should be treated with the same urgency as physical health (3,7). Mental illness can influence the onset, progression, and outcome of other illnesses and often correlates with health risk behaviors such as substance abuse, tobacco use, and physical inactivity (. Depression has emerged as a risk factor for such chronic illnesses as hypertension, cardiovascular disease, and diabetes and can adversely affect the course and management of these conditions (.

Treatment for mental disorders is available and effective (3,5). However, the majority of persons with diagnosed mental disorders do not receive treatment (4). The challenges for public health are to identify risk factors, increase awareness about mental disorders and the effectiveness of treatment, remove the stigma associated with receiving treatment, eliminate health disparities, and improve access to mental health services for all persons, particularly among populations that are disproportionately affected (1,3). Public health agencies can incorporate mental health promotion into chronic disease prevention efforts, conduct surveillance and research to improve the evidence base about mental health in the United States, and collaborate with partners to develop comprehensive mental health plans to enhance coordination of care.

CDC has mobilized multiple efforts to assess and address mental health and well-being. Data on mental health, risk behaviors, and comorbidity of mental illness and chronic disease are collected through various national surveillance initiatives. CDC also collaborates with the World Federation for Mental Health to address stigma, a pervasive barrier to seeking treatment, through promotion of public awareness campaigns, such as World Mental Health Day. As the nation's premier public health agency, CDC is well-positioned to expand its role in safeguarding mental health by supporting the efforts of other health agencies, such as the Substance Abuse and Mental Health Services Administration and the National Institute of Mental Health, through continued surveillance of mental illness and risk behaviors in the U.S. population and promotion of mental health across the life span.

This issue of MMWR begins a series of occasional reports on mental health in the United States and includes a report on attention-deficit/hyperactivity disorder in children.

Reported by: S Marshall Williams, PhD, D Chapman, PhD, J Lando, MD, National Center for Chronic Disease Prevention and Health Promotion, CDC.
References

   1. World Health Organization. The world health report 2001: mental health: new understanding, new hope. Geneva, Switzerland: World Health Organization; 2001.
   2. Murray CL, Lopez AD, eds. The global burden of disease and injury series. Vol 1: a comprehensive assessment of mortality and disability from diseases injuries and risk factors in 1990 and projected to 2020. Cambridge, MA: Harvard University Press; 1996.
   3. US Department of Health and Human Services. Mental health: a report of the Surgeon General. Rockville, MD: US Department of Health and Human Services; 1999.
   4. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psych 2005;62:593--602.
   5. National Institute of Mental Health. Treatment of children with mental disorders. Bethesda, MD: National Institute of Mental Health; 2000. Available at http://www.nimh.nih.gov/publicat/childqa.cfm.
   6. US Department of Health and Human Services. Mental health: culture, race, and ethnicity---a supplement to mental health: a report of the Surgeon General. Rockville, MD: US Department of Health and Human Services; 2001.
   7. President's New Freedom Commission on Mental Health. Achieving the promise: transforming mental health care in America. Rockville, MD: US Department of Health and Human Services; 2003.
   8. Chapman DP, Perry SG, Strine TW. The vital link between chronic disease and depressive disorders. Prevent Chronic Dis 2005;2 [serial pub online]. Available at http://www.cdc.gov/pcd/issues/2005.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

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[Anonymous]

Untreated ADHD Follows Youngsters into Adulthood

Deseret News (Salt Lake City) - September 08, 2005

WASHINGTON -- The problems of untreated attention-deficit disorder don?t end when kids grow up. Young adults who had ADHD are more likely than their peers to get fired, to shun birth control and become parents by age 21 and to have higher credit card debt and less savings, according to a 13-year study reported recently.

Although estimates vary, many children with ADHD go on to have it as adults, says psychologist Mariellen Fischer of the Medical College of Wisconsin in Milwaukee. Government figures show that about one out of 20 adults have ADHD.

Fischer released her study with co-author Russell Barkley at the American Psychological Association meeting here. They followed 147 children with ADHD by age 7, comparing them with 76 neighbor children who didn?t have the disorder. Most ADHD children took medication for a couple of years, but few were being treated by their early 20s, Fischer says.

Adults who had ADHD as kids started having sex a year earlier than classmates. About a third dropped out of high school, compared with none of the neighbor kids, Fischer says. And one out of three had become parents by their early 20s versus one in 25 of the classmates. They had less than half the savings of young adults they had grown up with and more debt. Yet researchers don?t know whether ADHD alone causes these ill effects.

Though ADHD is genetic, there has been much less research on it in adults than children. Mothers of ADHD children are 24 times as likely as the average woman to have it, and fathers? odds are five times higher than average, says psychologist Andrea Chronis of the University of Maryland.

Her research, believed the first to focus on how mothers with ADHD do as parents, studied 70 families with elementary-school-age children. The women often weren?t very involved with their children; they didn?t give praise or show affection regularly, and discipline was inconsistent, Chronis says. Most of their children also had ADHD, and these parenting practices could worsen the problem, she adds.

Because attention-deficit disorder runs in families, perhaps doctors should suggest that parents of children with the disorder also get checked for it, Chronis says.