A panel of experts from the University of Adelaide, published in 2022, strongly criticized the official Australian clinical practice guidelines for attention deficit hyperactivity disorder (ADHD), on April 28, writes the Australian Financial Review.
The manual contains 113 recommendations to recognize, diagnose and treat this syndrome. But experts at the University of South Australia believe the guide has been given undue authority and that some of the treatments it offers could be dangerous for children.
“More critical thinking is needed to protect children from overtreatment of ADHD”says Professor John Giureidini, who heads the Critical and Ethical Mental Health Research Group at the University of Adelaide.
The guide is described as “evidence-based”but according to Jureydini, only 12 of their recommendations are actually based on evidence of varying quality, and the remaining 101 are based on opinion and experience.
“Of the 12 recommendations, nine contain low or very low quality evidence. The other three are based on moderate-quality evidence.says a professor specializing in child and developmental psychiatry. — We are concerned that Australians, including parents of young children, are being misled into thinking that these recommendations are based on sound evidence, when they are primarily the opinions of those who consider drugs… to be an integral part of ADHD treatment..
Another member of the University of Adelaide group, Dr Martin Whiteley, is even more concerned about the recommendation for children’s medicines.
“The manual contains a ‘strong’ recommendation that [такие] drugs…should be used as the first line of treatment for children ages five to 17. But this recommendation is based on “low” quality evidence.he says. — This means that the weak evidence justifies the strong recommendation that 5-year-olds who are considered too impulsive/active or distractible should create a daily habit… [к употреблению наркотиков]»_.
Whiteley has a PhD in ADHD policy and wonders why the guideline excludes compelling evidence from numerous international studies on the “late birth date effect.” This refers to the statistical effect when younger children in the same parallel school are diagnosed with ADHD and prescribed medication more often than their older peers.
Whiteley notes that truly evidence-based guidance would include advising clinicians, teachers, and parents to consider the predictable behavioral consequences of such age-related immaturity and ADHD misdiagnosis.
Meanwhile, psychiatrist and epidemiologist Melissa Raven believes there is a campaign to “sell” the diagnosis of ADHD in adults, encourage more comprehensive diagnosis and drug treatment of children and adolescents, and promote ADHD as a supposedly serious condition that causes disability.
He notes that in 2018, the Australian ADHD Professional Association received A$1.5 million ($80.5 million) in funding from the government at the time. In 2019, a Deloitte Access Economics report commissioned by the association indicated that this fortune costs Australia A$20 billion (1.05 trillion rubles) a year. Much of the cost was attributed to lost productivity.
The current Australian government endorsed the 2022 clinical guidelines and approved the accompanying guidelines this week. In April 2023, an ADHD Senate review was announced. One of the aspects that it will address is the recognition of ADHD as a major disability.
But Raven argues that the treatment is not a panacea. “Clinical guidelines state that, if left untreated, ADHD can lead to significant functional impairment throughout life. But the reality is that most of the evidence for long-term problems actually comes from studies of treated children and adults.”she says.
The research team is also concerned about the potential impact on young people of becoming disabled when their ADHD may be a temporary reaction to life circumstances.
“We hope the Senate review provides an opportunity for a more informed understanding of the dangers and pitfalls associated with the labeling and treatment of children and adults suffering from inattention, hyperactivity, and/or impulsivity.”– summed up Jureydini.
Source: Rossa Primavera
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