In our ongoing series of posts that, although not advertised as such, are aimed at debunking myths associated with ADHD, a decision has been made to address the discrepancy in ADHD diagnoses in North America and Europe.
Those who are in the camp that suggests that ADHD is made up, will point out that there is no ADHD in many European countries.
Well, you got me. That’s pretty much true, as far as it goes. But they don’t say why that is.
They don’t mention that is that the Diagnostic and Statistical Manual of Mental Disorders, or DSM, is not commonly used for diagnosis there. Instead, they are more likely to use a reference work produced by the World Health Organization (WHO) called the International Statistical Classification of Diseases and Related Health Problems, or ICD.
How would that stop ADHD in Europe?
But there is no ADHD in the ICD. Instead they have a diagnosis for something called Hyperkinetic Disorder.
You see, it’s kind of like radiation, and the list of diagnostic criteria is like a radiation detector. Hundreds of years ago, there was radiation. Magnetic material produces it, the sun produces it, lots of things do. But they had no detectors that could show its existence.
Saying there was no radiation at that time would not be true, but saying there was no detection of radiation at that time would be true.
So is there any ADHD in Europe?
Yes, of course there is. When they say there is no ADHD in Europe, they are saying there is no detection, no diagnosis of it. It would be like saying there’s no Hyperkinetic Disorder here in North America and telling Europeans that it’s just a made up thing because of that.
Is ADHD and Hyperkinetic Disorder the same?
Yes. And no. The diagnostic criteria would suggest that they are looking at the same disorder. But the requirement for diagnosis in the ICD allows a diagnosis rate of one to two percent of children. Current figures sometimes suggest a diagnosis rate of six to seven percent for ADHD among children as per the DSM. Changes in the DSM’s description of ADHD from revision to revision also allow for changes in rates of diagnosis.
So what’s the message here?
The message is pretty simple. Depending on the criteria used when diagnoses are made, varying rates will occur.
And as to the existence of ADHD?
ADHD exists in Europe. In fact, when using the criteria from the DSM, there is little to no change in diagnostic rates from one country to another. I will assume that using the ICD as a diagnostic tool would provide results here in North America similar to those that occur in Europe.
The DSM is apples, the ICD is oranges, ADHD is ADHD and Hyperkinetic Disorder is Hyperkinetic Disorder.
And if we forget about countries and start simply addressing situations and misinformation, the world will be the better for it. That sounds like a good rule of thumb for a lot of things, war, poverty, crime … but also for ADHD.
Apparently calling a disorder by an alternate name will leave some people thinking that it doesn’t exist in some places. And apparently there are people who can be convinced that that bit of “magic” means someone is lying.