Dr Bryan Betty: General Practice NZ chair addresses concerns that ADHD may be overdiagnosed

ADHD diagnoses and prescriptions have surged around the world - but there's concern from experts that we might be overdoing it.

In New Zealand, prescriptions for the relevant medication have increased tenfold since 2006 and Pharmac has reported a 140 percent rise in demand for these medications.

General Practice NZ chair Dr Bryan Betty says it's a complex diagnosis - and there are several conditions that can mimic ADHD symptoms.

"ADHD is very complex, there's a list of diagnostic criteria. It's really really important that assessments give a proper diagnosis, because the treatment can be life-changing - and it's really important to understand that. However, it can mimic a whole lot of other things."

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Episode Transcript

Speaker 1 (00:00):
All right to ADHD. So are there concerns that we
might be over diagnosing this thing? Prescriptions for the medication
have jumped tenfold since two thousand and six, and in
just the last two years FARMACS reported one hundred and
forty percent rise in demand for these medications. Brian Betty
is the chair of General Practice New Zealand.

Speaker 2 (00:18):
With us now have Brian oh Hi Heaveret.

Speaker 1 (00:20):
So we've got this guy who's an addiction psychiatrist, doctor
Sam McBride, who reckons we are overdiagnosing and overprescribing medication.

Speaker 2 (00:27):
What do you think, Look, Bertie, I think this is
a very difficult area. ADHD is a complex diagnosis, it's
got a lot of criteria with it, and there are
a number of other conditions that can mimic ADHD, very
very serious. So there's one line of thought that are
we moving into over diagnosis of ADHD. There's another line

(00:47):
of thought that's saying, well, actually we're underdiagnosing ADHD and
this is reflective of the true numbers in society. So yeah, look,
I think it's very relevant what Sam McBride has brought up,
and I think it's something we do need to talk about.

Speaker 1 (01:02):
How would we know if we're overdiagnosing.

Speaker 2 (01:05):
Well. Look, one of the things that has emerged is
it's thought that about five percent of children or adolescents
potentially have underlining ADHD, and that has severe impacts on learning,
on schooling, on behavior, on interactions with the law, a
whole lot of things, so very very serious and short
of diagnosis. What's emerged in the US is now it's

(01:28):
estimated ten percent of children there are being prescribed ADHD medications.
So the question becomes is a research which says five
percent of possibly got ADHD, yet ten percent of prescribed
is there overdiagnosis as we've become more aware of ADHD
and maybe maybe simplified the diagnosis itself, and it's been

(01:50):
prescribed more often than it should be. So this is
where this has emerged from what is it?

Speaker 1 (01:56):
What is it that we could be confusing for ADHD?

Speaker 2 (01:59):
Look, ADHD is very complex. There's a list of diagnostic criteria.
It's really really important to get proper assessment, proper diagnosis
because the treatment can be life changing and it's really
really important to understand that. However, it can make a
whole lot of other things, learning, disability, environmental issues, things

(02:22):
like anxiety, depression. There's a number of different what we
call differential diagnosis that comes into play, and it is
so so important that there is a proper assessment that
is done to make sure it is ADHD and not
one of these other conditions which need to be approached
in a different way. So it's complex, but access to

(02:43):
diagnosis is really the key to it.

Speaker 1 (02:45):
Yeah, And this is the problem, right, is that actually
the access to diagnosis is really tough at the moment
because it's very a long wait. So Brian, get a
load of this again. I know a guy who reckons
that he's got ADHD, but he's fine, and he's he's
talked to some clinical experts said oh, look you have
you have potential for this to be the thing, But
he can't get in for proper diagnosis, so he's sourcing

(03:06):
rissalin from his friends. What do you think.

Speaker 2 (03:09):
Yeah, so look at that diversion as we call it,
is actually a real concern in that situation. And look
that the access to diagnosis or proper diagnosis has become
a real issue in New Zealand. That it is very,
very difficult to often access psychiatric an opinion through the
public system because of the constraints that are there. To

(03:31):
get a diagnosis in the private system costs you know,
one to two thousand dollars in terms of a private,
private visits and assessment. So this is a very very
real problem and it's one that we need to solve
I think through better resourcing and training of professionals in
the diagnose of ADHD and better access to it. Otherwise

(03:52):
we're going to see more of these type of issues arise,
and I think that's really really problematic and difficult.

Speaker 1 (03:58):
Yeah, Brian, Hey, thanks very much. Appreciate it, Betty, Chair
of General Practice New Zealand.

Speaker 2 (04:02):
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