Tuesday, June 12, 2007

Ritalin use doubles after divorce

Which of course means that divorce is a disaster for kids and parents and doctors just want to shove pills down their throats to shut them up. Or, at least that's about what the headline and the article want you to believe.

Children from broken marriages are twice as likely to be attention-deficit drugs as children whose parents stay together, a Canadian researcher said on Monday, and she said the reasons should be investigated...

"So the question was, 'is it possible that divorce acts a stressful life event that creates adjustment problems for children, which might increase acting out behavior, leading to a prescription for Ritalin?'" Strohschein said in a statement.

"On the other hand, there is also the very public perception that divorce is always bad for kids and so when children of divorce come to the attention of the health-care system -- possibly because parents anticipate their child must be going through adjustment problems -- doctors may be more likely to diagnose a problem and prescribe Ritalin."...

Her study was not designed to find out why the children were prescribed the drug.
I try to be slightly cautious of criticizing research on days when I'm far too lazy to go read the original study, but it's always easy to criticize how studies are presented to the people who are paying for them through tax dollars (yeah, it's a Canadian study, but still).

I won't entirely dismiss the mechanisms of increased stimulant prescription proposed by the study, as they're narratively compelling and probably are true on at least a limited scale. But why do children become children in a divorced household? Probably because mom and dad can't make things work. What's one reason that's often true? Mental illness, and given the prevalence of adult ADHD (that thing that was childhood ADHD before the child became an adult), we could imagine that folks who get divorced have a much higher prevalence of ADHD. What has a heritable component? ADHD.

So, I'd be shocked if diagnoses of ADHD, and psychostimulant prescriptions, didn't go up after divorce. Not because parents or doctors are seeing children any differently (although they probably are), and not even necessarily because divorce, even one that's best for all parties involved, is a stressful event for a child, which it most certainly is. As a cohort, children from divorced households would be expected to have much higher rates of ADHD from a purely genetic standpoint.

The fact that the risk of receiving a stimulant prescription only increases by a factor of two may be the most surprising result of the study, and might even suggest the opposite of what the article suggests: that doctors and parents view attention-deficit and impulsivity symptoms in a child in such a stressful situation as a transient phenomenon, and thus fail to prescribe in some instances.

Maybe, and maybe not. But the last thing we need is more articles in the media that suggest that a neurological condition is nothing but a result of an unfortunate but statistically normal childhood experience for many children, and the impatient parents (probably mothers) and physicians who want to chemically lobotomize children who display problem behaviors.


Anonymous said...

From the vantage point of having seen many college kids whose parents got divorced, I would add this: it is common for one parent to think the kid should be on an Rx, while the other parent does not. I don't have numbers to back this up, but my impression is that often the parent who ends up with primary custody is the one who was in favor of the Rx. So after the divorce, the parent who objected is not is a position to stop it, so the kid gets started on the medication.

None of this says anything about what is right and what is not, but it is another confounding variable...just the kind of thing that makes it difficult to interpret these kinds of studies.

Anonymous said...

My name is Lance Burnet and i would like to show you my personal experience with Ritalin.

I am 56 years old. I have taken Ritalin for 30 years. I have been diagnosed with a mild form of narcolepsy. I use 4 (10 MG ) pills per day. The drug ahs worked wonders and eliminated the drowsiness and sleep attacks. My concern now is the length of time I have been on it. When taking a "drug holiday" it seems like my symptoms are worse.

I have experienced some of these side effects-
rebound effect when dosage wears off.

I hope this information will be useful to others,
Lance Burnet