Over-diagnosed and Over-treated: The medicalization of childhood

John Abramson, MD, award-winning Harvard family practitioner, author of Overdosed America (log onto www.overdosedamerica.com to read further) has sagely weighed in as new normals have been adopted for blood pressure, cholesterol levels, blood sugar and new diseases like osteoporosis have been developed. According to Dr. Abramson, “American medicine has medicalized symptoms to market medications.” He speaks of the reach for a prescription pad before discussing lifestyle choices changes with a patient. Others including Beatrice Golumb, MD, PhD of the UCSD Statin Study Group speak of how science-based lifestyle changes are all-too-often under-utilized in patients at risk of heart disease in favor of using medications as a first-line approach. As Dr. Golumb’s studies and others have indicated, the risk-to-benefit analysis is often never discussed with patients before medications are used as the primary approach to address an increased risk of heart disease.
With the recent effort to utilize cholesterol lowering medication in children with high cholesterol readings (click here to read in more detail http://cholesterol.about.com/lw/Health-Medicine/Childrens-Health/Use-of-Statins-in-Kids-Children-and-High-Cholesterol-Prevention.htm) a discussion is prompted of “do we need to extend these changes in values to our children?” While we all acknowledge the Western lifestyle of inactivity, stress, and processed foods has been part of the reason we see “chronic diseases” at earlier ages than ever before, does that necessitate the use of medications including cholesterol lowering drugs with their risks in children? CDC researchers have now published a new study in the journal Pediatrics that seems to indicate high cholesterol readings in children may drop normally. Click here to read further http://www.reuters.com/article/idUSTRE66I0VL20100719. Cholesterol is a building block of membranes and of hormone production and growing kids may need more cholesterol physiologically. Maybe the effort to medicalize high cholesterol in children is well-intentioned but without merit.
Now, it appears that children’s behavior may be under medical scrutiny and subject to potential medicalizaton. Two upcoming published studies in the Journal of Health Economics indicate ADHD may be over-diagnosed in many American children who start school at a young age. Click here to read further http://news.msu.edu/story/8160. Michigan State U researchers found that about 900,000 young, immature children were told they have ADHD incorrectly. A second study from the U of Notre Dame found being young in a grade doubles the risk of being diagnosed ADHD-as much as 30% of ADHD may be diagnosed. Click here to read in more detail http://pagingdrgupta.blogs.cnn.com/2010/08/18/nearly-1-million-adhd-misdiagnoses-study-says/.
The figures from Phil Landrigan, MD’s research at Mt Sinai School of Medicine that one in six American children is behavior or learning disabled is troubling indeed. It is more troubling that often medications with sobering risks are used to treat symptoms as diagnoses like ADHD can be subjective. There appears no end in sight. Epidemiologically, more than 56% of American children under 12 in one study used more than one medication within the past 7 days. Click here to read in further detail http://pediatrics.aappublications.org/cgi/content/abstract/124/2/44a6.
Overdosed American Children may well be the title of the next book empowering American consumers that high cholesterol is not a disease, high blood pressure may respond to lifestyle changes before medication is used, and those who tried to lower blood sugar to a target range actually did much worse. It was in the not too distant past that medications were used cautiously in children and more cautiously in pregnant women. We may look back fifty years from now to wonder why our approach to symptoms related to lifestyle choices was not more prudent than marketing medications.
Deborah Ray, MT (ASCP)