ADHD: The role of social inequality in diagnosis

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common psychiatric disorders among children and most Western countries have witnessed an increase during the past two decades. Its core symptoms are inattention. hyperactivity, and impulsivity. Most children are diagnosed with ADHD around the time they reach school age (Sax & Kautz 2003). In some European societies, including the Danish, an ADHD diagnosis is likely to increase the individual resources available for a child, including government sponsored interventions such as school-based programs, psycho-education and behavioral parenting courses. Research has found that such interventions, especially if initiated early in the child's life, can strengthen the child's cognitive, emotional and social development (Kooij 2013; Smith, Barkley & Shapiro 2006; Pfiffer, Barkley & Du Paul 2006). At the same time, the trend of increasing rates of ADHD diagnosis have led to a public and scientific concern about the ethics of diagnosing children and treating them with psychotic drugs (Jørgensen 2014; Singh 2008; Timimi & Leo 2009) as well as to the questioning of ADHD as a valid psychiatric syndrome (Conrad 2004). While these issues are important, questions of inequality in access to diagnosis, and hence treatment, have been largely overlooked in this debate.