Fimea’s statistics show that in 2007 ADHD patients were prescribed 0.84 daily doses of methylphenidate or atomoxetine—the main ADHD medications—for every thousand people. By 2012 that figure had risen to 1.73.
Nine-year-old Otto is among a growing cohort of Finns taking medication to control ADHD. He was diagnosed with the condition four years ago.
”When Otto was three-years-old, we looked at whether he might have ADHD,” remembers Otto’s mum Anna-Elina Hovatta. ”We got feedback from his daycare centre that Otto didn’t quite manage in groups. Otto was very impulsive, a bit fidgety and always getting to places before the others.”
Behavioural therapy and medication started following the diagnosis, and provided some relief at daycare and at home. Mum Anna-Elina was cautious about the medication at first.
”It felt overwhelming that Otto took those kind of drugs that are classed as narcotics,” says Anna-Elina. ”Questions came to mind, such as ’could this lead to dependence’, and ’are there any alternative treatments’.”
New drug on the way
Half a dozen ADHD drugs are currently on the market, all classed as narcotics. According to Yle sources, one new amphetamine-derived drug, lisdexamfetamine, is set to be approved by Fimea for use in Finland.
Lisdexamfetamine differs from other ADHD drugs in that it is intended to be longer-lasting and to be more difficult to abuse than other meds. It can, however, slow growth in children and young people.
Arja Voutilainen, a child neurologist at the Hospital District of Helsinki and Uusimaa (HUS) says that modern families are ready to start medicating their children if it is recommended by their physician.
”But of course there are also families where they don’t want to give drugs to their children unless the situation is really bad,” notes the doctor.
Modern world makes concentration difficult
Voutilainen says it is difficult to say why the number of ADHD diagnoses has risen. One explanation could be a change in lifestyles.
”It is not difficult to think that the modern way of the world and lifestyles increase impatience and make it more difficult to concentrate on one thing in peace,” observes Voutilainen. ”But there is no way to prove that is the case.”
ADHD was previously part of the child neurologist’s field, but is now treated by child psychiatrists. That is because ADHD is not just a neurological disorder and its care is not simply medication. Psychotherapy and especially behavioural therapy are important parts of ADHD treatment.
”The most important thing is behavioural guidance, that helps children improve their self-control,” notes Voutilainen.
Daycare centres seeking over-diagnosis?
Terhi Pajunen, a child neuropsychologist at Helsinki University Central Hospital (HYKS), points out that a diagnosis does not necessarily mean that support can be granted for lively children who have difficulty paying attention.
”In many cases it is the daycare centre or school that has begun seeking a diagnosis, because the child’s liveliness stands out in group situations,” says Pajunen.
According to the child psychiatrist, it could be that there is a desire to use treatment to help calm ordinary, but slightly lively, children. She says that people can simply have high-spirited personalities.
”It is ugly that ADHD has become a synonym for liveliness and an insult that children might themselves use to each other in the playground, saying ’you’re one of those ADHD people,’” considers Pajunen.
’ADHD is a fashinable illness’
Anna-Elina Hovatta’s son Otto is truly in need of care for his condition. Therapy, support from school and medication have eased his symptoms.
”It is hard to receive critical feedback,” says Hovatta. ”So the diagnosis was a relief to us.”
She warns that ADHD should always be taken seriously.
”I hear easily that this is a kind of fashionable sickness and that everybody has it. But of course ADHD diagnoses are based on careful research. And I have also heard from doctors that if the patient responds to medication, that means the patient is suffering from a real condition.”
