Country lags in ADHD treatment

Experts say poor awareness and shortage of specialists to blame

Less than 1 percent of the 20 million children in China with attention deficit hyperactivity disorder are receiving proper treatment, according to health experts, who blamed the situation on a lack of awareness, trained specialists and standard clinical treatments.

In a typical classroom of 50 students on the mainland, two or three have the condition, said Shen Kunling, president-elect of the Society of Pediatrics under the Chinese Medical Association.

"The negative effects of the treatable chronic condition can last much longer than people expect," he said at the launch of the national ADHD Caring Week organized by the society and Xi'an Janssen Pharmaceuticals on Saturday.

ADHD is a developmental disorder that typically shows itself before the age of 7, and research suggests it is more common in boys than in girls. Symptoms include a short attention span and impulsive and hyperactive behavior.

Undetected and untreated, ADHD can cause serious problems, according to the World Health Organization. Child and adolescent patients face higher risks of school failure, substance abuse and even delinquency.

Shen estimated that, without timely intervention, some 50 to 60 percent of child patients will continue to exhibit the symptoms well into adulthood.

About 75 percent of adults with ADHD experience mental disorders such as chronic anxiety, substance abuse and addiction, depression, and other personality disorders.

In a 2002 study of inmates in juvenile detention facilities across the United States, researchers found about 47 percent had ADHD.

"Early detection and treatment helps substantially reduce the negative outcomes experienced by children living with ADHD, which otherwise might become a life-long condition," warned Zheng Yi, vice-president of Beijing Anding Hospital.

Wang Liyu, whose 4-year-old son was diagnosed with ADHD by Zheng in February, said previously she thought the disorder was just a school and academic issue. "But it also affected family and social relations, as no other children wanted to play with him," she said.

Now her son is on medication and his parents have received some training in coping with the disorder, and "the symptoms were alleviated somewhat and seemingly his self-esteem and control increased a bit", she noted.

But she still could not understand why her son had developed the condition, though she suspects that it might have been inherited from her husband, who is also highly active.

"Studies show that ADHD is related to factors including heredity, brain development problems and environmental pollution," said professor Jin Xingming of the Shanghai Children's Medical Center.

Internationally recognized treatment guidelines from the American Psychiatric Association suggest that medication should be the basis for treatment of ADHD, and doctors should adhere to standardized treatments in cooperation with parents and teachers.

Jin called for close cooperation between doctors and parents in following medication schedules, prescription adjustment and other follow-up steps. "We've seen some parents improperly stop their child's medication" as symptoms diminished or adverse drug reactions developed, such as decreased appetite, she said, adding that public education was important.

But she also warned of improper diagnosis of ADHD, which might result from confusing personality traits with medical conditions.

The campaign for ADHD Caring Week will be held at 40 hospitals in 20 cities (with three rounds for each hospital) through December, with the participation of more than 200 pediatric experts, according to the society.

It will provide free checkups, consultations and education, and it is estimated that as many as 10,000 children with ADHD will benefit from the campaign this year, said Thad Huston, president of Xi'an Janssen Pharmaceuticals. "Each child has just one chance to grow up."

shanjuan@chinadaily.com.cn