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Speaker 1: All right to ADHD. So are there concerns that we

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Speaker 1: might be over diagnosing this thing? Prescriptions for the medication

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Speaker 1: have jumped tenfold since two thousand and six, and in

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Speaker 1: just the last two years FARMACS reported one hundred and

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Speaker 1: forty percent rise in demand for these medications. Brian Betty

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Speaker 1: is the chair of General Practice New Zealand.

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Speaker 2: With us now have Brian oh Hi Heaveret.

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Speaker 1: So we've got this guy who's an addiction psychiatrist, doctor

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Speaker 1: Sam McBride, who reckons we are overdiagnosing and overprescribing medication.

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Speaker 2: What do you think, Look, Bertie, I think this is

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Speaker 2: a very difficult area. ADHD is a complex diagnosis, it's

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Speaker 2: got a lot of criteria with it, and there are

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Speaker 2: a number of other conditions that can mimic ADHD, very

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Speaker 2: very serious. So there's one line of thought that are

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Speaker 2: we moving into over diagnosis of ADHD. There's another line

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Speaker 2: of thought that's saying, well, actually we're underdiagnosing ADHD and

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Speaker 2: this is reflective of the true numbers in society. So yeah, look,

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Speaker 2: I think it's very relevant what Sam McBride has brought up,

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Speaker 2: and I think it's something we do need to talk about.

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Speaker 1: How would we know if we're overdiagnosing.

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Speaker 2: Well. Look, one of the things that has emerged is

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Speaker 2: it's thought that about five percent of children or adolescents

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Speaker 2: potentially have underlining ADHD, and that has severe impacts on learning,

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Speaker 2: on schooling, on behavior, on interactions with the law, a

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Speaker 2: whole lot of things, so very very serious and short

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Speaker 2: of diagnosis. What's emerged in the US is now it's

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Speaker 2: estimated ten percent of children there are being prescribed ADHD medications.

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Speaker 2: So the question becomes is a research which says five

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Speaker 2: percent of possibly got ADHD, yet ten percent of prescribed

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Speaker 2: is there overdiagnosis as we've become more aware of ADHD

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Speaker 2: and maybe maybe simplified the diagnosis itself, and it's been

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Speaker 2: prescribed more often than it should be. So this is

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Speaker 2: where this has emerged from what is it?

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Speaker 1: What is it that we could be confusing for ADHD?

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Speaker 2: Look, ADHD is very complex. There's a list of diagnostic criteria.

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Speaker 2: It's really really important to get proper assessment, proper diagnosis

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Speaker 2: because the treatment can be life changing and it's really

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Speaker 2: really important to understand that. However, it can make a

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Speaker 2: whole lot of other things, learning, disability, environmental issues, things

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Speaker 2: like anxiety, depression. There's a number of different what we

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Speaker 2: call differential diagnosis that comes into play, and it is

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Speaker 2: so so important that there is a proper assessment that

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Speaker 2: is done to make sure it is ADHD and not

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Speaker 2: one of these other conditions which need to be approached

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Speaker 2: in a different way. So it's complex, but access to

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Speaker 2: diagnosis is really the key to it.

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Speaker 1: Yeah, And this is the problem, right, is that actually

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Speaker 1: the access to diagnosis is really tough at the moment

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Speaker 1: because it's very a long wait. So Brian, get a

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Speaker 1: load of this again. I know a guy who reckons

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Speaker 1: that he's got ADHD, but he's fine, and he's he's

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Speaker 1: talked to some clinical experts said oh, look you have

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Speaker 1: you have potential for this to be the thing, But

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Speaker 1: he can't get in for proper diagnosis, so he's sourcing

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Speaker 1: rissalin from his friends. What do you think.

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Speaker 2: Yeah, so look at that diversion as we call it,

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Speaker 2: is actually a real concern in that situation. And look

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Speaker 2: that the access to diagnosis or proper diagnosis has become

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Speaker 2: a real issue in New Zealand. That it is very,

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Speaker 2: very difficult to often access psychiatric an opinion through the

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Speaker 2: public system because of the constraints that are there. To

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Speaker 2: get a diagnosis in the private system costs you know,

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Speaker 2: one to two thousand dollars in terms of a private,

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Speaker 2: private visits and assessment. So this is a very very

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Speaker 2: real problem and it's one that we need to solve

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Speaker 2: I think through better resourcing and training of professionals in

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Speaker 2: the diagnose of ADHD and better access to it. Otherwise

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Speaker 2: we're going to see more of these type of issues arise,

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Speaker 2: and I think that's really really problematic and difficult.

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Speaker 1: Yeah, Brian, Hey, thanks very much. Appreciate it, Betty, Chair

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Speaker 1: of General Practice New Zealand.

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