Ritalin Mystery

June 4, 2007 permalink

Researcher Lisa Strohschein has found that children of divorce get Ritalin prescriptions at a higher rate than the children of intact families, though she has no explanation of why. Following a news article below is the explanation.

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SCIENCE NEWS

June 04, 2007

Ritalin use doubles after divorce, study finds

By Scott Anderson

TORONTO (Reuters) - Children from broken marriages are twice as likely to be prescribed attention-deficit drugs as children whose parents stay together, a Canadian researcher said on Monday, and she said the reasons should be investigated.

More than 6 percent of 633 children from divorced families were prescribed Ritalin, compared with 3.3 percent of children whose parents stayed together, University of Alberta professor Lisa Strohschein reported in the Canadian Medical Association Journal.

The study of more than 4,700 children started in 1994, while all the families were intact, Strohschein said. They followed the children's progress to see what happened to their families and to see what drugs were prescribed.

"It shows clearly that divorce is a risk factor for kids to be prescribed Ritalin," Strohschein said.

Other studies have shown that children of single parents are more likely to get prescribed drugs such as Ritalin. But is the problem caused by being born to a never-married mother, or some other factor?

"So the question was, 'is it possible that divorce acts a stressful life event that creates adjustment problems for children, which might increase acting out behavior, leading to a prescription for Ritalin?"' Strohschein said in a statement.

"On the other hand, there is also the very public perception that divorce is always bad for kids and so when children of divorce come to the attention of the health-care system -- possibly because parents anticipate their child must be going through adjustment problems -- doctors may be more likely to diagnose a problem and prescribe Ritalin."

Ritalin, known generically as methylphenidate, is a psychostimulant drug most commonly prescribed for the treatment of attention-deficit hyperactivity disorder in children.

There is a big debate in much of the developed world over whether it may be over-prescribed -- given to children who do not really need it. In March, a University of California, Berkeley study found that the use of drugs to treat ADHD has more than tripled worldwide since 1993.

Strohschein said it is possible that some mental health problems pre-date the divorce, so "it is possible that these kids had these problems before, but are only being identified afterward."

Her study was not designed to find out why the children were prescribed the drug.

"I might be finished with the survey, but I am not necessarily finished with the question," she said in a telephone interview.

Source: Scientific American

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June 4, 2007

Strohschein, Lisa
University of Alberta
lisa.strohschein@ualberta.ca

Subject: Ritalin use

Madam:

In several articles in today's press you are quoted as the author of a study showing that Ritalin prescriptions are more frequent for children of divorced couples than for children of intact families. Research other than yours shows that children of single mothers also have higher prescription rates. The articles say you are now looking into why divorce leads to higher prescription rates.

I can save you some effort. The reason is the Canadian therapeutic system, which in the case of children is largely coercive. Divorce courts and child protection cases both steer children to psychiatrists in large numbers. The children of intact families are more likely to stay away from psychiatrists, and the parents who stay together are better able to resist the coercion.

Once referred for psychiatric help, the rest is driven by financial incentives for the professionals, and coercion for the parents and children. Wives are tempted to divorce their husbands by the prospect of generous child support and custody of the children. Child protectors get large per-diem rates for children in foster care, but the rates multiply as soon as a doctor diagnoses a disorder qualifying the child as "special needs". Doctors are not, as far as I know, rewarded per prescription, but they are assured of a steady stream of clients as long as they diagnose disorders and prescribe psychotropics. The drug companies can be relied on to mount a lobbying effort to preserve the current regime any time reform is on the legislative agenda. As for parents, refusing to follow a doctor's prescription is treated as medical neglect, allowing child protectors to take the child into long-term foster care.

In any future research, I hope you can include methods for measuring the effect of the therapeutic system on the rate of Ritalin use.

Robert T McQuaid
email: rtmq@fixcas.com