Grappling with ADHD; Men: The Scientific Truth; Scientific American Presents; by Beardsley; 2 Page(s)

More than 1.5 million children in the U.S., 80 percent of them boys, are now medicated to treat attention-deficit hyperactivity disorder (ADHD). The number is growing rapidly. Girls account for about one third of all cases but are less likely to be treated, probably because they are less disruptive.

The alarm that many physicians and parent-advocacy groups feel about this mass medication is not hard to understand. The ultimate cause of the syndrome, which leads to distractibility and impulsivity, is entirely obscure. A prominent researcher, Russell A. Barkley of the University of Massachusetts Medical Center in Worcester, has identified the condition as a developmental failure in brain circuitry that governs inhibition and self-control [see his article "Attention-Deficit Hyperactivity Disorder," SCIENTIFIC AMERICAN, September 1998]. And ADHD often persists into adulthood. Yet although the affliction can be inherited, genetic studies suggest that it is an extreme form of common types of behavior rather than a clear-cut pathology. Rules for diagnosis exist, but physicians probably both overdiagnose and underdiagnose it because of differences in methods of evaluating patients.