Ritalin use doubles after divorce

Psychiatry news:

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.

No, those really aren't the only possibilities. Maybe the misbehaving child caused the parents' divorce. Maybe no one wants to marry a single woman with a misbehaving child. Maybe parents with ADD genes are more likely to get divorced. Maybe the child doesn't have ADD at all, but is given ritalin as a way of scapegoating him or pretending that problems are being addressed. Maybe the child is doing just fine, but the single parent has trouble coping with normal misbehaviors and tries ritalin. Maybe there is no such thing as ADD, but ritalin is still a useful tool for lazy parents, and especially useful if no spouse is helping. Maybe the child is misbehaving because he is learning from the misbehavior of his parents, and not suffering emotional stress.

Conventional wisdom is that divorcing parents cause problems for kids, and not the other way around. But a scientific study should consider all the possibilities. There is no obvious link between emotional distress and attention deficits, so some of those other explanations seem more likely to me.