MONTREAL – Attention-deficit hyperactivity disorder is underdiagnosed among African American children, but African American parents suspect otherwise, Dr. Rahn Bailey said at the annual meeting of the American Academy of Psychiatry and the Law.
In a survey of 226 African American parents and 262 white parents, Dr. Bailey, a psychiatrist in private practice in League City, Tex., found striking differences in their perception of ADHD and its diagnosis. For instance, 41% of African Americans surveyed agreed that “African Americans are more likely than other ethnic groups to be diagnosed with ADHD,” compared with 13% of white respondents.
Similarly, 45% of African Americans agreed with the statement, “Teachers are more likely to suspect ADHD in African American children with learning or behavioral problems than in other ethnic groups.” About 12% of white parents agreed with that statement.
African Americans also were more concerned about the disease itself, with 71% saying that they “would be very concerned” if their children were diagnosed with ADHD, compared with 53% of white respondents. In addition, fewer African Americans–64% vs. 79% of whites–said they would know where to go for help if their children were diagnosed with the disorder.
“African Americans are less likely to go for diagnosis and care, and if they get the medicine, are less likely to take it,” Dr. Bailey said. And although African Americans think ADHD is overdiagnosed in their population, it is actually underdiagnosed because school personnel suspect conditions such as oppositional defiant disorder or conduct disorder, without being aware that those conditions can coexist with ADHD, he added.
African American parents also are less familiar with ADHD in general, with 10% saying they are “not at all familiar” with it, compared with 2% of white parents. And misperceptions about the disorder are common. One survey, for example, found that twice as many African American parents–59%–as white parents attribute ADHD to sugar in the diet.
“That's a point for education, for all doctors, to be aware of,” Dr. Bailey said. “It emphasizes that the misperceptions people get from the media can have more impact on what they believe and their resulting behavior than what they receive from physicians.”
As a result of this lack of knowledge, “it just stands to reason that in that setting, you are a lot less likely to receive a positive outcome or a fair outcome or a good outcome,” Dr. Bailey said.
“These families are less likely to go for diagnosis and care, and if they do go, they are more likely to go late. If they get a prescription, they are less likely to take it. It's very clear that, in the African American community, the prescription least likely to be filled in the first place is an ADHD prescription.”