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Study: Rate of Attention Deficit Disorder Cases Growing Faster in Maine
06/06/2013   Reported By: Jay Field

More new cases of attention deficit disorder are being diagnosed in Maine in recent years than in the rest of the country as a whole, according to a study by the company Express Scripts. The pharmacy benefit management firm, one of the largest in the nation, reports a 17 percent growth in the treatment of ADD in adults and children between 2008 and 2010, while the rate of increase in Maine was more than twice that much, at 35 percent. Jay Field reports.

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Study: Rate of Attention Deficit Disorder Cases G Listen
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ADD and its subset, Attention Deficit Hyperactivity Disorder, have long been treated as conditions that disproportionately affect children and teenagers. And there's been much debate in recent years over whether these disorders are being overdiagnosed in young people.

But what's most notable about this study, says Sharon Frazee, is what it says about the evolution of the condition in adults. Frazee is vice president of research and analysis at Express Scripts.

"And that's been the biggest growth - not only in Maine, but nationwide - has been the percentage of people that are adults, ages 18 to 40, that are being treated for attention deficit disorders," Frazee says.

Frazee says the company's study looked at a sample size of nearly 12 million people. All were between the ages of four and 40, and had commercial health insurance through either an employer or a managed care plan. The three-year period between 2008 and 2010 saw a 58 percent jump in the medical and pharmacy costs related to ADD in Maine.

The Maine Department of Health and Human Services says none of the data the state has been collecting suggests a larger than normal growth in new cases among kids.

"I'd say the consensus, really, is that people are diagnosing it more carefully," says Dr. Douglas Robbins, who says psychiatrists are also more aware of the disorder and its symptoms than at any time in recent years. Robbins, who runs Child and Adolescent Psychiatry at Maine Medical Center in Portland, says doctors are also more likely to treat ADD or ADHD with medication.

"In many disorders, we can treat them with counseling, working with the parents," he says. "In cases of well-established, clear ADHD, it turns out that that's generally not the case, and, in fact, medications do in fact work better than counseling. And so that may be also propelling more recognition, as well as more use of medication."

The greater overall recognition of the disorder may help explain why many more adults are now being treated. But there's still this disparity between the growth of new cases in Maine, compared to the overall increase nationwide. Sharon Frazee says it may have to do with something she calls the Northeastern effect.

"The Northeast tends to lead," she says. "So there are large medical centers with big medical schools that are very prestigious - places like Dartmouth and Yale and Harvard. And a lot of the knowledge comes from these institutions. Clinicians in the surrounding area tend to be first implementers of these new guidelines and of new findings."

So as new research emerges about the prevalence of ADD in adults, it may be that doctors in Maine are just more aware of the condition and more on the lookout for it than they've been in the past.



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