Hyperactivity: The Family Factor

Abstract

M ethylphenidate hydrochloride, a stimulant drug better known as Ritalin, is back on the hot seat. Although physicians have used it since the 1950s to treat children and adults with attention-deficit hyperactivity disorder (ADD), often referred to simply as hyperactivity, there have been recurring concerns that the drug is prescribed too freely for all sorts of behavior problems. Last November, for example, a Georgia mother filed suit against a public school district, charging that school-instigated methylphenidate treatment had made her son violent and suicidal. Her suit also contends the definition of attention-deficit hyperactivity disorder drawn up by the American Psychiatric Association is overly broad and invites misuse of the drug. Psychiatrists generally agree that methylphenidate often has a role, along with psychological and behavior modification approaches, in the treatment of ADD. But uncertainties over who benefits most from which treatment will persist, says psychiatrist Peter S. Jensen of Eisenhower Army Medical Center in Fort Gordon, Ga., until investigators address a much-neglected influence on the child with ADD: his or her family Research at an ADD clinic for children of military personnel indicates that the disorder often reflects a youngster's depression or anxiety, Jensen reported at the American Psychiatric Association's recent annual meeting in Montreal. He and his colleagues also find ADD is associated with an increased number of stressful events affecting a child's family and the presence of psychiatric symptoms in parents. These children's attention problems are merely one of a number of significant problems affecting them and their par-