A Nation Of Pathologies

One in 11 American children is diagnosed – or “diagnosed” – with ADHD in one form or another.

In France, the rate is one out of 200.


Here in the US, ADHD is considered a biological disorder with biological causes – although as with so many “biological” emotional and mental disorders, nobody has actually empirically found that cause yet.

In France, it’s another story:

French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children’s focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child’s brain but in the child’s social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child’s brain.

 French child psychiatrists don’t use the same system of classification of childhood emotional problems as American psychiatrists. They do not use the Diagnostic and Statistical Manual of Mental Disorders or DSM. According to Sociologist Manuel Vallee, the French Federation of Psychiatry developed an alternative classification system as a resistance to the influence of the DSM-3. This alternative was the CFTMEA (Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent), first released in 1983, and updated in 1988 and 2000. The focus of CFTMEA is on identifying and addressing the underlying psychosocial causes of children’s symptoms, not on finding the best pharmacological bandaids with which to mask symptoms.

DSM vs. CFTMEA = Tomayto / Tomahto?  Perhaps.

But for whatever reasons, ADHD isn’t an epidemic in France: 

To the extent that French clinicians are successful at finding and repairing what has gone awry in the child’s social context, fewer children qualify for the ADHD diagnosis. Moreover, the definition of ADHD is not as broad as in the American system, which, in my view, tends to “pathologize” much of what is normal childhood behavior. The DSM specifically does not consider underlying causes. It thus leads clinicians to give the ADHD diagnosis to a much larger number of symptomatic children, while also encouraging them to treat those children with pharmaceuticals.

Also, I’m going to take a wild guess here and assume that the French system leaves the diagnosing to actual medical and mental health practicioners, and not teachers with BAs from the French equivalent of Mankato State.

6 thoughts on “A Nation Of Pathologies

  1. “One in 11 American children is diagnosed – or “diagnosed” – with ADHD in one form or another.”

    Wow! A lot has changed since I attended school. Especially the marketing for drugs.

  2. And the fact that an ADHD diagnosis doubles the student’s funding allotment at the very least.

  3. lets not overlook the “gender” angle. Boys are much more often “diagnosed” as ADHD than girls.
    So yes in addition to turning boys into quiet, manageable, girls with Ritalin the school district gets a big dollop of additional funding from the state, not to mention earning the gratitude of the pharmaceutical industry for producing such a reliable revenue stream.

    what the teachers union calls a win-win-win!

  4. Mitch:

    I think it’s been shown a lot of parents because they can’t move to change their school districts or will pay for private school will get their child declared to be some type of special needs child which gets tutor help and other education dollars spent on their child.

    Your example probably didn’t say that in France the education system doesn’t pay extra for the kid thus not encouraging French parents to play this game, but that is probably why it’s 200 versus 11.

    Walter Hanson
    Minneapolis, MN

  5. I wasn’t that surprised about the scathing critique of the DSM-5 that the editor of the DSM-4 has recently offered. Many of his criticisms were similar — medicalization of normal behavior and excessive promotion of drugs. Whether or not those criticisms are valid, when you have eminent people in the same field, each supported by many of their colleagues, disagreeing so strongly about the DSM, it has to at least make one wonder how authoritative that book really is.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.