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Open Access Publications from the University of California

ADHD: BIOLOGICAL DISEASE OR PSYCHOSOCIAL DISORDER? Accounting for the French-American Divergence in Ritalin Consumption


Psychostimulants (such as Ritalin) are drugs that physicians prescribe to children with Attention Deficit Hyperactivity Disorder (ADHD). Following their introduction in the United States, the use of psychostimulants grew rapidly. However, this has not been the case everywhere, for the US represents 80-85% of the world’s psychostimulant consumption. Moreover, some countries, such as France, recognize ADHD as a medical condition but rarely treat it with medications. The aim of this article is to shed light on the American case. Towards that end, I compare the diagnostic systems used by American and French clinicians, an analysis that yields two important findings. First, the American diagnostic system has a much more liberal definition of ADHD, which leads to higher diagnoses and greater psychostimulant consumption. Second, where the American diagnostic system favors a biological understanding of ADHD and the use of medications to treat it, the French system emphasizes a psycho-social understanding and emphasizes psycho-social treatments (such as psychotherapy, family counseling, etc.). Beyond accounting for American medecine’s predilection for prescribing psychostimulants, this analysis contributes to a sociology of pharmaceuticals by revealing the synergistic relationship between disease classifications, the diagnosis of disease, and the use of pharmaceutical medications.

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