French Kids Don’t Have ADHD? Wrong

French Kids Have ADHD

Have you heard that “French kids don’t have ADHD?” It’s not true. French Kids do have ADHD—as do children around the globe, at generally the same prevalence rate.

When the post first appeared on Psychology  Today’s website, in 2012, I pegged it as more self-promotional nonsense, the kind we see too often around ADHD. The kind the Internet has fostered.

That is, some unknown person with a book to sell or lagging therapy practice to promote decides—Yes! Say something outrageous about ADHD! Because that’s a surefire way to boost notoriety.

And for too many profit-driven websites, such as Psychology Today‘s, it’s a take-all-comers policy. No editorial judgment required. Do most consumers know this? It doesn’t seem so.

Unfortunately, this “meme” from Marilyn Wedge has developed legs. That’s why I want to strongly counter it.  (By the way, she entitles her Psychology  Today spot “Suffer the Children.” Indeed!)

French Kids Have ADHD

 

Attention-Getting Recipe: Anti-ADHD Style

These sensationalist articles take predictable SEO-boosting potshots at ADHD as a:

  1. Big hoax
  2. Pharma conspiracy
  3. American invention, handled “without drugs” in more civilized/primitive/etc. countries.
  4.  “Woefully” over-diagnosed by greedy doctors, parents who don’t want to parent, teachers who don’t want to teach, etc..
  5.  “Brain difference” best handled with that particular writer’s self-styled guidance, game, or gizmo—without a smidgeon of evidence.

Never mind the thousands of published, peer-reviewed studies on ADHD by legitimate experts. These self-promoting online “columnists” insist they know better. Mostly, they know how to exploit the public’s ignorance of ADHD to their advantage.

 

Marilyn WedgeAbout the “French Kids” Author

The “French Kids Don’t Have ADHD” post comes from a Marilyn Wedge—a person on no discernible radar a psychotherapeutic expert.

She claims to have a practice in Westlake Village, a small community straddling the Los Angeles and Ventura County lines. Her stated Ph.D. is in social psychology, a field quite apart from clinical psychology; it’s much closer to sociology. She claims to practice as a masters-degree level therapist.

One simple definition of social psychology is the study of how people’s thoughts, feelings, and behaviors are influenced by the actual, imaged, or implied the presence of others.  Not to knock an entire field of study, but this surely seems a field highly vulnerable to subjective interpretations and fanciful narratives.

Marilyn Wedge: "French Kids Don't Have ADHD"
Marilyn Wedge: “French Kids Don’t Have ADHD”

On her website, Wedge identifies herself as a licensed marriage and family therapist (MFT). She also claims to have published “numerous professional articles in the  field of family therapy.”  I searched both PubMed and Google Scholar but could find only other articles on Psychology Today‘s take-all-clickbait website.

About Psychology Today‘s website: Did you know that basically anyone can post a “column” there? There are apparently no standards—and even less editorial oversight.

The magazine Psychology Today used to be fairly reputable, but that was a very long time ago. It is now little more than a profit vehicle, via ads and its directory (wherein therapists pay to advertise).  All the more disturbing: Therapists are allowed to receive continuing-education credits toward their continued licensure, simply for reading Psychology Today articles (and a fee).

 

A Disease Called Childhood

Marilyn Wedge’s Claims: Unsupported

Here’s her first paragraph from the “French Kids” post:

In the United States, at least 9 percent of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5 percent. How has the epidemic of ADHD—firmly established in the U.S.—almost completely passed over children in France?

She documents neither these nor the rest of her claims.  Did I mention? French kids do have ADHD.

The 9 Percent Figure for American Kids

The 9 percent figure comes from the U.S. Centers for Disease Control (CDC). It muddied the statistical waters with the publication of its 2012 survey, in which it found that 9.5% of children age 3-17 years have been diagnosed with ADHD.

I’ll save dissecting that survey for another post. For now, know that those numbers are based on phone surveys of parents, not any type of official clinical tally.

The bottom line is this:  Parental report, the basis of the CDC data, is controversial and known to over-report the prevalence of ADHD. (Sciutto MJ, Eisenberg M. Evaluating the evidence for and against the overdiagnosis of ADHD. J Atten Disord. 2007;11:106-113 and  Getahun D, Jacobsen SJ, Fassett MJ, Chen W, Demissie K, Rhoads GG. Recent trends in childhood attention-deficit/hyperactivity disorder. JAMA Pediatr. 2013;167:282-288.)

Most clinicians have expressed surprise at that high a number (9.5 percent). Without a more centralized system of data-gathering, such as with a national health system, this is how the CDC chose to gather data.

There are other, more reliable and scientific methods of arriving at these statistics. I include some below.

French Kids Probably Have More Structure

I’ll give Wedge that one. French parents do, at least traditionally, seem to provide more structure and discipline for their children. That’s true especially when compared to the U.S., with (it must be said) its increasingly lax parenting attitudes and lack of disciplined routines. In France, behavioral expectations also tend to be more typically clear, with unruliness little tolerated. In general.

France also has quite a strong safety net, with admirable child support for working families. Moreover, I’m willing to bet the average French child’s diet is much healthier than is the average American child’s.

But does all this means that French kids don’t have ADHD? Or that the structure and discipline they might enjoy in childhood serves to somehow make them higher-functioning for the rest of their lives?

Unfortunately, the facts just don’t bear that out.

Is The French Number “less than .5 percent”?

Wedge claims:

In the United States, at least 9 percent of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5 percent.

That’s a deceptive statement. She is comparing apples and oranges: 1) estimated pediatric ADHD prevalence rates (from parental reports by phone) to 2) the rates of children both diagnosed and taking medication. That’s two clearly separate categories!

As of 2013, the best evidence did point to .5% as the estimated number of French children both diagnosed with and medically treated for ADHD.

But a prevalence rate refers to the proportion of a population thought to have ADHD, diagnosed or not.  The  U.S. figure refers to the prevalence rate of 9 percent.  Moreover, due to the CDC data-gathering method, that figure is problematic.

In truth, French children do have ADHD—with France’s prevalence rate being similar to that of other countries: 3.5 to 5.6 percent.  It’s important to note that diagnostic criteria for such purposes are applied very conservatively. Therefore, it’s likely to account for the more severe cases of ADHD.  On the clinical level, there is more leeway to interpret the criteria in light of the individual’s challenges.

Why Wedge isWrong Overall

With this post, I’m not offering a point-by-point counter to Wedge’s claims. Most of her claims can be easily discounted by anyone having a passing familiarity with ADHD. Moreover,  her book titles clearly show her anti-psychiatry bent.

I am focusing on two points here:

  1. French children definitely do have ADHD
  2. They grow up to be adults whose predictable substance-use problems risk an early death.

1. Epidemiology: French Kids Have ADHD—Adults, Too

Thank goodness we have more than the opinion of an alleged therapist when it comes to examining the prevalence of ADHD in France. We have skilled, experienced researchers such as Stephen V, Faraone. He is the third most highly cited researcher in psychiatry and psychology.

In 2003, Faraone and colleagues published a review of 50 epidemiologic studies. They found the mean prevalence of DSM-defined ADHD to be similar around the world (Faraone, Sergeant, Gillberg, & Biederman, 2003). That result was confirmed by a meta-analysis of epidemiologic studies (Polanczyk, de Lima, Horta, Biederman, & Rohde, 2007).

Faraone later joined other colleagues to publish  Prevalence of Attention Deficit Hyperactivity Disorder and Associated Features Among Children in France in a 2011 issue of Journal of Attention Disorder.

Here is the paper’s conclusion:

The epidemiology of ADHD in French children is similar to the epidemiology of ADHD in other countries. The disorder occurs in between 3.5% to 5.6% of youth and is more common among boys than among girls. The authors replicate the well-known association of ADHD with CD, ODD, and indices of school failure. The impact of ADHD symptoms on school performance highlights the importance of screening for such symptoms in schools.

In the paper itself, the authors write:

Very little is known about the prevalence of ADHD in France. A literature search found no prevalence studies of ADHD in childhood and one prevalence study of ADHD in adults (Fayyad et al., 2007). This latter study examined a probability sample of 727 French adults and reported a prevalence estimate of 7.3%.

The fact that there were no pre-existing prevalence studies of ADHD in childhood in France proves only that it hadn’t been studied, not that it doesn’t exist.

French Kids Have ADHD

2. Rates of Substance-Related Deaths in France

Poorly managed ADHD symptoms increase vulnerability to developing substance-use problems. Substantive research documents this.

A sampling from news outlets:

Alcohol report lays bare France’s drink problem

subtitle: “The reputation of the French for drinking in moderation appears slightly misleading after a worrying report released on Monday revealed alcohol is responsible for around 49,000 deaths in France each year – around 134 each day.”

An excerpt from the article, based on the study Alcohol-attributable mortality in France:

According to the report published by the European Journal of Public Health, alcohol consumption was responsible for the deaths of around 49,000 people.

Catherine Hill, one of the authors of the report summed up the findings simply by saying “the French drink too much”.

The stats, based on the year 2009,  revealed that three times as many French men died as a result of an alcohol relate health problem than women.

The study, carried out by the Service for Biostatistics and Epidemiology at the Institue Gustave Roussy, near Paris found that around 36,500 French men die each year from alcohol-related illnesses, around 13 percent of the overall male mortality rate….

Perhaps the most worrying trend the survey revealed was that 40 percent of those deaths were people under the age of 65.

France’s Unhealthy Statistics: A new report has shattered the image of France being a healthy nation despite its fondness for drinking and smoking

excerpt:

The findings reveal that the widespread perception of the French as a healthy nation is rapidly becoming outdated.

A government study, published this month, showed that France’s male population has the highest level of cancer-related death of any country in the EU. Scientists concluded that the soaring death rate was directly attributable to the excessive consumption of tobacco and alcohol.

Figures showed that 20% more French men die from cancer each year than British, while Sweden has the EU’s lowest male mortality rate from cancer in the EU, with 196 deaths per 100,000 compared to France’s 283.3.

According to figures collated from 1999, the most recent year for which statistics are available, France has a far larger number of deaths from mouth, lip, throat, liver and lung cancers than neighbouring countries: a clear indication of the disease’s roots in unhealthy lifestyles.

The Psychoanalysts’ Lock-Hold in France

The researchers cited above do not mention that psychoanalysis has long dominated in France— far past the time when neuroscience came to inform psychiatric treatment in the United States and Canada. Perhaps it comes down to the extremely entrenched (some would say paralyzing) French bureaucracies. My French sources tell me that, no matter what your psychiatric issue, you are first offered psychoanalysis.

Yes, even for autism.

No matter how much the French National Health System is praised—or how great it is—how do we regard a system as truly great that censors the predominance of published literature documenting the seriousness of ADHD? And autism.

A rare critical exposure of France’s virtually closed-system came about in the 2012 documentary Le Mur, or The Wall, as reported in The New York Times“A French Film Takes Issue with the Psychoanalytic Approach to Autism.”

The documentary, the first film by Sophie Robert, follows two autistic boys: Guillaume, who has been treated with the behavioral, or “American,” approach; and Julien, who has been kept in an asylum for six years and treated with psychoanalysis. Guillaume, though challenged, is functioning at a high level in school. Julien is essentially silent, locked out of society.

What is really happening to French children and adults in France who have ADHD? That remains to be studied. Perhaps the strong (but rapidly eroding) social safety net is providing a degree of support. Or perhaps it is keeping them locked in a system that fails to give them greater autonomy and self-actualization—and lets them smoke and drink themselves to death.

Please see a later piece, Vive La France! But Adieu To Its Abusive “Psychiatry”, in which I examine the highly troubling roots of modern French psychiatry: a neo-Freudian figure named Jacques Lacan.

—Gina Pera

37 thoughts on “French Kids Don’t Have ADHD? Wrong”

  1. Ad hominem attack instead of addressing arguments from Cambridge University paper isn’t what I expected in your reply. Also, if you want to medicate your kids or yourself with amphetamines go ahead, you can do it, nobody is going to stop you. The same way you should have some basic respect and understand that if there are cultures, like French, where they don’t think it’s a great idea, with papers backing it — have some respect for that too. So, any response for this Cambridge University paper? Or are you going to stay mad because you think somebody is stopping you from treating ADHD any way you want? If you are tired of logical, rational arguments and prefer ad hominem attacks, sure this tells a lot about you. Go and cancel Cambridge University and their scholars because you are tired of it. While feeding your kids with amphetamines. Discusting. You sound like a low life. Ad hominem attack for an ad hominem attack. How do you like it now Sweety?

    1. French psychiatrists over-prescribe anxiolytics, no matter what the issue. That’s hardly supportable.

      Even if anyone buys the simplistic hunter-gatherer theory, we no longer live in a nomadic world. Just as humans found it necessary to use eyeglasses when books were invented, change and adaptation happens.

      Scientists understand that one article advancing theories does not science make.

      Good day.

    2. I’m a a french person diagnosed with ADHD in adulthood, after a lifetime of unacknowledged struggle. I’m finally taking a breath of air and are able to direct my energy on the things I love with the help of very mild, side effect free (for me at least) medicine. As a kid, the (french) adults in my life all but told me I had an attention deficit “he’s not attentive, he’s always talking, he’s always getting up”. Except that wasn’t with a view to help me in any way, rather I was deemed lazy and disrespectful. I was being bad and I should feel bad. I pushed through in life thinking I was inherently lazy, and that my inability to gather my thoughts and energy towards academic or professional goals were self inflicted. That what I couldn’t get to I just didn’t deserve.

      I was lucky to stumble onto the notion that some of the symptoms I exhibited corresponded to ADHD traits this year, in my mid thirties. I talked to my doctor (I now live in North America) who was supportive of my situation and offered to try a treatment. It’s been a few months and fully life changing.

      I have ADHD and I needed help, it’s insane that nobody even raised the question when “trouble paying attention” was written back and white on every report I ever got.

      The French have a backwards approach to mental health, and a lot of other things honestly. And we’re not happier for it. It’s possible we’re less whiny about it, people like you set a low bar in comparison.

      But how about you don’t speak for us, sweety?

      Disgusting, which by the way is spelt with a g.

      My thanks to the other of this post for their work and to the SEO gods for placing first in Google results.

    3. Thank you, Ivan. I’m saddened to read of the criticism-without-help you endured but delighted to read of your perseverance and breakthrough to truth.

      I would attempt to say “well done” in French, but I’m sure I’ll get it wrong. 🙂

      best,
      Gina

  2. Below you will find a document from Cambridge University:
    https://www.cambridge.org/core/journals/bjpsych-advances/article/how-evolutionary-thinking-can-help-us-to-understand-adhd/A4BBE292EB44B2230294367A4ACB3F88

    explaining that gene associated with ADHD (DRD4) assures better outcomes in hunter-gatherer communities. As the individuals expressing ADHD bahaviors in the hunter-gatherer communities are better hunters apparently. So the indivduals with ADHD in Kenyan tribes — according to the Cambridge paper above — are better suited to the environment in hunter-gatherer communities. So French are right according to this paper — ADHD is merely a social issue with anglo-saxons unable to raise their kids properly. Adding horrible diet on the top. We don’t want to excercise institutional racism and start treating Kenyan hunter-gatherers who thanks to the DRD4 gene are better hunters, do we?

    Two, and that’s even more important. The ATP says that diagnosis must be cross-cultural. ALL diagnosis must be cross-cultural. We can’t have a mess where in France it is a social problem. Kenyan tribes are better of with it, and in the US it is a psychiatric issue. If I’m depressed whether i will go to Framce, or Kenya, or the US, I will get standard depression test — which is Beck or Beck 2. Lack of cross-culture functioning of the ADHD diagnosis is the best proof that it is a social construct.

    1. Yeah, yeah, those have been batting around for decades. But here’s the thing, ADHD is MULTI-Genetic. And nothing is simple about genes, mutations, variants, alleles, etc.

      That is an article, an opinion piece, with six citations. The lead author seems to focus only on “evolutionary thinking” — not genetics. She even furthers the common misperception of “survival of the fittest” and “genes that persist serve a purpose.” But that’s simply not true. Mutations persist when any associated conditions don’t kill the carrier before pro-creation. Modern studies on ADHD populations show younger age for sexual intercourse — and more partners over time. Mutations are just along for the ride.

      And with that, I’ll bid you adieu. I have no more energy or tolerance for people hell-bent on depriving others of a diagnosis and medication that can truly enhance their lives, happiness, and longevity.

      g

  3. In France people live on average 11 years *longer* than in the USA. 88 years in France vs 77 years in USA. The USA is like this moron student with D grades explaining brilliant student with A grades that their “habits can be deadly”. What about medicating *kids* with amphetamines in millions — sure that “helps” this longevity difference…

    1. This 2020 paper found 3 years, at most.

      https://fbf.berkeley.edu/blog/length-life-compared-france-and-us#:~:text=Overall%2C%20the%20average%20length%20of,internal%20inequalities%20in%20the%20US.

      It’s tricky comparing numbers like this. Many other factors contribute to culture, including history, genetics, emigration/immigration.

      ADHD left untreated is associated with a premature death and a host of chronic diseases.

      Not sure we can call France a country with A grades. In which area of science is France a leader now? I can’t name one. Can you?

      g

  4. Hi, I am looking for authentic, scientifically researched studies on ADHD in children. Where is the BEST resource? I feel that there is so much misinformation posted on the Internet; even medical doctors are not thoroughly informed or fail to get to really know a patient before they prescribe the appropriate course of action for a problem. Mostly, symptoms are treated, NOT the cause of the symptoms.

    1. Hi Christine,

      I hear you. Some days it just gets me down, all the hustling and competing for traffic with “keywords”…..but articles that are superficial at best, horribly and wrongly opinionated at worse.

      There is no one best resource. There is the ongoing published literature and there is the consensus of clinical expertise. It’s often best to go by particular issues and find the best sources on that. For example, organization, sleep, supporting Executive Functions, etc. If you can tell me about the particular issues, maybe I can steer you toward good resources.

      The trouble is, we humans are complex. No two human brains are alike. Like snowflakes.

      ADHD affects individuals, and the genetic contribution varies individual to individual. There are no “ADHD genes”, for example.

      Some have co-existing conditions — autistic spectrum disorders, anxiety and depression disorders, bipolar disorder, etc..

      When it comes to managing ADHD symptoms, however, we have a good idea of what works. Unfortunately, the best clinical evidence does not always filter down to the clinical level. That is, what we know works….we don’t often see with most MDs and PhDs and other therapists. There is a lot of “winging it” with medications and therapy.

      That is a major reason I do this work, because I’m horrified that people are not getting the help they deserve. They are getting “winging it”—and sometimes worse. I work to educate the public on how treatment SHOULD go — based on the medical evidence and consensus among top experts — and how to guide it along when necessary.

      But I’m not sure what you mean about the “cause” of symptoms. ADHD has neurobiological underpinnings, related to gene-based dopamine transmission. This is why ADHD runs in families. It’s highly heritable.

      The medications used to treat ADHD help to regulate dopamine transmission. Thus relieving symptoms.

      The only time I hear questions about the “root cause” of ADHD, it’s typically from “natural” healers, naturopaths, etc.. The trouble is, when they have no background in neuroscience and molecular chemistry, they are really out of their depth when it comes to ADHD.

      Unfortunately, most MDs are out of their depth when it comes to nutrition, sleep, and other important factors. So, we’re left to fill in the gaps, ourselves, between the two extremes.

      I hope this helps.
      Gina

  5. I just had a moment of “whatever happened to that French ADD claim?” curiosity, and in the process of googling noticed this note at the head of the state digital article. Thought you might enjoy the update. It only took eight years.

    “ NOTE: This post was updated with a correction on March 16, 2020. The post and its headline had claimed that the prevalence of ADHD in France was lower than that of the U.S. or other developed countries. That inaccurate claim has been removed.”

    1. Sacre bleu! lol Thanks, Hilary.

      And we all know how tiny retractions are to big and damaging statements. As you say, “only” eight years later.

      Some days it just makes me tired. The fact that we’ve let companies such as Google be our news “gate keepers”, that hustling organizations such as Psychology Today promote quacks and con artists with the slimmest of credentials. The more shocking the claim, the more it goes “viral.” And many consumers just don’t have a clue — and, in some cases, don’t want one.

      g

      thank you!
      g

  6. We can confirm it in France… Wedge, like a proper neo-freudian who she is (regretting the spanking of children in order to help them get rid of invasive desires), is totally off the mark. These fake news join the bullshit about “virtual autism” (channeled by Ducanda and Terrasse in France, originated from Romania, exploited by Algerian quack Andaloussia…)

    1. Hi Copper,

      Thanks for the validation. Too many Americans fall for this nonsense.

      I’m glad I don’t know this character Andaloussia…..

      best,
      g

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