原文標題:ADHD Diagnosis Leads to Worse Quality of Life, Increased Self-Harm in Kids
原文來源:https://www.madinamerica.com/2022/10/adhd-diagnosis-leads-worse-quality-life-increased-self-harm-kids/

When comparing kids with the same symptoms who were either diagnosed with ADHD or not, those who received the diagnosis had worse outcomes.
當比較那些具有相同症狀但被診斷為 ADHD 和未被診斷的孩子時，接受診斷的孩子的結果更糟。

By Peter Simons – October 24, 2022
彼得·西蒙斯 – 2022年10月24日

In a new study, kids who received an ADHD diagnosis were compared with kids who had the same symptoms but who did not receive a diagnosis. Those who received a diagnosis had worse outcomes on five quality-of-life (QOL) measures and were more likely to engage in self-harm.
在一項新研究中，研究人員比較了接受 ADHD 診斷的孩子和那些有相同症狀但未被診斷的孩子。結果顯示，接受診斷的孩子在五個生活質量（QOL）指標上表現更差，並且更可能進行自我傷害。

The researchers write, “These findings suggest that childhood ADHD diagnosis may not result in any improvements in quality of life measures in adolescents and may negatively impact some outcomes, such as the risk of self-harm.”
研究人員寫道：「這些發現表明，兒童 ADHD 診斷可能不會改善青少年的生活質量，並且可能對某些結果產生負面影響，如自我傷害的風險。」

The study was led by Luise Kazda at the University of Sydney, Australia, and published in JAMA Network Open.
這項研究由澳大利亞悉尼大學的路易絲·卡茲達（Luise Kazda）領導，並發表在《JAMA Network Open》期刊上。

“Our study expands the current knowledge that children with ADHD often experience reduced QOL by showing that at least some of this is associated with the diagnosis itself,” the researchers write.
研究人員寫道：「我們的研究擴展了目前的認識，顯示 ADHD 兒童通常會經歷生活質量下降，而這至少部分與診斷本身有關。」

The data came from the Longitudinal Study of Australian Children, which surveys a representative sample of the Australian population. None of the participants had an ADHD diagnosis at the beginning of the study. The study began when the kids were 6 or 7 years old, and the final data points came when they were 14 or 15.
數據來自澳大利亞兒童縱向研究，該研究調查了澳大利亞人口的代表性樣本。研究開始時，參與者都沒有 ADHD 診斷。研究從孩子 6 或 7 歲時開始，最終數據來自他們 14 或 15 歲時的狀況。

At the endpoint, 393 adolescents had an ADHD diagnosis (72.2% male). They were matched on age, sex, and ADHD symptoms with 393 adolescents who did not receive an ADHD diagnosis.
在研究終點，共有 393 名青少年被診斷為 ADHD（72.2% 為男性）。研究人員根據年齡、性別和 ADHD 症狀，將這些青少年與 393 名未被診斷為 ADHD 的青少年進行匹配。

Both groups scored about the same on almost all the measures of QOL, health, and happiness used by the researchers. But there were a few notable differences:
兩組青少年在研究人員使用的幾乎所有生活質量（QOL）、健康和幸福感指標上得分相近。但有一些顯著差異：

Those who received the diagnosis scored worse on feeling that they belonged at school and could succeed academically, having a sense of self-efficacy, and demonstrating negative social behaviors. Most concerningly, they had higher levels of self-harm.
接受診斷的青少年在對學校的歸屬感、學業成功的信心、自我效能感以及社會行為方面的得分較低。最令人擔憂的是，他們的自我傷害水平較高。

In fact, kids who received the diagnosis of ADHD were 2.53 times more likely to harm themselves than kids who had the same level of ADHD symptoms but did not receive the diagnosis.
事實上，接受 ADHD 診斷的孩子自我傷害的可能性是那些具有相同 ADHD 症狀但未被診斷的孩子的 2.53 倍。

The researchers note that their study was observational, so causality could not be determined. However, they accounted for the level of ADHD symptoms—so they confirmed that the reduced quality of life and increased self-harm of those diagnosed are not due to the “underlying disorder,” as proponents of the ADHD diagnosis have often argued.
研究人員指出，他們的研究是觀察性的，因此無法確定因果關係。然而，他們考慮了 ADHD 症狀的嚴重程度，因此確認生活質量下降和自我傷害增加並非由“潛在疾病”引起，這與 ADHD 診斷支持者常見的論點相悖。

In conclusion, the researchers write:
研究人員在結論中寫道：

“Unfortunately, our results indicate no beneficial associations of an ADHD diagnosis with adolescents’ QOL, which is highly concerning. It implies that the harms associated with an ADHD label (such as stigma, prejudice, deflection from other problems, or the perceived inability to change) may not be offset by benefits associated with the diagnosis or treatment. This is problematic, as it indicates that youths may be harmed by the diagnosis and that interventions to support them are not achieving the desired effect.”
「不幸的是，我們的結果顯示，ADHD 診斷與青少年的生活質量（QOL）之間沒有任何有益的關聯，這是非常令人擔憂的。這意味著與 ADHD 標籤相關的傷害（如污名、偏見、對其他問題的轉移，或感覺無法改變）可能無法被診斷或治療帶來的好處所抵消。這是個問題，因為這表明青少年可能因診斷而受到傷害，並且用來支持他們的干預措施並未達到預期效果。」

Proponents of ADHD diagnosis and treatment argue that untreated ADHD negatively impacts kids’ lives. They suggest that treating ADHD symptoms can improve kids’ lives. However, previous research has not found such an effect. Instead, research has found that:
支持 ADHD 診斷和治療的人認為，未經治療的 ADHD 對孩子的生活會產生負面影響。他們主張，治療 ADHD 症狀可以改善孩子的生活。然而，之前的研究並未發現這樣的效果。相反，研究發現：

1.Stimulant drugs like Adderall and Ritalin don’t actually improve kids’ academic performance and may even increase the likelihood of kids dropping out of school;
2.Ritalin leads to an 18-fold increase in depression, which decreases back to baseline when kids stop taking the drug;
3.Stimulants stunt growth and then rapidly lead to obesity; and
4.Stimulants may lead to hallucinations and other psychotic experiences in 62.5% of kids.

1.像 Adderall 和 Ritalin 這類興奮劑實際上並不能改善孩子的學業表現，甚至可能增加孩子輟學的可能性；2.Ritalin 會導致抑鬱症發病率增加 18 倍，而當孩子停止服藥時，抑鬱症會回到基線水平；
3.興奮劑會抑制生長，並迅速導致肥胖；
4.興奮劑可能會導致 62.5% 的孩子出現幻覺和其他精神病性體驗。

Researchers have also consistently found that the youngest children in a classroom are far more likely to be diagnosed with ADHD and prescribed stimulant drugs, indicating that it is relative age—the relative immaturity of a 5-year-old compared to the 6-year-old right beside him—that accounts for many supposed “ADHD symptoms.”
研究人員還一致發現，班級中年齡最小的孩子更有可能被診斷為 ADHD 並被開具興奮劑處方，這表明所謂的 “ADHD 症狀” 很大程度上是由相對年齡引起的——即5歲的孩子與身邊6歲的孩子相比的相對不成熟。

The most well-regarded and highly cited study of childhood ADHD, the NIMH’s MTA study, found that, by the six-to-eight-year follow-up, those who received medication did no better than those who did not. Moreover, none of the treatments had been successful by that follow-up: the children who received treatment still scored worse than the normative comparison group on 91% of the measures they tested.

最受推崇且引用最多的兒童 ADHD 研究——美國國家精神衛生研究院（NIMH）的 MTA 研究發現，在六到八年的隨訪中，接受藥物治療的孩子並未比未接受藥物治療的孩子表現更好。此外，到隨訪時，所有治療均未取得成功：接受治療的孩子在所測試的 91% 指標上，得分仍然比標準對照組更差。

And in 2016, Keith Conners, who conducted the first tests of methylphenidate (Ritalin) and after whom the most-used ADHD rating scale is named, called our current use of the ADHD diagnosis “an epidemic of tragic proportions.”
2016 年，進行了首個哌甲酯（利他林）測試並且 ADHD 最常用評分量表以其名字命名的 Keith Conners 將我們當前對 ADHD 診斷的使用稱為「一場悲劇性規模的流行病」。

Kazda, L., McGeechan, K., Bell, K., Thomas, R., & Barratt, A. (2022). Association of attention-deficit/hyperactivity disorder diagnosis with adolescent quality of life. JAMA Netw Open, 5(10), e2236364. doi:10.1001/jamanetworkopen.2022.36364 (Link)

Kazda, L., McGeechan, K., Bell, K., Thomas, R., & Barratt, A. (2022)。注意力缺陷/多動障礙診斷與青少年生活質量的關聯。《JAMA Netw Open》，5(10)，e2236364。doi:10.1001/jamanetworkopen.2022.36364

Peter Simons
彼得·西蒙斯

Peter Simons was an academic researcher in psychology. Now, as a science writer, he tries to provide the layperson with a view into the sometimes inscrutable world of psychiatric research. As an editor for blogs and personal stories at Mad in America, he prizes the accounts of those with lived experience of the psychiatric system and shares alternatives to the biomedical model.
彼得·西蒙斯曾是一名心理學的學術研究員。現在作為一名科學作家，他試圖為普通讀者揭示有時難以理解的精神病學研究世界。作為《Mad in America》博客和個人故事欄目的編輯，他非常重視那些曾經親身經歷過精神醫療系統的人們的敘述，並分享與生物醫學模式不同的替代方案。