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The youngest get the pill: ADHD misdiagnosis in Germany, its regional correlates and international comparison

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  • Schwandt, Hannes
  • Wuppermann, Amelie

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) is a leading diagnosed health condition among children in many developed countries but the causes underlying these high levels of ADHD remain highly controversial. Recent research for the U.S., Canada and some European countries shows that children who enter school relatively young have higher ADHD rates than their older peers, suggesting that ADHD may be misdiagnosed in the younger children due to their relative immaturity. Using rich administrative health insurance claims data from Germany we study the effects of relative school entry age on ADHD risk in Europe's largest country and relate the effects for Germany to the international evidence. We further analyze different mechanisms that may drive these effects, focusing on physician supply side and demand side factors stemming from the production of education. We find robust evidence for school-entry age related misdiagnosis of ADHD in Germany. Within Germany and internationally, a higher share of misdiagnoses are related to a higher overall ADHD level, suggesting that misdiagnoses may be a driving factor of high ADHD levels. Furthermore, the effects in Germany seem to be driven by teachers and parents in an attempt to facilitate and improve the production of education. (C) 2016 Published by Elsevier B.V.

Suggested Citation

  • Schwandt, Hannes & Wuppermann, Amelie, 2016. "The youngest get the pill: ADHD misdiagnosis in Germany, its regional correlates and international comparison," Munich Reprints in Economics 43485, University of Munich, Department of Economics.
    • Handle: RePEc:lmu:muenar:43485
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    References listed on IDEAS

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    Cited by:

    1. Persson, Petra & Qiu, Xinyao & Rossin-Slater, Maya, 2021. "Family Spillover Effects of Marginal Diagnoses: The Case of ADHD," IZA Discussion Papers 14020, Institute of Labor Economics (IZA).
    2. Simone Balestra & Beatrix Eugster & Helge Liebert, 2017. "The Effect of School Starting Age on Special Needs Incidence and Child Development into Adolescence," CESifo Working Paper Series 6837, CESifo.
    3. Persson, Petra & Qiu, Xinyao & Rossin-Slater, Maya, 2021. "Family Spillover Effects of Marginal Diagnoses: The Case of ADHD," CEPR Discussion Papers 15660, C.E.P.R. Discussion Papers.
    4. Fumarco, L. & Baert, S. & Sarracino, F., 2020. "Younger, dissatisfied, and unhealthy – Relative age in adolescence," Economics & Human Biology, Elsevier, vol. 37(C).
    5. Michael Bahrs & Mathias Schumann, 2020. "Unlucky to be young? The long-term effects of school starting age on smoking behavior and health," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(2), pages 555-600, April.
    6. Marcus, Jan & Reif, Simon & Wuppermann, Amelie & Rouche, Amélie, 2020. "Increased instruction time and stress-related health problems among school children," Journal of Health Economics, Elsevier, vol. 70(C).
    7. Berniell, Inés & Estrada, Ricardo, 2020. "Poor little children: The socioeconomic gap in parental responses to school disadvantage," Labour Economics, Elsevier, vol. 66(C).
    8. Fumarco, Luca & Baert, Stijn, 2019. "Relative age effect on European adolescents’ social network," Journal of Economic Behavior & Organization, Elsevier, vol. 168(C), pages 318-337.
    9. Mari, Gabriele, 2023. "Less for more? Cuts to child benefits, family adjustments, and long-run child outcomes in larger families," SocArXiv e3n82, Center for Open Science.
    10. Kelly Bedard & Allison Witman, 2020. "Family structure and the gender gap in ADHD," Review of Economics of the Household, Springer, vol. 18(4), pages 1101-1129, December.
    11. Jill Furzer & Elizabeth Dhuey & Audrey Laporte, 2022. "ADHD misdiagnosis: Causes and mitigators," Health Economics, John Wiley & Sons, Ltd., vol. 31(9), pages 1926-1953, September.
    12. Bahrs, Michael & Schumann, Mathias, 2016. "Unlucky to Be Young? The Long-Term Effects of School Starting Age on Smoking Behaviour and Health," hche Research Papers 13, University of Hamburg, Hamburg Center for Health Economics (hche).
    13. Kivinen, Aapo, 2018. "The Effect of Relative School Starting Age on Having an Individualized Curriculum in Finland," Working Papers 104, VATT Institute for Economic Research.
    14. Peña, Pablo A., 2020. "Relative age and investment in human capital," Economics of Education Review, Elsevier, vol. 78(C).
    15. Schwandt, Hannes, 2017. "The Lasting Legacy of Seasonal Influenza: In-utero Exposure and Labor Market Outcomes," DaCHE discussion papers 2017:5, University of Southern Denmark, Dache - Danish Centre for Health Economics.
    16. Bertoni, Marco & Marin-Lopez, Blas A. & Sanz-de-Galdeano, Anna, 2023. "Subjective Gender-Based Patterns in ADHD Diagnosis," IZA Discussion Papers 16634, Institute of Labor Economics (IZA).
    17. Fumarco, Luca & Baert, Stijn, 2018. "Younger and Dissatisfied? Relative Age and Life-satisfaction in Adolescence," MPRA Paper 89968, University Library of Munich, Germany.
    18. Seth M. Freedman & Kelli R. Marquardt & Dario Salcedo & Kosali I. Simon & Coady Wing, 2023. "Societal Disruptions And Child Mental Health: Evidence From ADHD Diagnosis During The COVID-19 Pandemic," NBER Working Papers 30909, National Bureau of Economic Research, Inc.
    19. Landry, Peter, 2021. "A behavioral economic theory of cue-induced attention- and task-switching with implications for neurodiversity," Journal of Economic Psychology, Elsevier, vol. 86(C).
    20. Bertoni, M.; & Marin-Lopez, B.A.; & Sanz-de-Galdeano, A.;, 2023. "Subjective Gender-Based Patterns in ADHD Diagnosis," Health, Econometrics and Data Group (HEDG) Working Papers 23/17, HEDG, c/o Department of Economics, University of York.
    21. Marie Connolly & Catherine Haeck, 2018. "Le lien entre la taille des classes et les compétences cognitives et non cognitives," CIRANO Project Reports 2018rp-18, CIRANO.

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