Why there’s no ADHD in France

Amy Taylor May 22, 2013

Attention deficit/hyperactivity disorder or ADHD is a behavioural disorder that affects one in twenty children in the United States, according to a study published in the journal World of Psychiatry. The predominance of American research for the past decades has led to the impression that ADHD is an American disorder that is less prevalent in other countries, most especially in France. Why?

Why is ADHD not common in France as it is in the US?

Let us begin this discussion by understanding how ADHD is viewed by French psychologists and how it is different from the perception of American doctors. In the United States, experts consider ADHD as a purely biological disorder that has biological causes, for example, a chemical imbalance in the brain. Because of this, American children diagnosed with ADHD are treated with medications, particularly psycho stimulant drugs such as Ritalin and Adderall.

In France however, psychiatrists look at it as a medical condition that has social and situational causes. Instead of treating the behavioural problems of the child using medications, French doctors start with identifying the root causes of the child’s distress. The patient is then treated using psychotherapy or family counselling. These techniques do not involve the use of medications, rather, thought-altering therapies that help the child deal with his or her condition.

Another thing, French doctors do not use the Diagnostic and Statistical Manual of Mental Disorders (DSM) in the classification of childhood emotional problems, which is widely used in the United States. The French Federation of Psychiatry has created their own system called Classification Française des Troubles Mentaux de L’Enfant et de L’Adolescent (CFTMEA). This was designed to identify and address the underlying psychosocial issues that trigger the symptoms of behavioural disorders rather than to develop pharmacological interventions that do not necessarily address the root cause of the problem but only masks its symptoms.

Role of Nutrition and Parenting on ADHD

Because of the holistic approach of French doctors in treating children with ADHD, part of the treatment gives emphasis on the role of nutrition. They believe that some foods, particularly the processed ones, affect the behaviour of some children and worsen their symptoms. On the other hand, fresh and healthy foods such as fruits and vegetables contribute to the improvement of the symptoms, particularly in the mood of the child. In the United States, interventions only focus on the use of pharmaceutical drugs and less, if there’s any, to diet.

The low rate of ADHD in France can also be attributed to how children are raised by their parents. From the time they were born, these kids are given a cadre or “structure” that they should follow. For example, mealtimes are scheduled four times a day and children are not allowed to eat whenever they want. These kids are also aware of their limitations. Yes, even at an early age, most French children are already aware of the concept of “self-control”.

All these things – from the definition to the treatment approach and parenting styles – contribute to the low prevalence of ADHD in France which is only less than .5%. That is very, very small as compared to the prevalence of ADHD in the United States, which is 9%. What does this mean to all of us? It means it is possible to protect children from ADHD. No one could confirm whether the French concept of ADHD is right and the American concept is wrong, or vice versa. But the statistic shows that the French approach is much better. If their way of treating ADHD will be used in other parts of the world, probably fewer children will be diagnosed with this debilitating disorder. What do you think? Share your insights by posting a comment below.