ADHD and MBD in Norway

Curious about potential cross-cultural differences in the perception of ADHD (Attention Deficit Hyperactivity Disorder), I took a look through articles on the topic appearing in Norwegian newspapers over the last few years. While ADHD is not as high profile in Norway as it is in the United States, I came across some interesting similarities and differences that represent a range of viewpoints.

ADHD in Norway more so than in the US is still referred to sometimes as MBD (Minimal Brain Dysfunction). This is a term that fell out of common usage in the United States some years ago, in preference for terms such as ADD (Attention Deficit Disorder) and ADHD. The change was partially due to differences in how it was thought the specific mechanisms of the disorder worked and related also to the stigmatizing label of brain dysfunction, a term that blames the whole brain, rather that aspects of it.

As with the United States, boys are far more likely than girls to be diagnosed with ADHD, leading officials to worry that a feminization of teaching styles and preferences is influencing the number of boys diagnosed as hyperactive each year. It was reported last September that boys account for approximately 70% of the special education instruction available in Norway. In regular classes, girls overall tended to score higher in all subjects, with the exception of physical education.

According to an article in the Norwegian paper VG, whereas about 1000 children in Norway were taking medications such as Ritalin for the disorder in 1996, by 2000 this number had doubled. Parliament representative Ursula Evje expressed fears in November of last year that the ease and relatively low expense of medicating disruptive children had effectively blocked efforts to work with teachers in adjusting their curriculum and teaching styles.

In 1997, two researchers with the Norwegian Institute for City and Regional Research (NIBR) suggested that those diagnosed with ADHD were attracted in large numbers to extreme rightist groups, including neo-nazi and criminal organizations. “It looks like people diagnosed with ADHD, Tourettes, and Aspergers syndrome are over represented in the extreme right miljø. Many young people with these diagnoses have problems with empathy. It could be said that they have problems putting themselves in another person’s situation,” said one of these researchers, Yngve Carlsson.

While some say that Norway’s children are in danger of misdiagnosis and overmedication, others complain that children aren’t receiving the help they need due to an overburdened health system. In Norway, only pediatric specialists can diagnose children with ADHD. Family practitioners may do follow-up work, but many are reluctant to because they feel inadequately educated on disorders such ADHD. As a result, it may takes years to receive a confirming diagnosis and prescriptions for behavioral disorders.

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