ADHD usually a fetal alcohol syndrome?

Often misdiagnosis ADHD
Alcohol in pregnancy usually harms the child for life. The consequences are, for example, in brain damage, growth disorders, perceptual disorders. The alcohol-related disorder syndrome is called FAS (Fetal Alcohol Syndrome) or FASD (also milder manifestations, Fetale alcohol spectrum disorder) and applies, especially if the prenatal alcohol consumption is proven, as undisputed and clearly diagnosed.

As serious as this actually easy to avoid damage is to take, so frightening is the ignorance about it. In Germany, about 2 000 FAS babies are born each year, about 10 000 are currently diagnosed. Approximately 44% of women do not know anything about the partly devastating effects of alcohol during pregnancy, and above all not that even small amounts of alcohol can have dire consequences and only protect complete abstinence. Approximately one of the 68 mothers who drink during pregnancy gives birth to a FAS child, and if you count FASD, it is more. FAS is therefore more common than Down syndrome.

ADHD diagnoses often wrong? Picture: Kitty - fotolia

In the milder forms of FASD, the syndrome has virtually the same symptoms as ADHD. "Characteristics are constant motor unrest, nervousness, very short-term interest in a task or rapid change from one toy to another, uninhibitedness and impulsivity in social behavior" (Feldmann 2017). Many FASD children receive the ADHD diagnosis, so to speak, as a bonus even though ADHD, unlike the FAS, can not be objectified at all. It is the well-known mistake to infer from a syndrome to several diseases, although these are objectively indistinguishable. A FASD child therefore has no ADHD, as long as ADHD is not objectifiable. Many ADHD children are likely to be misdiagnosed FASD children, especially if the diagnosis of alcohol was unknown, disregarded, or concealed in terms of social desirability.

So far, a connection between alcohol during pregnancy and later "ADHD" could not be proven. 6 years ago, a German research group led by Burger, PH, pointed to the methodological weakness of previous studies, in which prenatal alcohol consumption was not measured objectively but only by means of maternal self-reports, which are subject to social desirability. "The questionnaire-based / interviewed data can not be considered reliable. Studies evaluating objective alcohol degradation parameters, such as fatty acid ethyl ester or ethyl glucuronide, showed dramatically higher rates of alcohol use in pregnant women than the data suggest (Burger et al.)..

Studies that seek to investigate the association between prenatal alcohol and ADHD therefore need to use objective data. And this is exactly what a research group led by A. Eichler has now done with a prospective study: The self-reports of the examined mothers about prenatal alcohol showed no relation to the ADHD behavior of their elementary age children. However, the ethyl glucuronide levels measured at birth showed a clear correlation with cognitive development and childhood ADHD behavior 6 years later at primary school age. Behind "ADHD" can also hide a fetal alcohol syndrome. (Dipl.-Psych. Hans-Reinhard Schmidt)

Swell:

1. P.H. Burger, T.W. Goecke, P.A. Fasching, G.Moll, H.Heinrich, M.W. Beckmann, J. Kornhuber: Influence of maternal alcohol consumption during pregnancy on the development of ADHD in the child. Georg Thieme 2011.

2. The Drugs Commission of the Federal Government: Alcohol Use in Pregnancy and Fetal Alcohol Syndrome. 1. 11.2016

3. DER SPIEGEL: Every fourth pregnant woman in Germany drinks alcohol.

4. Eichler A et. al .: Effects of prenatal alcohol consumption on cognitive development and ADHD-related behavior in primary-school age: a multilevel study based on meconium ethyl glucuronide. J Child Psychol Psychiatry 2017 Sep 11.

Feldmann, R .: The Fetal Alcohol Syndrome. Campus Münster 2017