ADHD awareness may cause false self-diagnoses, study finds

A new study from the University of Toronto (U of T Scarborough) has found that raising awareness of attention deficit hyperactivity disorder (ADHD) can lead to false self-diagnoses among young people.

The work, published in the journal Psychological Medicine, showed that information campaigns aimed at raising awareness of ADHD sometimes cause healthy people to believe they suffer from the disorder, even if there are no clinical symptoms.

But the scientists also found a way to reduce this effect: a short educational session about the so-called "nocebo effect," a phenomenon in which a person's negative expectations intensify or even cause symptoms of the disorder.

"We wanted to understand whether educational programmes have side effects and how to make them safer and more balanced," explains study author Dasha Sandra, a PhD student in the Department of Psychology.

When knowledge leads to mistakes

The study involved 215 young people aged 18-25 who had no diagnosis of ADHD and no clinical signs of the disorder. The participants were divided into three groups:

• the first underwent a conventional seminar on ADHD awareness;

• the second received the same seminar but with a 10-minute module on the nocebo effect;

• the third group listened to a lecture on sleep (control group).

The results were striking. After the seminar on ADHD, the number of participants who were sure they had the disorder rose from 30 per cent to 60 per cent, and after a week about half still thought they were ill - even though their actual symptoms hadn't changed.

But in the group told about the nocebo effect, the proportion of false self-diagnoses halved immediately and disappeared completely after a week.

Why it happens

Awareness can inadvertently cause people to perceive ordinary life difficulties as signs of mental illness, Sandra says.

"The certainty that you have a diagnosis helps give meaning to the chaos of everyday experiences that may actually be completely normal - especially in young people," says the researcher.

She notes that this phenomenon is similar to the classic medical nocebo effect: patients in clinical trials report side effects even if they receive a dummy, simply because they expect negative consequences.

How to make education safer

Sandra's team suggested adding short modules to mental health programmes explaining the nocebo effect. In about 10 minutes, participants are told that irritability, fatigue and difficulty concentrating are common in students and are not necessarily indicative of a disorder.

This approach, the scientists believe, could be easily incorporated into school and university courses, as well as online resources.

The researchers stress that their findings do not mean that mental health programmes are harmful. On the contrary, they are vital - especially as ADHD still often goes undiagnosed in women and adults.

"It's important not to reduce awareness but to improve the quality of awareness. People need to be helped to interpret their experiences correctly," emphasises Sandra.

Researchers warn that false self-diagnosis can get in the way of getting real help and divert resources away from those who really need professional support.