Give me a Patch and I will Create a Market: Institutional Disparities between Tic Disorders and ADHD in China during the Xi era

Abstract

This thesis examines the role of the state in the pharmaceuticalization of Tic Disorders (TD) and ADHD in China. Empirically, it investigates the factors that led to institutional disparities in the professional associations for TD and ADHD, two medical conditions that often coexist, during the Xi Jinping era. It asks why a national-scale, hierarchical professional association has formed around TD, a condition less diagnosed and recognized, while ADHD remains a decentralized organizational structure to date. Adopting a mixed-methods approach, this research draws on data from interviews with fifteen pediatricians, ethnographic observations at six medical conferences, and extensive digital archives, including 40 hours of conference recordings, publications in 20 medical journals and newspapers, China’s healthcare and pharmaceutical policies, and sales statistics for TD and ADHD drugs in China’s market. It argues that the contested biomedical knowledge of TD created a space for a robust network of expertise to coalesce around tics and its biopharmaceutical medication, LittlePatch. By contrast, the well-established biomedical knowledge of ADHD precluded the space to assemble a similarly centralized network of expertise around ADHD and its medications. Within these expertise networks, state actors played a central role in shaping the structure of professional associations for managing these medical conditions. This research enriches our understanding of the state’s multifaceted roles in driving medicalization processes.