Follow up to ADHD Post

Here's one article suggesting that ADHD is not overdiagnosed and, among select populations, is actually underdiagnosed. I realize it's from 2002, but this controversy has been going on since the mid-90s. I also don't have the time to do more thorough searches on this.

Of course, at this point, it's important to point out that proper diagnosis depends on a child meeting the diagnostic criteria set (I presume from my days in psych classes) by the American Psychiatric Association's Diagnostic and Statistics Manual (probably version IV -- though it may be IV-R by now -- I don't know off the top of my head and I don't feel like figuring it out ). So, it is possible for someone to disagree with the criteria themselves. However, in that Washington Post article I refer to in an earlier post on this, Roberts certainly does not take that approach. Rather, she just blatantly states that children are being overdiagnosed without any evidence to back her up.

As I mentioned, it has become popular sentiment for people to say that ADHD is overdiagnosed. However, assuming that that is not the case, I think the real problem may lie in our discomfort with the idea of children having psychiatric problems -- or as Roberts labels them "mental illnesses". Obviously, the use of such labels carries negative connotations and "mentally ill" is normally reserved for more serious problems, particularly those in which the patients are not fully in touch with reality. Roberts uses this term to pull at people's emotions because no one likes to think of children with ADHD as "mentally ill" or even of having a psychiatric disorder.

Perhaps what would be best is to do away with such terms. These terms create a false dichotomy between "normal" and "abnormal". They fail to take into account that brains, even those without psychiatric disorders, are not all the same and each has its own quirks. Some quirks are more serious than others and impair people's abilities. Some are so serious that people are no longer able to function within society. When we consider that such "quirks" of the brain are creating problems for people, then it seems reasonable to determine whether we can treat them. This certainly applies to ADHD as much as it applies to more serious disorders such as schizophrenia.

I also believe that people believe ADHD is overdiagnosed in part because it did not used to have such prevalence. Mostly, that's due to the fact that psychiatry, as performed in a more rigorous, scientific, criteria-driven manner, is actually a recent phenomenon (~40 years old). Without the ability to simply peer into someone's head to see what's wrong and with the vast array of possible things that CAN go wrong in someone's head, it's not surprising that so many diagnoses have been created in the past 40 years (or less). It's also not going to be the least bit surprising to me that such diagnoses will be refined and changed as knowledge of the brain becomes better.