<story><title>Overselling A.D.H.D.</title><url>http://www.nytimes.com/2016/08/28/books/review/adhd-nation-alan-schwarz.html</url></story><parent_chain><item><author>panglott</author><text>The thing is, diagnosis rates in the U.S. are something like 3-4 times as high as in most countries in Europe, which are themselves 3-4 times as high as a country like France, which is averse to ADHD diagnoses. The main treatment for ADHD is lifelong maintenance of powerful amphetamines, when we have no idea what the long-term consequences of that would be, nor what proportion of children would normally develop out of the ADHD spectrum with time.&lt;p&gt;Overdiagnosis at that rate means that millions of children are being given amphetamines, when they shouldn&amp;#x27;t be!</text></item><item><author>anexprogrammer</author><text>As someone in my 5th decade, with lifelong ADHD (though given my age it did not exist in my youth, and was only diagnosed relatively recently), I&amp;#x27;m wary of backing away from treatments until we actually do have real viable alternatives.&lt;p&gt;It took far too long to get ADHD widely recognised, and even now it&amp;#x27;s often more likely to be received with humour than real recognition.  Much more research, especially on other possible treatments and therapies, is needed before we turn too zealously against the only treatment actually shown to work.  We have a long history of over diagnosing and overdoing pretty much everything.&lt;p&gt;I&amp;#x27;ve only ever managed it with limited success.  There&amp;#x27;s little doubt that the &lt;i&gt;drugs can work.&lt;/i&gt;  Despite some evidence of over-diagnosis and over-prescription there are many people who have had their prospects transformed as a result.  I suggest the ADHD label is being significantly over applied because real awareness, even in the medical profession, is still abysmal.  Doctors don&amp;#x27;t have time to look at home circumstances, or parents and other factors that might affect behaviour.  Awareness coming from some TV comedy skit however is high.&lt;p&gt;I don&amp;#x27;t actually care that we don&amp;#x27;t yet have full understanding of how the drugs work, or that OMG they&amp;#x27;re amphetamines. I &lt;i&gt;often&lt;/i&gt; wonder how things may have turned out differently for me had I encountered more GP awareness and less ridicule, or even earlier self-awareness or teen diagnosis and treatment.&lt;p&gt;If we are too successful &amp;quot;exposing big pharma&amp;quot; and overdiagnosis in the minds of GPs and the public, lives will be ruined once again. Let&amp;#x27;s not throw the baby out with the bathwater here rather than seek wider understanding.</text></item></parent_chain><comment><author>anexprogrammer</author><text>We don&amp;#x27;t yet know how many of those are being overdiagnosed - we don&amp;#x27;t yet know the limits of the spectrum.  There&amp;#x27;s a lot of opinion on both sides, which is never helpful.&lt;p&gt;I can say that I wish I had had 30 more years on amphetamines, the difference has been marked.  For the first time &lt;i&gt;in my life&lt;/i&gt; the engine wasn&amp;#x27;t misfiring.  If it were certain to take a decade or more of my remaining life, I&amp;#x27;d continue fully aware.  I still drift, but I think that&amp;#x27;s more because I have the habits. For me it&amp;#x27;ll still be a lifelong process to try and correct the bad habits and thought patterns reinforced throughout the first half of my life.  Others will be less clear beneficiaries of treatment or better served in other ways.&lt;p&gt;I think diagnosing and treating toddlers and 7 year olds is appalling - better to try and manage it, or look into causative factors like poor home environment and such.  A more Scandinavian approach to school may help more (The UK would benefit from this too).  A good proportion will grow out of it.  That comes back to wider &lt;i&gt;real&lt;/i&gt; awareness though especially with first contact - teachers and GPs etc.</text></comment>
<story><title>Overselling A.D.H.D.</title><url>http://www.nytimes.com/2016/08/28/books/review/adhd-nation-alan-schwarz.html</url></story><parent_chain><item><author>panglott</author><text>The thing is, diagnosis rates in the U.S. are something like 3-4 times as high as in most countries in Europe, which are themselves 3-4 times as high as a country like France, which is averse to ADHD diagnoses. The main treatment for ADHD is lifelong maintenance of powerful amphetamines, when we have no idea what the long-term consequences of that would be, nor what proportion of children would normally develop out of the ADHD spectrum with time.&lt;p&gt;Overdiagnosis at that rate means that millions of children are being given amphetamines, when they shouldn&amp;#x27;t be!</text></item><item><author>anexprogrammer</author><text>As someone in my 5th decade, with lifelong ADHD (though given my age it did not exist in my youth, and was only diagnosed relatively recently), I&amp;#x27;m wary of backing away from treatments until we actually do have real viable alternatives.&lt;p&gt;It took far too long to get ADHD widely recognised, and even now it&amp;#x27;s often more likely to be received with humour than real recognition.  Much more research, especially on other possible treatments and therapies, is needed before we turn too zealously against the only treatment actually shown to work.  We have a long history of over diagnosing and overdoing pretty much everything.&lt;p&gt;I&amp;#x27;ve only ever managed it with limited success.  There&amp;#x27;s little doubt that the &lt;i&gt;drugs can work.&lt;/i&gt;  Despite some evidence of over-diagnosis and over-prescription there are many people who have had their prospects transformed as a result.  I suggest the ADHD label is being significantly over applied because real awareness, even in the medical profession, is still abysmal.  Doctors don&amp;#x27;t have time to look at home circumstances, or parents and other factors that might affect behaviour.  Awareness coming from some TV comedy skit however is high.&lt;p&gt;I don&amp;#x27;t actually care that we don&amp;#x27;t yet have full understanding of how the drugs work, or that OMG they&amp;#x27;re amphetamines. I &lt;i&gt;often&lt;/i&gt; wonder how things may have turned out differently for me had I encountered more GP awareness and less ridicule, or even earlier self-awareness or teen diagnosis and treatment.&lt;p&gt;If we are too successful &amp;quot;exposing big pharma&amp;quot; and overdiagnosis in the minds of GPs and the public, lives will be ruined once again. Let&amp;#x27;s not throw the baby out with the bathwater here rather than seek wider understanding.</text></item></parent_chain><comment><author>scottmf</author><text>&amp;gt;we have no idea what the long-term consequences of that would be&lt;p&gt;Perhaps &lt;i&gt;you&lt;/i&gt; have no idea, but we actually have a pretty good idea from 80 years of stimulant medication usage.&lt;p&gt;Do you have data suggesting negative consequences of decades of stimulant usage?&lt;p&gt;No? Then it&amp;#x27;s surely the best decision to ignore this FUD and continue treating people &lt;i&gt;of all ages&lt;/i&gt; with stimulants which have been shown to be safe in such low doses.&lt;p&gt;Particularly when we have evidence suggesting &lt;i&gt;not medicating&lt;/i&gt; is dangerous, as I mentioned in my other comments.</text></comment>