Whoa, that does sound like an extreme position! I've never stated anything even remotely similar to that though. All of medicine includes errors, bias, and sometimes even outright dodgy dealings, but my point is simply that the evidence clearly shows that there is no systematic problem of overdiagnosis. There may be influence from drug companies but we know that this influence must be minimal given that the rate of diagnosis is still lower than the actual prevalence rate and the rates in the US are consistent with the rest of the world (where pharmaceutical companies have no direct way of affecting the judgement of clinicians). More importantly, the people who make the diagnoses are usually clinical psychologists who have no prescribing rights anyway and they have to give their "business" to someone else to treat them, which doesn't seem like the best way to make a profit.JimC wrote:There seems to be two extremes in this ADHD debate. One is those who are convinced that either it does not exist, or that, even if it does, it is a condition that can always be dealt with by either a change in diet, counselling or better parenting/teaching.
The other seems to come from Mr Samsa, stating basically that every (or virtually ever) case of ADHD is a correct diagnosis, with the right prescription, and that there is simply no possibility of a degree of over diagnosis or prescription, and that the pharmaceutical industry has no impact on doctor's decisions at all...
And again the evidence shows that there is currently a problem of underprescription due to the "what about the children!" mommy-science that is affecting our ability to treat these kids in the same way that the Wakefield fears have affected vaccination rates. There may be pockets and areas of overprescription but we do know that, on the whole, there is a serious problem of underprescription that needs to be addressed and fixed.
This isn't an opinion topic. You can't say that holding the middle ground is the most rational when the evidence flatly states that it's false. We don't have to entertain the idea that there is a problem of overprescription when there isn't. This is the same problem with the "false balance" debates we have on TV where they pit a single scientist against a single vaccine denier, or a single scientist against a single climate change denier. We don't have to afford an equal amount of time to things which are wrong just because we have this irrational need for "fairness".
Journalists eh? Too bad the actual evidence suggests otherwise. I'll give you one thing though - there is a problem with GPs trying to diagnose and treat ADHD, and that's the suspected reason for some fluctuation and instances of overdiagnosis in certain parts, but there is no evidence of systematic overdiagnosis. As I've explained, if anything, there is a serious problem of underdiagnosis and undertreatment.JimC wrote:I'm certain, like Hermit, that the condition exists, and that treatment by drugs can be very effective, because I've seen in with my own eyes. However, I have read many a report by responsible journalists suggesting that over-prescription, for a variety of reasons, is a real phenomenon. It doesn't take a weird conspiracy theory to understand that a variety of human motivations from companies and individuals can and does distort rational decision making...
The fact that these discussions always devolve into comments along the lines of: "I believe ADHD exists but too many normal kids who just have too much energy are just being diagnosed to make them easier to control by their teachers and parents" demonstrates that the people who tend to like discussing this topic don't have the basic knowledge they need to have to meaningfully comment on it. Like I mention above, it's like entering a vaccination discussion and saying that you think that they can work for some people but there's a problem with them being given to too many children.
No, by all accounts we have the opposite problem. There may be some areas where there is a problem of overdiagnosis or overprescription but focusing on them in a discussion of ADHD is like worrying about dropping a glass of milk in your kitchen whilst an earthquake rips your city apart - yes, it's a problem that the milk might stain your floor but how about we deal with the more pressing issue first?
