ADHD

Distinguished developmental psychologist Jerome Kagan argues that the current spate of childhood mental health diagnoses such as ADHD and bipolar disorder do not represent biological diseases but rather convenient explanations that get us off the hook by covering up social problems. He discusses social trends that may account for childhood behavioral difficulties.

via Cerebrum

I agree that childhood disorders are overdiagnosed and that, in general, we are in an era of overmedicalization of behavioral problems for a variety of reasons, not the least of them being the influence of Big Pharma. I hope no one thinks any longer that psychiatric diagnoses are immutable gospel truths. From revision to revision, the nomenclature changes. The boundaries of what is considered psychopathology expand and contract (in this era, mostly expand) and the internal pigeonholes are everchanging. Our research practices, supposed to contribute to “evidence-based” medical reasoning, compound the errors, because drug companies have a subtle and not-so-subtle vested interest in the results, they fund much of it, and there is an inherent bias against the publication of negative or disconfirmatory results.

On the other hand, let us not throw the baby out with the bathwater. We should be long past the need to debate nature vs. nurture in mental ilness, social context vs. biology. There are of course contributions of both, and Dr Kagan’s argument should not be seen as dismissing the biological bases of behavioral problems whole hog. I do agree with him, vehemently, though, that overdiagnosis and overattribution is rife, and that it is obscene when you look at the major consequences, the pathologizatioon and the foisting of enormous volumes of medication on our children and youth. A good psychiatrist’s role should be as much to take patients off medication as to get them on it.

See also:

• What Determines the Diagnosis of Adhd?
• ADHD drugs should be last resort: new guidelines
• Magazine Preview: The Bipolar Puzzle
• 3 Ways to Be Wise About Psychiatric Drugs for Kids
• Treatment And Diagnosis Of Mental Disorders In Children
• Tranquillisers putting lives at risk
• Coping With Bipolar Disorder in Children
• When Are Therapeutic Interventions Recommended?