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[Discussion of attention deficit-hyperactivity disorder (ADHD): facts, opinions and emotions]
1Universitair Medisch Centrum, afd. Kinderpsychiatrie, Postbus 85.500, 3508 GA Utrecht. j.k.buitelaar@psych.azu.nl
Abstract:
Critics of the concept of attention deficit/hyperactivity disorder (ADHD) claim that it is not a clear-cut psychiatric disorder, but rather a social stigma attached to a child that is difficult to handle. The counter-argument to this view is that ADHD is a descriptive diagnosis in which indices of the severity of behaviour enable it to be distinguished from normal behaviour. Both over-diagnosis and under-diagnosis occur. Treatment with medications is criticised on the basis that it is an inadequate replacement for good parenting and education, that it medicalises a psychosocial problem but does not cure it, and that the long-term effects of this approach have not been proven. Those in favour of medical treatment claim that medication and efforts to improve parenting and education are not counter-effective, but that they complement each other. Medication is an important contributory factor in the proper care of ADHD patients. Treatment with psychostimulants is criticised on the basis that the extent of the side-effects are underestimated, and that there is a risk of addiction. However, proponents of this approach claim that, if used correctly, the unpleasant side-effects only occur in a small minority of children.