Evidence and belief in attention deficit hyperactivity disorder

doi:10.1136/bmj.322.7285.555/a

BMJ 2001;322:555 ( 3 March )

Letters

Evidence and belief in attention deficit hyperactivity disorder

Narrow focus of editorial was disappointing

Reintroduction of methylphenidate in Italy needs careful monitoring

Narrow focus of editorial was disappointing

The first 150 words of the full text of this article appear below.

EDITOR $---$ The editorial by Zwi et al suggested that current practice in attention deficit hyperactivity disorder is largely basedon belief with little good evidence available.¹ Its narrowfocus on inadequate methods in studies was, however, disappointing,barely touching the surface of the controversies surrounding attentiondeficit hyperactivity disorder and the prescription of stimulants.The disorder construct raises more questions than it answers.For example, where is the cut-off point between normal behaviourand attention deficit hyperactivity disorder? Who defines this,and why? (What does the >30-fold variance in prevalence ratesin epidemiology studies mean?) Why is this diagnosis predominantlygiven to boys? (Is Western culture more concerned with externalisedbehaviour seen in boys than internalised behaviour of girls?)Why the very high rates of comorbidity with other psychiatricdisorders? (Is attention deficit hyperactivity disorder a researchgenerated idea that has little relation to the complexity commonlyfound in . . . [Full text of this article]