Editorials

Attention deficit hyperactivity disorder

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7113.894 (Published 11 October 1997) Cite this as: BMJ 1997;315:894

There is no easy answer on whether to medicate or not

  1. Florence Levy, Senior staff specialista
  1. a Prince of Wales Hospital, University of New South Wales, Randwick, New South Wales 2031, Australia

    A syndrome that was described by the ancient Greeks and has been widely observed by physicians since then is likely to have considerable face validity, but there continues to be disagreement about the diagnosis, cause, prevalence, and treatment of attention deficit hyperactivity disorder.1 From the beginning of this century the concept of the condition has evolved from it being a biologically based disorder of behaviour control, from a condition with minimal brain dysfunction, to a disorder characterised by a deficit of attention.2 The main controversy now is about how to treat the condition.

    The past 20 years have seen the development of diagnostic criteria in both Britain and America. In 1981 the criteria of the Diagnostic and Statistical Manual version III (DSM-III) departed from those of the International Classification of Diseases ninth edition (ICD-9) in creating subtypes of attention deficit disorder with and without hyperactivity. Meanwhile, the ICD-9 continued to emphasise “pervasive hyperactivity” as the hallmark of …

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