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Scientists find new disease: motivational deficiency disorder

BMJ 2006; 332 doi: http://dx.doi.org/10.1136/bmj.332.7544.745-a (Published 30 March 2006) Cite this as: BMJ 2006;332:745
  1. Ray Moynihan
  1. Sydney

    Extreme laziness may have a medical basis, say a group of high profile Australian scientists, describing a new condition called motivational deficiency disorder (MoDeD).

    The condition is claimed to affect up to one in five Australians and is characterised by overwhelming and debilitating apathy. Neuroscientists at the University of Newcastle in Australia say that in severe cases motivational deficiency disorder can be fatal, because the condition reduces the motivation to breathe.

    Neurologist Leth Argos is part of the team that has identified the disorder, which can be diagnosed using a combination of positron emission tomography and low scores on a motivation rating scale, previously validated in elite athletes. “This disorder is poorly understood,” Professor Argos told the BMJ. “It is underdiagnosed and undertreated.”

    Professor Argos is an adviser to a small Australian biotechnology company, Healthtec, which is currently concluding phase II trials of indolebant, a cannabinoid CB1 receptor antagonist. Although still unpublished, the preliminary results from the company's phase II studies are promising, according to Professor Argos: “Indolebant is effective and well tolerated. One young man who could not leave his sofa is now working as an investment adviser in Sydney.”

    David Henry, a clinical pharmacologist at the University of Newcastle and long time critic of pharmaceutical marketing strategies, says that although he appreciates that some people with severe motivational deficiency disorder may need treatment, he is concerned that the prevalence estimates of one in five are inflated and that ordinary laziness is being medicalised. “Indolebant may bring some relief to those with a debilitating form of MoDeD, but common laziness is not a disease. People have an absolute right to just sit there.”



    Embedded Image

    “People have an absolute right to just sit there”

    Credit: ALEX & IAILA/STONE+/GETTY IMAGES

    Professor Henry has organised a conference at Newcastle University to highlight what he describes as “disease mongering,” which will take place 11-13 April 2006 (www.diseasemongering.org). The conference will produce a consensus statement to be published in PLoS Medicine, which will launch its theme issue on disease mongering this week.

    A study of the economic impacts of motivational deficiency disorder estimates the condition may be costing the Australian economy $A2.4bn (£970m; €1.4bn; $1.7bn) a year in lost productivity. This has prompted calls from industry and advocacy groups for a fast tracking of the regulatory assessment of indolebant in Australia and worldwide.