Commentary: Controversies in NICE guidance on attention-deficit/hyperactivity disorder

In 2002 both attention-deficit disorder and hyperactivity appeared in a list of human problems that BMJ readers believed were “non-diseases.”1 In producing its third and most comprehensive synthesis of research, clinical consensus, and economic analysis on attention-deficit/hyperactivity disorder (ADHD),2 the National Institute for Health and Clinical Excellence (NICE) will no doubt fuel the controversy about the nature of ADHD.

The full report of the NICE guidance acknowledges the social scientific paradigm that casts doubt on the utility and appropriateness of ADHD as a diagnostic category. The report goes on to examine the diagnosis of ADHD and concludes it is a valid concept. Persistent sceptics will read sobering accounts from both research and personal testimony of the impairment experienced by hyperactive people, including the iatrogenic impairment resulting from professional ignorance and disbelief.

If those who purchase services fund fully NICE’s recommendations for …