Head To Head

Is ADHD a valid diagnosis in adults? No

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c547 (Published 26 March 2010) Cite this as: BMJ 2010;340:c547
  1. Joanna Moncrieff, senior lecturer and honorary consultant psychiatrist1,
  2. Sami Timimi, consultant child and adolescent psychiatrist and visiting professor of child and adolescent psychiatry, Lincoln University2
  1. 1University College London and North East London Mental Health Trust, UCL Department of Mental Health Sciences, London W1W 7EJ
  2. 2Lincolnshire Partnership NHS Foundation Trust, Sleaford, NG34 8QA
  1. Correspondence to: J Moncrieff j.moncrieff{at}ucl.ac.uk
  • Accepted 14 December 2009

Philip Asherson and colleagues argue that the concept of ADHD in adults is valid (doi:10.1136/bmj.c549) but Joanna Moncrieff and Sami Timimi believe that it is supported by little more than aggressive marketing

Interest in adult attention deficit hyperactivity disorder (ADHD) has grown rapidly in some countries because drug companies have realised that it provides an “expanding and lucrative market” for stimulants and related drugs.1 They have promoted the concept by suggesting that common behaviours, such as forgetting car keys, may be symptoms,2 and many adults are being diagnosed who were never diagnosed as children. We explain why little more than aggressive marketing is available to support adult ADHD.

Diagnostic validity

Whether childhood ADHD is a valid and useful diagnosis is disputed on many grounds, including lack of physical or psychological markers, high comorbidity rates, difficulty in differentiating normal symptoms from pathological ones, inconsistent clustering of symptoms, differing cultural perceptions and variation of diagnosis across sex and class,3 and serious adverse outcomes being more strongly related to co-occurring problems such as conduct disorder and familial conflict.4 Even if we accept childhood ADHD as valid, the …

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