Head To Head

Is ADHD a valid diagnosis in adults? Yes

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.c549 (Published 26 March 2010) Cite this as: BMJ 2010;340:c549
  1. Philip Asherson, professor of molecular psychiatry and honorary consultant psychiatrist1,
  2. Marios Adamou, consultant psychiatrist2,
  3. Blanca Bolea, consultant psychiatrist and honorary lecturer3,
  4. Ulrich Muller, university lecturer and honorary consultant psychiatrist4,
  5. Susan Dunn Morua, founder and chairwoman adult attention deficit disorder UK (AADD-UK)5,
  6. Mark Pitts, clinical nurse specialist6,
  7. Johannes Thome, professor of psychiatry7,
  8. Susan Young, senior lecturer in clinical forensic psychology and consultant clinical and forensic psychologist8
  1. 1MRC Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King’s College London SE5 8AF
  2. 2Service for adults with ADHD, Manygates Clinic, South West Yorkshire Partnership NHS Foundation Trust, Yorkshire WF1 5PN
  3. 3University of Bristol, Bristol Adult ADHD Clinic, Avon and Wiltshire Partnership Mental Health Trust, Bristol BS2 8HW
  4. 4Adult ADHD Research Clinic, Department of Psychiatry, University of Cambridge/Cambridgeshire and Peterborough NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge CB2 2QQ
  5. 5Adult Attention Deficit Disorder UK (AADD-UK), London SW15 6NP and Bristol BS40 7RT
  6. 6Adult ADHD Service, Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London SE5 8AZ
  7. 7Swansea Medical School, University of Wales, Swansea SA2 0GH
  8. 8Department of Forensic Mental Health Science, Institute of Psychiatry, King’s College London, London SE5 8AF
  1. Correspondence to: P J Asherson philip.asherson{at}kcl.ac.uk

    Philip Asherson and colleagues argue that the concept of ADHD in adults is valid but Joanna Moncrieff and Sami Timimi (doi:10.1136/bmj.c547) believe that it is supported by little more than aggressive marketing

    Attention deficit hyperactivity disorder (ADHD) is well established in childhood, with 3.6% of children in the United Kingdom being affected.1 Most regions have child and adolescent mental health or paediatric services for ADHD. Follow-up studies of children with ADHD find that 15% still have the full diagnosis at 25 years, and a further 50% are in partial remission, with some symptoms associated with clinical and psychosocial impairments persisting.2

    ADHD is a clinical syndrome defined in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, by high levels of hyperactive, impulsive, and inattentive behaviours in early childhood that persist over time, pervade across situations, and lead to notable impairments. ADHD is thought to result from complex interactions between genetic and environmental factors.3

    Proof of validity

    Using the Washington University diagnostic criteria, the National Institute for Health and Clinical Excellence (NICE) reviewed the validity of the system used to diagnose ADHD in children and adults.4 5

    Symptoms of ADHD are reliably identifiable. The symptoms used to define ADHD are found to cluster together …

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