Intended for healthcare professionals

Views & Reviews From the Frontline

Bad medicine: adult attention-deficit/hyperactivity disorder

BMJ 2011; 343 doi: (Published 07 November 2011) Cite this as: BMJ 2011;343:d7244
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

US medicine is a paradox—the best and the worst of medicine. US psychiatry engages in widespread polypharmacy and willingly medicates children, actions that I profoundly fail to understand. How did US psychiatry get to this point?

My theory runs like this. The Diagnostic and Statistical Manual of Mental Disorders (DSM) defines a condition. But this is descriptive, almost literary narrative, not robust science. This description is loose, so loose that it always includes traits common to us all. Psychiatry has thus become pharma’s goldmine, with a simple business plan. Seek a small group of …

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