Intended for healthcare professionals

Views & Reviews Review

Has Ritalin replaced the rod?

BMJ 2012; 345 doi: (Published 19 December 2012) Cite this as: BMJ 2012;345:e8532
  1. Iain McClure, consultant child and adolescent psychiatrist, Royal Hospital for Sick Children, Edinburgh, UK
  1. iain.mcclure{at}

The current construct of attention-deficit/hyperactivity disorder (ADHD) may not be helping us understand hyperactivity. Iain McClure finds this book a good starting point for inquiry

Psychiatric conditions are best fit constructs, informed both by science and the society within which they are observed. Some have stood for centuries, owing to their persistence through subjective human internal experience and observed external behaviour. Thus melancholia has transmuted into depression. Matthew Smith’s Hyperactive argues that it is by no means certain that similar longevity will be accorded to attention- deficit/ hyperactivity disorder (ADHD).

Instead, argues Smith, a lecturer in the history of medicine at the University of Strathclyde and a 2012 BBC Radio 3 “new generation thinker,” if more attention were applied to the complex underpinnings of ADHD, a less impulsive social and scientific understanding of this aspect of human behaviour might result.

Hyperactive shows that hyperactivity, and how it is defined and construed, is a touchstone of psychiatry’s increasing identity confusion since the 1950s. In place of the ascent of ADHD as a child psychiatric condition to a position …

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