Attention-deficit/hyperactivity disorder: are we helping or harming?

Clarification—Contrary to the statement in the second paragraph and the first sentence in box 1 of this Analysis article by Rae Thomas and colleagues (BMJ 2013;347:f6172, doi:10.1136/bmj.f6172), the authors have been made aware that the published version of DSM-5 does define mild, moderate, and severe ADHD. This was not in the draft changes to DSM-5 that the authors used when writing the article. Although DSM-5 gives a framework to the labels of mild, moderate, and severe by attempting to quantify the number of symptoms required, it does not help with defining the subjectivity of impairment. For example, what is meant by “no more than minor impairment in social or occupational functioning” and how many are “few, if any symptoms” when attempting to quantify impairment? The authors therefore stand by their statement that there is no consistent way to assess severity of ADHD symptoms and remain committed to conservative diagnosis and treatment.