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ADHD Redefined?

Experts disagree over whether this will help or harm in the long run
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"In trying never to miss a case, they may mislabel millions of people with a disorder they don't have. Everyone has problems with distractibility, but when ADHD is real, it starts early, it's intense and it's unmistakable," said Dr. Allen Frances, chair of the task force for the DSM-4 and former chair of psychiatry at Duke University School of Medicine in Durham, N.C. The fourth edition of the DSM has been in force since 1994.

"We're already overdiagnosing ADHD. Almost 20 percent of teen boys get the diagnosis of ADHD, and about 10 percent of boys are on stimulant drugs. We don't need to make it easier to diagnose ADHD," Frances said.

His biggest concern is that by expanding the diagnosis of ADHD, more children and adults will be put on stimulant medications, such as Adderall, Ritalin, Concerta and Vyvanse.

"In the short-term, performance is improved, which makes it highly desirable. In the long-run, there's a risk of addiction. Would you think it's OK for people to take steroids to improve their tennis game? It's pill-pushing," Frances said.

"If we decide as a society that the use of stimulants is good, it shouldn't be done through a fake medical diagnosis. Making it a medical diagnosis is what's wrong here," Frances explained. "I'm not against these drugs being legal, but I'm against the backdoor medical diagnosis."

Another concern is that people who have other psychiatric disorders may be wrongly classified as having ADHD.

"Every single psychiatric disorder has distractibility as part of it. If you misdiagnose someone with bipolar disorder as having ADHD and put them on stimulants, you'll throw them into mania," he cautioned.

Norcross agreed that ADHD diagnosis in adults needs to be done very carefully. But, he said the traits of inattention and disorganization often do continue into adulthood. And, for teens and young adults, ADHD can have an impact on education and employment opportunities.

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