Kommentar

Norway must avoid copying America's mistakes

Allen Frances
Professor Emeritus & former Chair, Department of Psychiatry, Duke University; Chair DSM IV Task Force
Interessekonflikt:  Nei

Norway must avoid copying America's mistakes in psychiatric diagnosis. Our careless over-treatment of Attention Deficit Hyperactivity Disorder has been driven by: First, its loose definition in the DSM (1). Second, ubiquitous and misleading marketing by drug companies. Third, overcrowded classrooms and overworked teachers (2). Fourth, the frequent misuse of psychiatric labels to make educational decisions (2). Fifth, clinicians not having enough time to know their patients and the context of symptoms. Sixth, diagnostic decisions made on first visits rather than after longitudinal evaluation. And seventh, worried parents who want the best for their kids, but don't realize that the small, short term gains of medicines usually don't offset longer term risks.

ADHD should be a diagnosis of last resort, not a first reflex. Best to begin with watchful waiting, normalization, advice, parent and teacher training. and psychotherapy. Medication is necessary only for a small group of severe, classic cases - when all else has failed.

References
1. Batstra L, Frances A. DSM-5 further inflates attention deficit hyperactivity disorder. J Nerv Ment Dis. 2012 Jun;200(6):486-8. doi: 10.1097/NMD.0b013e318257c4b6.
2. Meerman S, Batstra L, Grietens H et al. ADHD: a critical update for educational professionals. Int J Qual Stud Health Well-being. 2017; 12(sup1): 1298267. doi: 10.1080/17482631.2017.1298267

Publisert: 13.02.2018
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