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Monday, December 16, 2013

Fads in Mental Diagnoses

From Mind Hacks:

The New York Times has an important article on how Attention Deficit Disorder, often known as ADHD, has been ‘marketed’ alongside sales of stimulant medication to the point where leading ADHD researchers are becoming alarmed at the scale of diagnosis and drug treatment.

It’s worth noting that although the article focuses on ADHD, it is really a case study in how psychiatric drug marketing often works.

Read more:
A disorder of marketing

SuccubaSuprema writes:

I'm not sure why ADHD researchers are only now becoming alarmed, nor why this trend was not anticipated -- not the trend specific to overdiagnosis of ADHD, but the trend to overdiagnose certain "popular" disorders.  It's hardly a new phenomenon, after all:  "Hyperactivity" was the condition overdiagnosed in the 1970s, while "Manic Depression" or "Manic-Depressive Disorder" was the overdiagnosis of the '80s.  In the '90s, the lingering Manic Depression (by this time renamed to "Bipolar Disorder" for various reasons, not least of which was a need to be more specific and more inclusive at the same time) continued to be overdiagnosed, but a new diagnosis was also on the rise, and "Attention Deficit Disorder" began to be overdiagnosed.  Moving into the first decade of the 21st century, this name expanded to "Attention Deficit Hyperactivity Disorder," and had become the dominant overdiagnosis.  In the present decade, it's too early to say for sure, but "Asperger Syndrome" was viewed as pretty sexy at the beginning of the decade, and "Autism Spectrum Disorder" (which is the new label in DSM-5, and which includes what has up till now been called "Asperger Syndrome") seems to be replacing that as a popular diagnosis.

I'm also far from sure that this can be laid at the feet of advertisers.  "Hyperactivity" in the '70s, for example, was treated with a specific diet ("the Feingold diet," which involved omitting artificial flavors, artificial colors, preservatives, caffeine, and sugar from the child's diet) rather than medication.

What may be most telling is that these diagnoses pertain to behaviors and attitudes often noticed in childhood and/or adolescence.  I would be inclined to refrain from making any explicit explanation of this observation here, due to relatives whose children were diagnosed with one or another of these conditions, but I do think the connection is worth considering.  To be more precise, I would suggest that the ones in need of therapy and/or medication may more often be the parents than the children!

A parent has a "problem child" and takes the child to a mental health professional, where the child is diagnosed with "XXXXX disorder," and then the parent shares this information with another parent, and that parent wonders if his/her child might also have "XXXXX disorder."  The next act in this tragedy is easy enough to predict.

Fads in Mental Diagnoses Revisited

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