That paper is very clear that they did not study misdiagnosis. They are a bit jargony with the use of "overdiagnosed."
"Overdiagnosed" does not mean incorrectly diagnosed, it means that there are subgroups who get a net harm from being treated.
A more understandable term for what they measure is "overtreated." The solution is likely better protocols for mild cases, not to state that ADHD is not a thing.
80% of ASD kids meeting criteria for ADHD doesn't mean that 80% of ADHD kids meet the criteria for ASD. ADHD seems a lot more common.
This is untrue. There is lots of data to suggest elevated LDL is a risk of cardiovascular disease and that high HDL lower risk.
Pfizer's drug failed because of safety issues, not because "There's no such thing as good / bad cholesterol".
Elevated LDL is a symptom of inflammation. It is not a cause and lowering it doesn't help. The research mixed up cause vs correlation.
Genetic errors which cause high LDL levels result in significant cardiovascular disease. It's a very strong cause and effect.
I won't argue that inflammation doesn't play some role (it seems to play a role in many diseases), but I wouldn't dismiss current medical opinion on LDL.
https://en.wikipedia.org/wiki/Familial_hypercholesterolemia
Familial hypercholesterolemia (FH) is a genetic disorder characterized by high cholesterol levels, specifically very high levels of low-density lipoprotein (LDL cholesterol), in the blood and early cardiovascular disease.
There is zero data to suggest that once you adjust for oxidized/damaged LDL.
Smokers don't have elevated LDL but they still suffer the effects of inflammation/oxidization that ultimately lead to cardiovascular disease. If you want to guarantee cardiovascular disease just eat straight up oxidized cholesterol in the form of trans fats.
Trans fats aren't oxidized.
Like I said, I love reading HN health comments.
All current nutrition advice? Does this equally include the nutrition advice that your cousin gives on Facebook, as well as the advice given by doctors of nutritional science?
I get where this skepticism comes from. Nutrition is complicated, and there's a lot of bad advice shared by random people you meet. There's also the diet supplement aisle at your local grocery store, which is full of poorly-regulated products with dubious claims. (At least, in the US, we have these. They are not regulated as drugs.)
At the same time, nutrition-based interventions are some of the most effective public health policies we've ever implemented. In the US, we have programs like WIC. We have iodized salt. We cure blindness in children. We cure scurvy. These are all amazing things--things which we kind of take for granted, because we're not ever exposed to scurvy, childhood blindness, etc.
This is not the first time I've heard such extreme skepticism of nutritional science and it just boggles the mind because if you talk to someone who works in the field, they have amazing success stories to talk about.
You know, just the other day I read about some brain scan study which suggested high-functioning autism looked, in brain scans, more like ADHD than like profound autism. But I think to some extent this sort of problem is inevitable if you're trying to dream up a taxonomy for conditions entirely from how they present themselves with a limited understanding of their biological basis.
If you really want to dive into the wealth of counter narrative research that's being conducted, here's a huge collection http://haidut.me
Go on…
(I’m adult diagnosed, for disclosure, but please do go on and tell me how suspect my diagnosis was, how I shouldn’t have been diagnosed as a child, how my medication is harmful. Go on and tell me about my life which you know better than I do.)
I'm sure you must be tired of people telling you about how overdiagnosed adhd is, I'm sorry about that, but don't take it personal, it's just a person on the internet.
> Findings
> In this systematic scoping review of 334 published studies in children and adolescents, convincing evidence was found that ADHD is overdiagnosed in children and adolescents. For individuals with milder symptoms in particular, the harms associated with an ADHD diagnosis may often outweigh the benefits.
What I mean is that we feed children Ritalin without a second thought. It's absolute nuts. There are many many ways to work with ADHD which doesn't require giving a children meds. We should be way more cautious about doing that.
Oh I take it personally. I’m alive today because I sought diagnosis and treatment. I very nearly wasn’t alive from the consequences of being undiagnosed and untreated. I very probably would be dead today if I had taken this “just person on the internet” more seriously than I already had. I’m more than tired of people offering their ignorant opinions about stuff they don’t understand.
People have different experiences/backgrounds. It's both inevitable and natural that there are different points of view on this or any other complex topic.
I dropped out at 15 and taught myself computer science, so it was all provably horseshit but it sure made my life harder as a child.
ADHD is frequently hereditary, and substance abuse and addiction are common for people with undiagnosed ADHD.
Your own story of dropping out and teaching yourself isn’t just familiar to me, it’s similar to both my brothers’ stories as well.
I’m sorry you experienced this the way you did. I wish you had better medical care, and better parental guidance. I hope the life that you’ve made for yourself is joyful and prosperous, and I hope if it’s ever not you’ll find your way to that however it makes sense.
Does my brain work differently than other people? Yes. Would this have been a problem for me in any pre-industrial society? (Which, to be clear, is most of human history?) I don't think so. Is it a problem for me when I have a fair bit of control over the work I do? Not really! I only experience it as a problem when I am expected to function in contexts with industrial-age labor models, where there's a hierarchy that expects me to labor like a robot in line with how my betters have decided how the work should be done.
So I can entirely believe that authority figures over-use ADHD as a diagnosis so that their lives are easy. Reading through the DSM, it seems to me there are quite a number of diagnoses that could be used as Authority Inconvenience Syndrome. And I don't think I've ever seen one where people might need treatment for being too obedient.
It is quite illogical but very popular because well adapted people can just talk about superior genes and how everyone else has inferior genes and they can never change anything about that except with extensive medical treatment.
I remember the first time I took one of those pills, I was astounded my how clear my mind became. It was like the noise switched off, and I could just get on with what I needed to.
Like you, I was diagnosed as an adult. I have considerable regret for all those years prior wasted without diagnosis and medication. I'm trying to undo all the maladaptive behaviours I've developed likely because of this, and shed myself of the many, many guilts I feel. But it's a long hard slog.
I wish my parents were still alive so I could talk to them about it all, and show them the person I've become since.
When I see confident expressions of ignorance about ADHD, or even worse, scammers and liars trying to take advantage of people with ADHD, it also makes me see red. You're not alone in this. I think you were right to speak out here, whatever anyone else says.
People of the internet: there are better things you can be doing than playing armchair psychiatrist, especially by invoking notions that can ultimately be harmful to a class of people who have forever been told they just need to put in more effort. You don't know what it's like to live with this so please stop with the conjectures. Thank you.
I for one am actually interested if he can back up that claim. So when you as them to “Go on…”, please leave it at that. There’s no reason to be snarky.
> Findings In this systematic scoping review of 334 published studies in children and adolescents, convincing evidence was found that ADHD is overdiagnosed in children and adolescents. For individuals with milder symptoms in particular, the harms associated with an ADHD diagnosis may often outweigh the benefits.
Personally I think all drugs should be legal and people should be able to take whatever they think helps them, although I always recommend the 'less is more' mentality and would urge people not to develop dependencies.
I understand this in the comment’s expression too, and it’s emphatically wrong.
> benefit from the use of 'medication' (i.e. amphetamines and derivatives, from Adderall to Desoxyn(methamphetamine) to Ritalin), is mostly unrelated to any 'diagnosis'.
You’re incorrect.
> Personally I think all drugs should be legal and people should be able to take whatever they think helps them
I agree, but this has nothing to do with the validity of actual diagnoses of actually treatable conditions.
> This literature is increasingly contributing to the notion that the pathophysiology of ADHD reflects abnormal interplay among large-scale brain circuits. Moreover, recent studies have begun to illuminate the mechanisms of action of pharmacological treatments.
1. There's no such thing as good / bad cholesterol. This is complete baloney and Pfizer lost a staggering amount of money when a drug raising good cholesterol got as far as human trials -- and failed them. There is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease. There's growing amount evidence though that cholesterol is a symptom and not a cause.
2. The diagnosis and treatment of ADHD in adults but most especially in children is extremely suspect. Last year there was a study pretty much confirming it is overdiagnosed in children. But even worse, whether ADHD is even a thing or multiple conditions wrongly bundled under a single name is basically an open question. We basically put labels on children with "problematic behaviors" like "autistic spectrum disorder" and "ADHD" and then eventually find that 30-80% of ASD children are meeting criteria for ADHD. First of all what sort of study is 30-80%? But if the higher end is true, the question strongly arises: are these even two things?
3. I would bet dollars to doughnuts in a few decades we will look at all current nutrition advice to something akin of medieval quackery. How is this not self evident: genes obviously affect how foodstuff interact with our bodies thus any sweeping generalization is inherently suspect or most likely complete baloney. Like, how can anyone seriously think only lactose intolerance is an inherited genetic trait.
I would need to dig into my notes if someone needs them but a group of statisticians at a university started to look into medical studies and then FOIA the raw data and found like 80% of them cherry picking the data.
The incentives are not exactly at the right place.