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In the recent cleanup, this picture got binned in the process. I thought it was nice and would better replace the general brain picture in the pathophysiology section. The only problem is I can't find the context the picture was used in in order to source it appropriately, see if the source is acceptable, and verify if the public use rationale is correct. Anyone else know where in the NIMH materials it came from? 152.16.15.144 ( talk) 21:59, 21 April 2010 (UTC)
http://www.aafp.org/afp/2001/0901/p817.html - It's a good potential source. It looks like a usable secondary RS to me, but I am asking for a second opinion on whether it looks appropriate. 152.16.15.144 ( talk) 22:30, 21 April 2010 (UTC)
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Doc James (
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email) 04:16, 22 April 2010 (UTC)I removed the "either" / "or" statements in the diagnosis criteria according to dsm-iv. It is just not correct, as can be seen from the reference. Lova Falk talk 06:29, 19 May 2010 (UTC)
This reference is to an article that's totally irrelevant to ADHD, it's an editorial on words like "wheelchair-bound." Check it out: http://journals.lww.com/ajpmr/Citation/1991/02000/Words,_Words,_Words.1.aspx
cite journal |author=Johnson EW |title=Words, words, words |journal=American Journal of Physical Medicine & Rehabilitation |volume=70 |issue=1 |pages=1–2 |year=1991 |month=February |pmid=1994964 |doi=10.1097/00002060-199102000-00001 It's not really a source for diagnostic procedure, since it's an op-ed that's on a different topic. Who does this? Why does this happen? 75.73.32.46 ( talk) 18:54, 27 April 2010 (UTC)
Under the above mentioned header, it says: "Other medications which may be prescribed off-label include alpha-2A adrenergic receptor blockers such as and clonidine " - as you can see, a brand or generic medication name seems to be missing in the sentence (such as XXXXX and clonidine"). I tried to find an answer to it online, but couldn't, so hopefully somebody else can add it. Peapeam ( talk) 03:16, 25 May 2010 (UTC)
In an article about ADHD, a list of famous people just takes up space and makes for even slower loading. I don't think it belongs here.
One solution might be the one used for Dyslexia. There is a separate article: List of people diagnosed with dyslexia, listed, of course, as a See also. -- Hordaland ( talk) 19:24, 27 May 2010 (UTC)
The reference to the letter to the editor regarding tolerance was misrepresented. This article said that tolerance occured in doses above 60 mg but the letter actually said it may be necessary to increase the dose above 60 mg to counter-act the effects of tolerance. Looks like a good faithed misinterpretation of the source. I have fixed the issue. Tolerance and dependence are listed in the British National Formulary as adverse effects of methylphenidate as well as dexamphetamine; might be worth referencing it, although it doesn't say much about it other than they are adverse effects.-- Literaturegeek | T@1k? 00:08, 10 June 2010 (UTC)
Get rid of TV advertisements where children programs are on. :) —Preceding unsigned comment added by 89.111.97.100 ( talk) 18:59, 2 July 2010 (UTC)
The section on diet are a bit missleading about E-numbers and the US. It mentions that the England has forced manufacturers that use(for example)ponceau 4R (E124)in food to display a warning. Then the text go on that "In the US, little has been done to curb food manufacturer’s use of specific food colors, despite the new evidence presented by the Southampton study". But if you go into the articel about ponceau 4R (E124) it says that this E-product is banned in the US. And that it seems that it has been banned for a long time. A search on the FDA page marks allmost all of the E-products mentioned,as "unapproved colours".
Thus, this text about diet contains missleading information and there I have will remove it. —Preceding unsigned comment added by 192.71.219.1 ( talk) 07:52, 11 July 2010 (UTC)
In order to progress this I am going to list each one and their status from the FDA list [2] and have highlighted the US status merely so it can be easily seen...
It seems to me that this can be broken down simply.
Chaosdruid ( talk) 19:27, 12 July 2010 (UTC)
The management section, especially the stimulant med section, is getting out of hand. It's too long and a disproportional amount of it is spent on discussing in detail about addiction and abuse such that it overwhelms other important information such as what the actual stimulant drugs are, how they work, what general practice is on prescribing them, etc. The discussion of the various studies really ought to be moved to the management page, with brief summary of the current prevailing medical opinion (or lack of one whatever the case) on addiction and abuse. 152.16.15.144 ( talk) 22:09, 30 July 2010 (UTC)
I'm wondering if we can provide a more substantiated reference for the following statement:
"In one study which looked at adult cocaine users, it was found that those individuals who used Ritalin between one and ten years of age had a percentage of cocaine abuse twice that of those who had been diagnosed with ADHD but had not utilized Ritalin.[146]"
I question the context and accuracy of the above statement for a number of reasons. First, it references http://www.addictionsearch.com/treatment_articles/article/ritalin-abuse-addiction-and-treatment_43.html and does not directly reference an academic source. Second, the context is questionable and does not consider cocaine use among individuals diagnosed with ADHD who are not taking any medication, or those who discontinued medication and now use illicit substances.
Tshortho ( talk) 04:27, 2 November 2010 (UTC)
This study seems worth mentioning in the article: http://www.sciencedaily.com/releases/2010/08/100817103342.htm Gandydancer ( talk) 23:12, 17 August 2010 (UTC)
It has been proposed at Wikipedia talk:Invitation to edit that, because of the relatively high number of IP editors attracted to Attention-deficit hyperactivity disorder, it form part of a one month trial of a strategy aimed at improving the quality of new editors' contributions to health-related articles. It would involve placing this:
You can edit this page. Click here to find out how.
at the top of the article, linking to this mini-tutorial about MEDRS sourcing, citing and content, as well as basic procedures, and links to help pages. Your comments regarding the strategy are invited at the project talk page, and comments here, regarding the appropriateness of trialling it on this article, would be appreciated. Anthony ( talk) 11:42, 31 August 2010 (UTC)
Joel Nigg in What Causes ADHD? makes a case for lead poisoning, mercury poisoning, as well as other environmental contaminants causing 2-15% of cases of ADHD. He also relates premature birth (in this article already?).
Joel Nigg, What Causes ADHD? Lead poisoning - p. 246,247,215,262,344,377 Mercury poisoning - p. 251,318,345,253,335,262,276,299 http://books.google.com/books?id=y_LCZuc-F8wC&printsec=frontcover&dq=joel+nigg&hl=en&ei=QB2KTNzdLoHGlQft87WeDA&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCwQ6AEwAA#v=onepage&q&f=false Natural ( talk) 12:00, 10 September 2010 (UTC)Natural
Nigg, p.282, 284, 287, 345, 288, 317, 100 Nigg sees a correlational relationship, not necessarily a cause - effect relationship, as far as the evidence of existing studies goes. He feels that more research is needed before coming to conclusive statements on this. Most parents are interested in the role of television and ADHD.
Another significant study is --- reported in- PEDIATRICS Vol. 113 No. 4 April 2004, pp. 708-713 Early Television Exposure and Subsequent Attentional Problems in Children Dimitri A. Christakis, MD, MPH*,,,||, Frederick J. Zimmerman, PhD,, David L. DiGiuseppe, MSc, Carolyn A. McCarty, PhD*,
http://pediatrics.aappublications.org/cgi/content/abstract/113/4/708
which again, gives evidence for a correlationtial relationship, rather than definite proof that TV viewing among children causes ADHD.
Nigg also mentions video games in connection with ADHD as a possible cause. p.345,280,103,301,74
Natural ( talk) 12:07, 10 September 2010 (UTC)Natural
Basically, what Susan Ashley states in her book, http://books.google.com/books?id=ZKpBEPd0w5kC&printsec=frontcover&dq=susan+ashley+adhd&hl=en&ei=vTqRTM-jC4P88Aa6vZGUDQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CDYQ6AEwAA#v=onepage&q=television&f=false
on this page, sums it up in the proper manner. page 15. Nigg says more research is needed on this, which is a good point for the professional public to note as well. No one is really sure if TV or video games cause ADHD. So, if some professional studies were forthcoming to give a more definitive answer, it would help all the way around. Natural ( talk) 21:32, 15 September 2010 (UTC)Natural
I just removed the following, apparently added just a few minutes ago right at the beginning of the article:
Undiognosed ADHD is often the cause of many disorders in Adults such as Anxiety and Depression. The inability to organise, maintain focus and dibilitating social interaction and working memory problems can and do cause these aditional disorders in adults who go through life undiognosed.
It apears that the medical industry as a whole are narrow minded when it comes to the effects of Adhd in an Adult and therefore are prone to completly ignoring it as a possability in a patiant. This is mostly down to lack of education on the doctors behalf and lack of skill in how to question a possible Adhd patiant. It is shocking to see how many doctors and medical “experts” fail to gain a basic knowledge on Adult Adhd as well as Adhd in Teenagers, they are only just starting to get to grips with Adhd as a real disorder.
Aside from being badly spelled and carelessly written, it is blatantly POV. An in any case, it does not belong at the beginning of the article. Regardless of the merits--or lack thereof--of the point someone is trying to make, this sounds like someone just got on a soapbox to vent his or her frustrations. 140.147.236.194 ( talk) 12:45, 21 September 2010 (UTC)Stephen Kosciesza
The PET image is very old. Pet scans are not used outside of research in ADHD. Thus having the image in the lead is WP:UNDUE. Moved to appropriate section. Doc James ( talk · contribs · email) 18:16, 23 September 2010 (UTC)
The result of the move request was: page moved: has run 19 days. Anthony Appleyard ( talk) 08:46, 18 October 2010 (UTC)
Attention-deficit hyperactivity disorder → Attention deficit hyperactivity disorder —
That first paragraph is poorly written. There is one sentence, "Stimulant medication or non-stimulant medication may be prescribed." which is out of place. It breaks up the flow of the paragraph (still poorly written) as much as me now saying, "This page has a white background." —Preceding unsigned comment added by 74.138.131.215 ( talk) 05:16, 25 November 2010 (UTC)
Move indepth discussion of stimulants and off label medications belongs on the management subpage. Doc James ( talk · contribs · email) 01:08, 10 January 2011 (UTC)
A few reviews with which to update this article.
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help)-- Doc James ( talk · contribs · email) 03:10, 10 January 2011 (UTC)
Sources for Caffeine as a stimulate for ADHD focusing: http://www.asktheneurologist.com/Adult-ADHD.html (Slides 22-24) http://en.wikipedia.org/wiki/Low_arousal_theory http://www.youtube.com/user/DocADHD http://www.youtube.com/watch?v=DzH9sNQmclo
Personal Experiences: I have Adult ADHD at age of 24 and I find Caffeine makes a big different when needing to focus. If I'm doing a task or anything and become stuck due to a lack of stimulation Caffeine is a great way to fill the gap which allows the continuation of the task. Improvements for ADHD is already mentioned "In essence, caffeine consumption increases mental performance related to focused thought while it may decrease broad-range thinking abilities." but not linked to ADHD in the statement. —Preceding unsigned comment added by 86.0.140.137 ( talk) 10:49, 30 January 2011 (UTC)
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Well placed theory that ADHD does not exist, and that people are made how they are made. For example, a child may be on the Attention Deficit Hyperactivity Disorder (ADHD) scale, and will act disruptively, but a child that is disruptive is not necessarily ADHD. Many would argue that an ADHD boy is just a boy being a boy, and indeed when the child is around peers acting in a similar way, he will automatically act the same to fit in.
Halarond ( talk) 13:33, 4 February 2011 (UTC)
Per Jmh649's comment, Already done. Qwyrxian ( talk) 14:05, 4 February 2011 (UTC)
User:Jmh649, please stop removing data from the article that was created by multiple editors! Removing information bring down the quality of the article. I think you more concern about removing criticism and promoting your ideas, then improvement of the article. Innab ( talk) 20:03, 4 February 2011 (UTC)
While reading this article, in particular the "Causes" section, I got the distinct impression that the word "theory" is being used inappropriately to describe what are, in fact, merely hypotheses. According to Wikipedia itself (as attributed to the Unites States National Academy of Sciences), in pedagogical contexts -- such as in an encyclopedia -- a "scientific theory" is "... a comprehensive explanation of some aspect of nature that is supported by a vast body of evidence". None of the "theories" described in the ADHD article seem to fit this rigorous definition. To the contrary, a number of wildly differing and possibly conflicting theories about the same subject generally cannot all be theories simultaneously, by definition. Because if one theory is comprehensive enough, and supported by enough evidence, then the other competing theories would have by then been disproved. I propose that each use of the word "theory" in this article be scrutinized and changed to "hypothesis" where it is found to be the more appropriate choice of word. Moulding ( talk) 17:08, 15 February 2011 (UTC)
While medication has been shown to improve behavior when taken over the short term, they have not been shown to alter long term outcomes.[126]
126 refers to Yamada A, Takeuchi H, Miki H, Touge T, Deguchi K (July 1990). "[Acute transverse myelitis associated with ECHO-25 virus infection]" (in Japanese). Rinshō Shinkeigaku 30 (7): 784–6. PMID 2242635.
How is this related to long term treatment of ADHD with medication? —Preceding unsigned comment added by 149.43.82.54 ( talk) 18:04, 25 February 2011 (UTC)
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Please change "ADHD is diagnosed two to four times as frequently in boys as in girls" to "ADHD is diagnosed two to four times more frequently in boys as in girls", or so.
--
114.250.17.77 (
talk) 06:28, 26 February 2011 (UTC)
In the "In adult" section, it states "Researchers found that 60 percent of the children diagnosed with ADHD continue having symptoms well into adulthood.", but the lead states "It is a chronic disorder with 30 to 50 percent of those individuals diagnosed in childhood continuing to have symptoms into adulthood." phalacee ( talk) 01:08, 4 March 2011 (UTC)
{{ edit semi-protected}} On the page "Attention deficit hyperactivity disorder" under section 10: Society and Culture, subsection 10.2: Controversies, two spelling/grammar errors need to be corrected in the first paragraph and a sentence needs restructuring in the second paragraph. Below are the sections that need editing. Two copies of each section are given, the first is the original text highlighting the errors currently present and the second is the edited version of the original highlighting the corrections made. Both the errors and the corrections are bolded and enlarged in parenthesis.
1) In the first paragraph of subsection 10.2: Controversies, the word dunctioning three lines from the bottom needs to be changed to functioning, and the word state two lines from the bottom needs to be changed to states:
"...thresholds are socially and culturally influenced and determine how an individual's level of (d)unctioning within the "normal cultural environment" is assessed. It further state(_) that "the acceptable thresholds for impairment are partly driven by the contemporary societal view of what is an acceptable level of deviation from the norm." "
"...thresholds are socially and culturally influenced and determine how an individual's level of (f)unctioning within the "normal cultural environment" is assessed. It further state(s) that "the acceptable thresholds for impairment are partly driven by the contemporary societal view of what is an acceptable level of deviation from the norm." "
2) In the second paragraph of subsection 10.2: Controversies, the second sentence needs reconstruction. (Current and recommended reconstruction will be shown below, the sentence reconstruction is isolated to 4 areas labelled 1-4 to easily match the original text with the reconstructed [the numbers are NOT part of the reconstruction], the first sentence has been added in for orientation purposes but has been reduced in size in order to differentiate it from the problem sentence):
"Others have included that it may stem from a misunderstanding of the diagnostic criteria and how they are utilized by clinicians,[15]:p.3 teachers, policymakers, parents and the media.[17] 1) (Debates center around): whether ADHD is a disability or 2) (whether it is) merely a neurological description, the cause of the disorder, the changing of the diagnostic criteria, 3) (and) the rapid increase in diagnosis of ADHD 4) (_) and the use of stimulants to treat the disorder."
"Others have included that it may stem from a misunderstanding of the diagnostic criteria and how they are utilized by clinicians,[15]:p.3 teachers, policymakers, parents and the media.[17] 1) (Debates center around key controversial issues): whether ADHD is a disability or 2) (text deleted) merely a neurological description, the cause of the disorder, the changing of the diagnostic criteria, 3) (text deleted) the rapid increase in diagnosis of ADHD 4) (,) and the use of stimulants to treat the disorder." 130.39.0.200 ( talk) 04:18, 16 March 2011 (UTC)
The wikipedia page http://en.wikipedia.org/wiki/Methylphenidate states:
"Israel Over The Counter: February 9, 2011 The Ethics Committee of the Medical Histadrut (Federation) will now be permitted to sell the psycho-stimulant drug that treats attention-deficit hyperactivity disorder (ADHD) Ritalin (Methylphenidate) without a doctor’s prescription. http://www.onejerusalem.com/2011/02/09/medical-histadrut-permits-over-the-counter-ritalin/"
This ADHD page section on the legal status of ADHD medications may need to be updated to reflect this change and to be consistent. —Preceding unsigned comment added by 66.75.76.27 ( talk) 04:27, 12 April 2011 (UTC)
Images are important. If we do not wish this one is there a better one people can propose? Doc James ( talk · contribs · email) 23:21, 20 April 2011 (UTC)
But what is the *point* of the image? What does it do? Does it inform the reader in any way? Does it clarify anything? Wikipedia:Image#Pertinence_and_encyclopedic_nature —Preceding unsigned comment added by 79.97.92.28 ( talk) 02:33, 21 April 2011 (UTC) Sorry, ^that^ was me on someone else's computer, didn't realise I wasn't logged in. 79.97.92.28 ( talk) 15:36, 21 April 2011 (UTC) Shit. Forgot to log in again. Dbpjmuf ( talk) 16:34, 21 April 2011 (UTC)
Shouldn't there at least be some mention of Dr. Daniel G. Amen and his AD/HD subtypes? OzW ( talk) 15:47, 6 May 2011 (UTC)
This article ignores the Hyperfocus aspect of ADHD. I was part of a group studied by Ohio State University in the early 1970s (it was still called Hyperkinesis) and they found that if we found something we were interested we would Hyperfocus on that one task. There should be some material in the literature regarding this.-- BruceGrubb ( talk) 12:07, 26 May 2011 (UTC)
I consider adding this unnecessary as we link just a couple paragraphs above to the whole article thus linking to a single subsection here [15] is not needed. Doc James ( talk · contribs · email) 20:02, 1 June 2011 (UTC)
We all are trying to write a better and more accurate encyclopedia. Thus I was surprised that the article has failed to address the issue of overdiagnosis (and is quite skimpy on this topic in its satellite article on Attention-deficit hyperactivity disorder controversies). Recently, two studies brought this issue into the public limelight. My attempt to bring the topic into the main article was twice censored the main argument being that the supporting studies were made by "economists" in an "economic journal." Really? Do we want to restrict medical information - important enough to be picked up by CNN [16] and Time Magazine (August 30, page 16) - from inclusion simply by flimsy assertions that the information was not written by experts and the (peer-reviewed) journal is not “medical” and thus can be excluded as a reliable source in medical articles? The articles have been published, and it is not productive to dismiss the authors as "economists" instead of looking at the evidence.
I submit that, as the response by CNN and Time Magazine shows, the issue of overdiagnosis is important enough to be addressed in the main article, and I suggest the following section to be placed in its “Controversies” section:
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Ekem ( talk) 13:25, 31 August 2010 (UTC)
Dear ::Cresix, This is not a 'medical' article as ADHD is not formed of a biological basis it is environmental and thus a psychological article and therefore one which can be debated in various articles. This whole article is in fact bias. kind regards. Dr.A.Williams (Consultant Clinical Psychologist) — Preceding unsigned comment added by 86.163.127.47 ( talk) 00:32, 25 June 2011 (UTC)
Ekem, I would never object to any discussion on a talk page. That having been said, this change needs a solid consensus because the "science" behind it is weak. I don't have access to the Journal of Health Economics, but from what I can see in the pmid links you provided, there is absolutely nothing to support your statement: "substantial increase in the diagnosis of ADHD in recent decades" or your assertion of "overdiagnosis". From what I can see, the most that is demonstrated is that diagnosis may be confounded with age of entry in school. That may be a legitimate point, but it is a far cry from substantiating "overdiagnosis" of ADHD. Note I am not arguing one way or the other as to whether ADHD is overdiagnosed. My criticism is directed at making such a conclusion with little to no scientific evidence, as is the case in the sources you provide. And this speaks directly to my earlier point: Economists, even healthcare economists, do not have sufficient expertise to address diagnostic procedures for a medical disorder; and it doesn't matter how many numbers they crunch. I'm a doctor, but I would not dare try to publish anything in a journal related to economics, unless it directly pertained to medicine. These articles (at least as much as I have access to), although interesting and informative in some issues related to ADHD, are simply inadequate to draw conclusions about "overdiagnosis" of ADHD. Cresix ( talk) 00:00, 2 September 2010 (UTC)
(undent) I agree with both people here. First of all concerns about over diagnosis have been voiced. Second we should use a medical review article to support this assertion. Doc James ( talk · contribs · email) 18:41, 2 September 2010 (UTC)
Basically I agree, WhatamIdoing, although I think a very brief mention of the findings in the context of diagnostic controversies might be appropriate. The LeFever article makes a good case for overdiagnosis, but I think we need to proceed with caution in placing such a conclusion in the Wikipedia article.
BTW, one other issue that occurred to me (because I don't have access to the economic journals) is how the authors determined that the children had ADHD. That has been a problematic issue in some other research. If someone who has read the articles could enlighten me I would appreciate it.
Cresix (
talk) 20:41, 2 September 2010 (UTC)
In many school districts in the United States, there are procedures for early entry into kindergarten if the parent seeks it, and (more often) it can be a parent's choice to delay entry into kindergarten or have a child repeat kindergarten. As for whether it is reasonable to conclude that older children may be underdiagnosed, I think WhatamIdoing's point is that the data in the studies cited provide no less evidence for underdiagnosis of older children than it provides evidence for overdiagnosis of younger children. That makes perfect sense. If a child is more likely to be diagnosed by being a younger child in his/her grade, then by definition a child who is an older child in a grade is less likely to be diagnosed. What we don't know is why. Cresix ( talk) 21:24, 2 September 2010 (UTC)
Gandydancer, I'm not suggesting that we add anything about early or late entry into kindergarten in the article. I don't need a reference any more than you do for your assertion that it doesn't happen. It may not be your experience in your geographical area, but in my work I see at least five or six kids every year who have entered kindergarten at four years old. I see dozens of children whose parents voluntarily delayed their kindergarten entry because their parents felt they weren't ready. I'm not saying that parents have absolute authority or that it's done 100% of the time parents request it (school are especially hesitant to allow early entry; much less so with late entry). I'm saying there are procedures used by many school systems (and I've worked throughout the USA) for these exceptions to five-year-old kindergarten entry when parents request it. To some extent we have strayed from the main issue, however. The important point is that there are potentially confounding factors in the research on greater diagnosis of ADHD according to age within a grade. We simply can't conclude on the basis of the journal articles cited that age is the only factor leading up to a younger child's diagnosis of ADHD. It may be one factor in the diagnosis, but that doesn't mean it's the only factor. For example, there may be differences in how parents treat children who enter kindergarten at a younger age (and I emphasize may be); we don't know that unless we examine it or control for it in the research. There could be many other differences in these younger children that we are unaware of. That's the challenge of behavioral research: ruling out all of the possible alternative explanations. That is rarely done with one or two studies. And that is why we have to be cautious in jumping to conclusions about overdiagnosis or underdiagnosis. Cresix ( talk) 03:31, 3 September 2010 (UTC)
There are three studies as, far as I see, that indicate that young-for-grade children are more likely to be diagnosed with ADHD, the two recent studies in the Journal of Health Economics (JHE) and the earlier study by DeFever, a psychologist. It would be nice to have an objective review or analysis, but, I fear, that there has not yet enough time for such an analysis.
Regarding the data collection:
Evans et al use three data sets that are not merged for their analysis. One is the NHIS , an “annual survey of roughly 60,000 households that collects data on the extent of illness, disease, and disability in the civilian, non-institutionalized population of the United States” which includes self-reported medical conditions of respondents including information on ADHD diagnosis in its Sample Child Supplement. The authors state that “ ADHD incidence rates from the NHIS are comparable to results from other national surveys from similar periods”. Their second data source is the Medical Expenditure Survey (MEPS), “ a series of surveys administered since 1996 by the Agency for Healthcare Research and Quality and the National Center for Health Statistics”. For this purpose it evaluates medication use for ADHD identified by its ICD-9 code 314.10. The third data set comes from a “proprietary claims data base constituting private insurance contracts for nearly 1 million covered lives and representing at least 40 of the 50 U.S. states”. Elder uses in his study the ECLS-K, a “ National Center for Education Statistics (NCES) longitudinal survey that initially included 18,644 kindergarteners from over 1000 kindergarten programs in the fall of the 1998–1999 school year”. Individuals, parents and teachers were again re-sampled five times until 8th grade. Elder states that the ECLS-K is “ particularly useful for studying ADHD because it includes binary measures of ADHD diagnoses and treatment as well as teacher and parent reports of ADHD-related symptoms”. The study also includes follow-up questions on medication use. Although different data sets are used, the two studies are in agreement that young-for –grade children are at higher risk for a diagnosis of ADHD.
Regarding over- and underdiagnosis:
The data , by themselves, as Evans et al point out, do not indicate whether the diagnostic pattern is correct for the young-for-grade group or the old-for-grade group; all they show is that there is a difference which means that factors other than neurological causes are at work. It is their interpretation that the younger group contains more individuals who are misdiagnosed because of immaturity. Elder comes to the same conclusion. As the authors speak of “inappropriate diagnosis” and “misdiagnosis”, I agree to drop the perhaps loaded term “overdiagnosis” and use the terms they use.
Things are complicated and the project is getting bigger as we look at it. I hope that we can agree that the basic notion - younger-for-grade children at higher risk for diagnosis - goes into the controversies section, and a more detailed discussion into the satellite article. Back after the weekend. Ekem ( talk) 03:49, 3 September 2010 (UTC)
Let me try and come to some kind of consensus here. This here is like an onion, as there appears layer after layer of controversy, yet not much of this is evident when reading the main article. In any case, it appears that we can agree (can we?) on the point that there is some credible evidence of “inappropriate diagnosis”, as shown by three studies referenced above that show a higher risk for the diagnosis of ADHD in young-for-grade children (or lower risk for old-for-grade children): this information should be in the main article, maybe briefly, and can be more elaborated on in the satellite article. A second controversy is the topic of overdiagnosis per se: can we agree to make a statement that this is, first of all, a valid topic, something that is being discussed when ADHD is addressed, an item of concern? The 2007 study by Sciutto and Eisenberg [17] is founded on the premise that there is a common perception that AHDH is overdiagnosed. Assuming there is no overdiagnosis, there is also evidence of significant variation in the diagnosis - this is, indeed, brought out in the article, but not explained. Another issue is the steep increase in medical therapy in the 90s that has been documented (Zuvekas et al, 2006 [18]) which, in turn, may be related to a perception of overdiagnosis. Let me add another controversy, the recent finding that medical therapy has been reported to have failed to show long term benefits (but, instead, treated subjects ended up shorter) - the reference is in the article only to indicate that subjects later have problems "regardless of treatment" (Molina et al, 2009 [19]). Ekem ( talk) 02:08, 10 September 2010 (UTC)
How about phrasing it this way:
The quoted sentence is from the authors, not me. I plan to return to Molina et al later. Ekem ( talk) 13:43, 13 September 2010 (UTC)
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Some minor spelling errors (e.g., terminal s missing from some plural words) in section on History/Society.
Davsch65 ( talk) 13:15, 21 June 2011 (UTC)
The history section appears to have had some vandalism, see below. Anyone know how to clean this up? Also, the source referenced is just a link to the civil rights act, which is, obviously, off-topic.
However, in 2010, Dr. Taylor Warfield, a scientist at the ADHD research institute in , Missouri, attempted to prove his theory that "ADHD is not a disease, but merely a disorder,"
—Preceding unsigned comment added by 207.22.18.147 ( talk • contribs) 21:02, 9 April 2010 (UTC)
Espoo ( talk · contribs) has twice changed the capitalization and punctuation in spelling the name of the disorder. This is not something worth edit warring over, but my main point is that there is flexibility in how the disorder is spelled. In fact, in the United States (and I presume Canada) the official name for the disorder according the most authoritative source ( DSM-IV) is "Attention-Deficit/Hyperactivity Disorder" with that exact capitalization and punctuation. Other medical diagnostic systems have different ways to capitalize and punctuate. Espoo has sourced his version with NIMH materials and various dictionaries. I personally prefer the medical sources because this is a medical article. In any event, I would like some comment here. Thanks. Cresix ( talk) 23:09, 26 September 2010 (UTC)
OK, so we've agreed to lowercase. The reason seems to be because MOS says to avoid capitalisation unless necessary and because all other diseases and disorders on Wikipedia are lowercase.
But trying to decide whether or not to use a hyphen here can't be resolved that easily, and it can't really or shouldn't be decided on the basis of a consensus because it's not a question of style. We should go by what the majority of carefully edited texts do (attention deficit hyperactivity disorder).
Whether or not to use a hyphen in a normal compound modifier is usually a style issue and often the cause of senseless and petty fights (often along ENGVAR lines or between generations). A hyphen in a normal compound modifier is only rarely necessary to prevent misunderstanding (e.g. "little-celebrated paintings" to prevent "little celebrated paintings" from being misunderstood or at least momentarily misread as celebrated paintings that are little).
ADHD is not a (or the) hyperactivity disorder characterised by attention deficit. Only if that were the case, would the spelling "attention-deficit hyperactivity disorder" be correct. ADHD is a disorder usually characterised by both attention deficit and hyperactivity and rarely characterised by only one of these two behaviors. If we try to make a single term out of all that, we get the long but plain-English expression: "attention-deficit and hyperactivity or attention-deficit or hyperactivity disorder". (As you can see, i'm far from being an enemy of the hyphen. Each of these hyphens could be left out without causing confusion, but they help the reader, and i'd definitely prefer a hyphen even in the short term "attention-deficit disorder".)
Various spellings such as "attention deficit-hyperactivity disorder" and "attention deficit/hyperactivity disorder" try to use a slash or a hyphen (or an en dash) to indicate that the term "attention deficit" does not modify the term "hyperactivity" or the term "hyperactivity disorder" and to indicate, on the contrary, that the terms "attention deficit" and "hyperactivity" express a parallel relationship or alternatives.
But the majority of medical and other carefully edited publications nowadays use "attention deficit hyperactivity disorder" without any hyphen or slash. I think it's because they've decided that "a-d h d" would be illogical and wrong (as explained above) and "a d/h d" and "a d-h d" are very hard to parse and would be misread and misunderstood, probably as something chaotic such as "a disorder affecting attention and characterised by deficit or hyperactivity" and "a disorder affecting attention and characterised by 'deficit hyperactivity'" respectively. By not using a hyphen or a slash, the most common (and apparently most modern) spelling "attention deficit hyperactivity disorder" elegantly avoids misleading the reader (and the public). So what looks like sloppiness (many people, including myself, prefer using hyphens in compound modifiers even when not necessary) is in fact less confusing or illogical. -- Espoo ( talk) 21:55, 13 October 2010 (UTC)
The International Reading Association Guide to Style and Usage, the Encyclopaedia Britannica, the Centers for Disease Control and Prevention, the DSM-IV-TR, the National Institute of Neurological Disorders and Stroke, and the Mayo Clinic use the hyphen. The National Institute of Mental Health, the American Academy of Child and Adolescent Psychiatry, the Attention Deficit Disorder Association, ADDitude magazine, and Children and Adults with Attention Deficit/Hyperactivity Disorder do not use the hyphen. From this admittedly small sample, it appears that while academics are split and possibly lean slightly toward using the hyphen, advocacy groups may prefer no hyphen. rouenpucelle ( talk) 23:44, 1 July 2011 (UTC)
This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page. |
Archive 15 | ← | Archive 18 | Archive 19 | Archive 20 | Archive 21 | Archive 22 | → | Archive 25 |
In the recent cleanup, this picture got binned in the process. I thought it was nice and would better replace the general brain picture in the pathophysiology section. The only problem is I can't find the context the picture was used in in order to source it appropriately, see if the source is acceptable, and verify if the public use rationale is correct. Anyone else know where in the NIMH materials it came from? 152.16.15.144 ( talk) 21:59, 21 April 2010 (UTC)
http://www.aafp.org/afp/2001/0901/p817.html - It's a good potential source. It looks like a usable secondary RS to me, but I am asking for a second opinion on whether it looks appropriate. 152.16.15.144 ( talk) 22:30, 21 April 2010 (UTC)
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Doc James (
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email) 04:16, 22 April 2010 (UTC)I removed the "either" / "or" statements in the diagnosis criteria according to dsm-iv. It is just not correct, as can be seen from the reference. Lova Falk talk 06:29, 19 May 2010 (UTC)
This reference is to an article that's totally irrelevant to ADHD, it's an editorial on words like "wheelchair-bound." Check it out: http://journals.lww.com/ajpmr/Citation/1991/02000/Words,_Words,_Words.1.aspx
cite journal |author=Johnson EW |title=Words, words, words |journal=American Journal of Physical Medicine & Rehabilitation |volume=70 |issue=1 |pages=1–2 |year=1991 |month=February |pmid=1994964 |doi=10.1097/00002060-199102000-00001 It's not really a source for diagnostic procedure, since it's an op-ed that's on a different topic. Who does this? Why does this happen? 75.73.32.46 ( talk) 18:54, 27 April 2010 (UTC)
Under the above mentioned header, it says: "Other medications which may be prescribed off-label include alpha-2A adrenergic receptor blockers such as and clonidine " - as you can see, a brand or generic medication name seems to be missing in the sentence (such as XXXXX and clonidine"). I tried to find an answer to it online, but couldn't, so hopefully somebody else can add it. Peapeam ( talk) 03:16, 25 May 2010 (UTC)
In an article about ADHD, a list of famous people just takes up space and makes for even slower loading. I don't think it belongs here.
One solution might be the one used for Dyslexia. There is a separate article: List of people diagnosed with dyslexia, listed, of course, as a See also. -- Hordaland ( talk) 19:24, 27 May 2010 (UTC)
The reference to the letter to the editor regarding tolerance was misrepresented. This article said that tolerance occured in doses above 60 mg but the letter actually said it may be necessary to increase the dose above 60 mg to counter-act the effects of tolerance. Looks like a good faithed misinterpretation of the source. I have fixed the issue. Tolerance and dependence are listed in the British National Formulary as adverse effects of methylphenidate as well as dexamphetamine; might be worth referencing it, although it doesn't say much about it other than they are adverse effects.-- Literaturegeek | T@1k? 00:08, 10 June 2010 (UTC)
Get rid of TV advertisements where children programs are on. :) —Preceding unsigned comment added by 89.111.97.100 ( talk) 18:59, 2 July 2010 (UTC)
The section on diet are a bit missleading about E-numbers and the US. It mentions that the England has forced manufacturers that use(for example)ponceau 4R (E124)in food to display a warning. Then the text go on that "In the US, little has been done to curb food manufacturer’s use of specific food colors, despite the new evidence presented by the Southampton study". But if you go into the articel about ponceau 4R (E124) it says that this E-product is banned in the US. And that it seems that it has been banned for a long time. A search on the FDA page marks allmost all of the E-products mentioned,as "unapproved colours".
Thus, this text about diet contains missleading information and there I have will remove it. —Preceding unsigned comment added by 192.71.219.1 ( talk) 07:52, 11 July 2010 (UTC)
In order to progress this I am going to list each one and their status from the FDA list [2] and have highlighted the US status merely so it can be easily seen...
It seems to me that this can be broken down simply.
Chaosdruid ( talk) 19:27, 12 July 2010 (UTC)
The management section, especially the stimulant med section, is getting out of hand. It's too long and a disproportional amount of it is spent on discussing in detail about addiction and abuse such that it overwhelms other important information such as what the actual stimulant drugs are, how they work, what general practice is on prescribing them, etc. The discussion of the various studies really ought to be moved to the management page, with brief summary of the current prevailing medical opinion (or lack of one whatever the case) on addiction and abuse. 152.16.15.144 ( talk) 22:09, 30 July 2010 (UTC)
I'm wondering if we can provide a more substantiated reference for the following statement:
"In one study which looked at adult cocaine users, it was found that those individuals who used Ritalin between one and ten years of age had a percentage of cocaine abuse twice that of those who had been diagnosed with ADHD but had not utilized Ritalin.[146]"
I question the context and accuracy of the above statement for a number of reasons. First, it references http://www.addictionsearch.com/treatment_articles/article/ritalin-abuse-addiction-and-treatment_43.html and does not directly reference an academic source. Second, the context is questionable and does not consider cocaine use among individuals diagnosed with ADHD who are not taking any medication, or those who discontinued medication and now use illicit substances.
Tshortho ( talk) 04:27, 2 November 2010 (UTC)
This study seems worth mentioning in the article: http://www.sciencedaily.com/releases/2010/08/100817103342.htm Gandydancer ( talk) 23:12, 17 August 2010 (UTC)
It has been proposed at Wikipedia talk:Invitation to edit that, because of the relatively high number of IP editors attracted to Attention-deficit hyperactivity disorder, it form part of a one month trial of a strategy aimed at improving the quality of new editors' contributions to health-related articles. It would involve placing this:
You can edit this page. Click here to find out how.
at the top of the article, linking to this mini-tutorial about MEDRS sourcing, citing and content, as well as basic procedures, and links to help pages. Your comments regarding the strategy are invited at the project talk page, and comments here, regarding the appropriateness of trialling it on this article, would be appreciated. Anthony ( talk) 11:42, 31 August 2010 (UTC)
Joel Nigg in What Causes ADHD? makes a case for lead poisoning, mercury poisoning, as well as other environmental contaminants causing 2-15% of cases of ADHD. He also relates premature birth (in this article already?).
Joel Nigg, What Causes ADHD? Lead poisoning - p. 246,247,215,262,344,377 Mercury poisoning - p. 251,318,345,253,335,262,276,299 http://books.google.com/books?id=y_LCZuc-F8wC&printsec=frontcover&dq=joel+nigg&hl=en&ei=QB2KTNzdLoHGlQft87WeDA&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCwQ6AEwAA#v=onepage&q&f=false Natural ( talk) 12:00, 10 September 2010 (UTC)Natural
Nigg, p.282, 284, 287, 345, 288, 317, 100 Nigg sees a correlational relationship, not necessarily a cause - effect relationship, as far as the evidence of existing studies goes. He feels that more research is needed before coming to conclusive statements on this. Most parents are interested in the role of television and ADHD.
Another significant study is --- reported in- PEDIATRICS Vol. 113 No. 4 April 2004, pp. 708-713 Early Television Exposure and Subsequent Attentional Problems in Children Dimitri A. Christakis, MD, MPH*,,,||, Frederick J. Zimmerman, PhD,, David L. DiGiuseppe, MSc, Carolyn A. McCarty, PhD*,
http://pediatrics.aappublications.org/cgi/content/abstract/113/4/708
which again, gives evidence for a correlationtial relationship, rather than definite proof that TV viewing among children causes ADHD.
Nigg also mentions video games in connection with ADHD as a possible cause. p.345,280,103,301,74
Natural ( talk) 12:07, 10 September 2010 (UTC)Natural
Basically, what Susan Ashley states in her book, http://books.google.com/books?id=ZKpBEPd0w5kC&printsec=frontcover&dq=susan+ashley+adhd&hl=en&ei=vTqRTM-jC4P88Aa6vZGUDQ&sa=X&oi=book_result&ct=result&resnum=1&ved=0CDYQ6AEwAA#v=onepage&q=television&f=false
on this page, sums it up in the proper manner. page 15. Nigg says more research is needed on this, which is a good point for the professional public to note as well. No one is really sure if TV or video games cause ADHD. So, if some professional studies were forthcoming to give a more definitive answer, it would help all the way around. Natural ( talk) 21:32, 15 September 2010 (UTC)Natural
I just removed the following, apparently added just a few minutes ago right at the beginning of the article:
Undiognosed ADHD is often the cause of many disorders in Adults such as Anxiety and Depression. The inability to organise, maintain focus and dibilitating social interaction and working memory problems can and do cause these aditional disorders in adults who go through life undiognosed.
It apears that the medical industry as a whole are narrow minded when it comes to the effects of Adhd in an Adult and therefore are prone to completly ignoring it as a possability in a patiant. This is mostly down to lack of education on the doctors behalf and lack of skill in how to question a possible Adhd patiant. It is shocking to see how many doctors and medical “experts” fail to gain a basic knowledge on Adult Adhd as well as Adhd in Teenagers, they are only just starting to get to grips with Adhd as a real disorder.
Aside from being badly spelled and carelessly written, it is blatantly POV. An in any case, it does not belong at the beginning of the article. Regardless of the merits--or lack thereof--of the point someone is trying to make, this sounds like someone just got on a soapbox to vent his or her frustrations. 140.147.236.194 ( talk) 12:45, 21 September 2010 (UTC)Stephen Kosciesza
The PET image is very old. Pet scans are not used outside of research in ADHD. Thus having the image in the lead is WP:UNDUE. Moved to appropriate section. Doc James ( talk · contribs · email) 18:16, 23 September 2010 (UTC)
The result of the move request was: page moved: has run 19 days. Anthony Appleyard ( talk) 08:46, 18 October 2010 (UTC)
Attention-deficit hyperactivity disorder → Attention deficit hyperactivity disorder —
That first paragraph is poorly written. There is one sentence, "Stimulant medication or non-stimulant medication may be prescribed." which is out of place. It breaks up the flow of the paragraph (still poorly written) as much as me now saying, "This page has a white background." —Preceding unsigned comment added by 74.138.131.215 ( talk) 05:16, 25 November 2010 (UTC)
Move indepth discussion of stimulants and off label medications belongs on the management subpage. Doc James ( talk · contribs · email) 01:08, 10 January 2011 (UTC)
A few reviews with which to update this article.
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Sources for Caffeine as a stimulate for ADHD focusing: http://www.asktheneurologist.com/Adult-ADHD.html (Slides 22-24) http://en.wikipedia.org/wiki/Low_arousal_theory http://www.youtube.com/user/DocADHD http://www.youtube.com/watch?v=DzH9sNQmclo
Personal Experiences: I have Adult ADHD at age of 24 and I find Caffeine makes a big different when needing to focus. If I'm doing a task or anything and become stuck due to a lack of stimulation Caffeine is a great way to fill the gap which allows the continuation of the task. Improvements for ADHD is already mentioned "In essence, caffeine consumption increases mental performance related to focused thought while it may decrease broad-range thinking abilities." but not linked to ADHD in the statement. —Preceding unsigned comment added by 86.0.140.137 ( talk) 10:49, 30 January 2011 (UTC)
{{edit semi-protected}}
Well placed theory that ADHD does not exist, and that people are made how they are made. For example, a child may be on the Attention Deficit Hyperactivity Disorder (ADHD) scale, and will act disruptively, but a child that is disruptive is not necessarily ADHD. Many would argue that an ADHD boy is just a boy being a boy, and indeed when the child is around peers acting in a similar way, he will automatically act the same to fit in.
Halarond ( talk) 13:33, 4 February 2011 (UTC)
Per Jmh649's comment, Already done. Qwyrxian ( talk) 14:05, 4 February 2011 (UTC)
User:Jmh649, please stop removing data from the article that was created by multiple editors! Removing information bring down the quality of the article. I think you more concern about removing criticism and promoting your ideas, then improvement of the article. Innab ( talk) 20:03, 4 February 2011 (UTC)
While reading this article, in particular the "Causes" section, I got the distinct impression that the word "theory" is being used inappropriately to describe what are, in fact, merely hypotheses. According to Wikipedia itself (as attributed to the Unites States National Academy of Sciences), in pedagogical contexts -- such as in an encyclopedia -- a "scientific theory" is "... a comprehensive explanation of some aspect of nature that is supported by a vast body of evidence". None of the "theories" described in the ADHD article seem to fit this rigorous definition. To the contrary, a number of wildly differing and possibly conflicting theories about the same subject generally cannot all be theories simultaneously, by definition. Because if one theory is comprehensive enough, and supported by enough evidence, then the other competing theories would have by then been disproved. I propose that each use of the word "theory" in this article be scrutinized and changed to "hypothesis" where it is found to be the more appropriate choice of word. Moulding ( talk) 17:08, 15 February 2011 (UTC)
While medication has been shown to improve behavior when taken over the short term, they have not been shown to alter long term outcomes.[126]
126 refers to Yamada A, Takeuchi H, Miki H, Touge T, Deguchi K (July 1990). "[Acute transverse myelitis associated with ECHO-25 virus infection]" (in Japanese). Rinshō Shinkeigaku 30 (7): 784–6. PMID 2242635.
How is this related to long term treatment of ADHD with medication? —Preceding unsigned comment added by 149.43.82.54 ( talk) 18:04, 25 February 2011 (UTC)
{{edit semi-protected}}
Please change "ADHD is diagnosed two to four times as frequently in boys as in girls" to "ADHD is diagnosed two to four times more frequently in boys as in girls", or so.
--
114.250.17.77 (
talk) 06:28, 26 February 2011 (UTC)
In the "In adult" section, it states "Researchers found that 60 percent of the children diagnosed with ADHD continue having symptoms well into adulthood.", but the lead states "It is a chronic disorder with 30 to 50 percent of those individuals diagnosed in childhood continuing to have symptoms into adulthood." phalacee ( talk) 01:08, 4 March 2011 (UTC)
{{ edit semi-protected}} On the page "Attention deficit hyperactivity disorder" under section 10: Society and Culture, subsection 10.2: Controversies, two spelling/grammar errors need to be corrected in the first paragraph and a sentence needs restructuring in the second paragraph. Below are the sections that need editing. Two copies of each section are given, the first is the original text highlighting the errors currently present and the second is the edited version of the original highlighting the corrections made. Both the errors and the corrections are bolded and enlarged in parenthesis.
1) In the first paragraph of subsection 10.2: Controversies, the word dunctioning three lines from the bottom needs to be changed to functioning, and the word state two lines from the bottom needs to be changed to states:
"...thresholds are socially and culturally influenced and determine how an individual's level of (d)unctioning within the "normal cultural environment" is assessed. It further state(_) that "the acceptable thresholds for impairment are partly driven by the contemporary societal view of what is an acceptable level of deviation from the norm." "
"...thresholds are socially and culturally influenced and determine how an individual's level of (f)unctioning within the "normal cultural environment" is assessed. It further state(s) that "the acceptable thresholds for impairment are partly driven by the contemporary societal view of what is an acceptable level of deviation from the norm." "
2) In the second paragraph of subsection 10.2: Controversies, the second sentence needs reconstruction. (Current and recommended reconstruction will be shown below, the sentence reconstruction is isolated to 4 areas labelled 1-4 to easily match the original text with the reconstructed [the numbers are NOT part of the reconstruction], the first sentence has been added in for orientation purposes but has been reduced in size in order to differentiate it from the problem sentence):
"Others have included that it may stem from a misunderstanding of the diagnostic criteria and how they are utilized by clinicians,[15]:p.3 teachers, policymakers, parents and the media.[17] 1) (Debates center around): whether ADHD is a disability or 2) (whether it is) merely a neurological description, the cause of the disorder, the changing of the diagnostic criteria, 3) (and) the rapid increase in diagnosis of ADHD 4) (_) and the use of stimulants to treat the disorder."
"Others have included that it may stem from a misunderstanding of the diagnostic criteria and how they are utilized by clinicians,[15]:p.3 teachers, policymakers, parents and the media.[17] 1) (Debates center around key controversial issues): whether ADHD is a disability or 2) (text deleted) merely a neurological description, the cause of the disorder, the changing of the diagnostic criteria, 3) (text deleted) the rapid increase in diagnosis of ADHD 4) (,) and the use of stimulants to treat the disorder." 130.39.0.200 ( talk) 04:18, 16 March 2011 (UTC)
The wikipedia page http://en.wikipedia.org/wiki/Methylphenidate states:
"Israel Over The Counter: February 9, 2011 The Ethics Committee of the Medical Histadrut (Federation) will now be permitted to sell the psycho-stimulant drug that treats attention-deficit hyperactivity disorder (ADHD) Ritalin (Methylphenidate) without a doctor’s prescription. http://www.onejerusalem.com/2011/02/09/medical-histadrut-permits-over-the-counter-ritalin/"
This ADHD page section on the legal status of ADHD medications may need to be updated to reflect this change and to be consistent. —Preceding unsigned comment added by 66.75.76.27 ( talk) 04:27, 12 April 2011 (UTC)
Images are important. If we do not wish this one is there a better one people can propose? Doc James ( talk · contribs · email) 23:21, 20 April 2011 (UTC)
But what is the *point* of the image? What does it do? Does it inform the reader in any way? Does it clarify anything? Wikipedia:Image#Pertinence_and_encyclopedic_nature —Preceding unsigned comment added by 79.97.92.28 ( talk) 02:33, 21 April 2011 (UTC) Sorry, ^that^ was me on someone else's computer, didn't realise I wasn't logged in. 79.97.92.28 ( talk) 15:36, 21 April 2011 (UTC) Shit. Forgot to log in again. Dbpjmuf ( talk) 16:34, 21 April 2011 (UTC)
Shouldn't there at least be some mention of Dr. Daniel G. Amen and his AD/HD subtypes? OzW ( talk) 15:47, 6 May 2011 (UTC)
This article ignores the Hyperfocus aspect of ADHD. I was part of a group studied by Ohio State University in the early 1970s (it was still called Hyperkinesis) and they found that if we found something we were interested we would Hyperfocus on that one task. There should be some material in the literature regarding this.-- BruceGrubb ( talk) 12:07, 26 May 2011 (UTC)
I consider adding this unnecessary as we link just a couple paragraphs above to the whole article thus linking to a single subsection here [15] is not needed. Doc James ( talk · contribs · email) 20:02, 1 June 2011 (UTC)
We all are trying to write a better and more accurate encyclopedia. Thus I was surprised that the article has failed to address the issue of overdiagnosis (and is quite skimpy on this topic in its satellite article on Attention-deficit hyperactivity disorder controversies). Recently, two studies brought this issue into the public limelight. My attempt to bring the topic into the main article was twice censored the main argument being that the supporting studies were made by "economists" in an "economic journal." Really? Do we want to restrict medical information - important enough to be picked up by CNN [16] and Time Magazine (August 30, page 16) - from inclusion simply by flimsy assertions that the information was not written by experts and the (peer-reviewed) journal is not “medical” and thus can be excluded as a reliable source in medical articles? The articles have been published, and it is not productive to dismiss the authors as "economists" instead of looking at the evidence.
I submit that, as the response by CNN and Time Magazine shows, the issue of overdiagnosis is important enough to be addressed in the main article, and I suggest the following section to be placed in its “Controversies” section:
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Ekem ( talk) 13:25, 31 August 2010 (UTC)
Dear ::Cresix, This is not a 'medical' article as ADHD is not formed of a biological basis it is environmental and thus a psychological article and therefore one which can be debated in various articles. This whole article is in fact bias. kind regards. Dr.A.Williams (Consultant Clinical Psychologist) — Preceding unsigned comment added by 86.163.127.47 ( talk) 00:32, 25 June 2011 (UTC)
Ekem, I would never object to any discussion on a talk page. That having been said, this change needs a solid consensus because the "science" behind it is weak. I don't have access to the Journal of Health Economics, but from what I can see in the pmid links you provided, there is absolutely nothing to support your statement: "substantial increase in the diagnosis of ADHD in recent decades" or your assertion of "overdiagnosis". From what I can see, the most that is demonstrated is that diagnosis may be confounded with age of entry in school. That may be a legitimate point, but it is a far cry from substantiating "overdiagnosis" of ADHD. Note I am not arguing one way or the other as to whether ADHD is overdiagnosed. My criticism is directed at making such a conclusion with little to no scientific evidence, as is the case in the sources you provide. And this speaks directly to my earlier point: Economists, even healthcare economists, do not have sufficient expertise to address diagnostic procedures for a medical disorder; and it doesn't matter how many numbers they crunch. I'm a doctor, but I would not dare try to publish anything in a journal related to economics, unless it directly pertained to medicine. These articles (at least as much as I have access to), although interesting and informative in some issues related to ADHD, are simply inadequate to draw conclusions about "overdiagnosis" of ADHD. Cresix ( talk) 00:00, 2 September 2010 (UTC)
(undent) I agree with both people here. First of all concerns about over diagnosis have been voiced. Second we should use a medical review article to support this assertion. Doc James ( talk · contribs · email) 18:41, 2 September 2010 (UTC)
Basically I agree, WhatamIdoing, although I think a very brief mention of the findings in the context of diagnostic controversies might be appropriate. The LeFever article makes a good case for overdiagnosis, but I think we need to proceed with caution in placing such a conclusion in the Wikipedia article.
BTW, one other issue that occurred to me (because I don't have access to the economic journals) is how the authors determined that the children had ADHD. That has been a problematic issue in some other research. If someone who has read the articles could enlighten me I would appreciate it.
Cresix (
talk) 20:41, 2 September 2010 (UTC)
In many school districts in the United States, there are procedures for early entry into kindergarten if the parent seeks it, and (more often) it can be a parent's choice to delay entry into kindergarten or have a child repeat kindergarten. As for whether it is reasonable to conclude that older children may be underdiagnosed, I think WhatamIdoing's point is that the data in the studies cited provide no less evidence for underdiagnosis of older children than it provides evidence for overdiagnosis of younger children. That makes perfect sense. If a child is more likely to be diagnosed by being a younger child in his/her grade, then by definition a child who is an older child in a grade is less likely to be diagnosed. What we don't know is why. Cresix ( talk) 21:24, 2 September 2010 (UTC)
Gandydancer, I'm not suggesting that we add anything about early or late entry into kindergarten in the article. I don't need a reference any more than you do for your assertion that it doesn't happen. It may not be your experience in your geographical area, but in my work I see at least five or six kids every year who have entered kindergarten at four years old. I see dozens of children whose parents voluntarily delayed their kindergarten entry because their parents felt they weren't ready. I'm not saying that parents have absolute authority or that it's done 100% of the time parents request it (school are especially hesitant to allow early entry; much less so with late entry). I'm saying there are procedures used by many school systems (and I've worked throughout the USA) for these exceptions to five-year-old kindergarten entry when parents request it. To some extent we have strayed from the main issue, however. The important point is that there are potentially confounding factors in the research on greater diagnosis of ADHD according to age within a grade. We simply can't conclude on the basis of the journal articles cited that age is the only factor leading up to a younger child's diagnosis of ADHD. It may be one factor in the diagnosis, but that doesn't mean it's the only factor. For example, there may be differences in how parents treat children who enter kindergarten at a younger age (and I emphasize may be); we don't know that unless we examine it or control for it in the research. There could be many other differences in these younger children that we are unaware of. That's the challenge of behavioral research: ruling out all of the possible alternative explanations. That is rarely done with one or two studies. And that is why we have to be cautious in jumping to conclusions about overdiagnosis or underdiagnosis. Cresix ( talk) 03:31, 3 September 2010 (UTC)
There are three studies as, far as I see, that indicate that young-for-grade children are more likely to be diagnosed with ADHD, the two recent studies in the Journal of Health Economics (JHE) and the earlier study by DeFever, a psychologist. It would be nice to have an objective review or analysis, but, I fear, that there has not yet enough time for such an analysis.
Regarding the data collection:
Evans et al use three data sets that are not merged for their analysis. One is the NHIS , an “annual survey of roughly 60,000 households that collects data on the extent of illness, disease, and disability in the civilian, non-institutionalized population of the United States” which includes self-reported medical conditions of respondents including information on ADHD diagnosis in its Sample Child Supplement. The authors state that “ ADHD incidence rates from the NHIS are comparable to results from other national surveys from similar periods”. Their second data source is the Medical Expenditure Survey (MEPS), “ a series of surveys administered since 1996 by the Agency for Healthcare Research and Quality and the National Center for Health Statistics”. For this purpose it evaluates medication use for ADHD identified by its ICD-9 code 314.10. The third data set comes from a “proprietary claims data base constituting private insurance contracts for nearly 1 million covered lives and representing at least 40 of the 50 U.S. states”. Elder uses in his study the ECLS-K, a “ National Center for Education Statistics (NCES) longitudinal survey that initially included 18,644 kindergarteners from over 1000 kindergarten programs in the fall of the 1998–1999 school year”. Individuals, parents and teachers were again re-sampled five times until 8th grade. Elder states that the ECLS-K is “ particularly useful for studying ADHD because it includes binary measures of ADHD diagnoses and treatment as well as teacher and parent reports of ADHD-related symptoms”. The study also includes follow-up questions on medication use. Although different data sets are used, the two studies are in agreement that young-for –grade children are at higher risk for a diagnosis of ADHD.
Regarding over- and underdiagnosis:
The data , by themselves, as Evans et al point out, do not indicate whether the diagnostic pattern is correct for the young-for-grade group or the old-for-grade group; all they show is that there is a difference which means that factors other than neurological causes are at work. It is their interpretation that the younger group contains more individuals who are misdiagnosed because of immaturity. Elder comes to the same conclusion. As the authors speak of “inappropriate diagnosis” and “misdiagnosis”, I agree to drop the perhaps loaded term “overdiagnosis” and use the terms they use.
Things are complicated and the project is getting bigger as we look at it. I hope that we can agree that the basic notion - younger-for-grade children at higher risk for diagnosis - goes into the controversies section, and a more detailed discussion into the satellite article. Back after the weekend. Ekem ( talk) 03:49, 3 September 2010 (UTC)
Let me try and come to some kind of consensus here. This here is like an onion, as there appears layer after layer of controversy, yet not much of this is evident when reading the main article. In any case, it appears that we can agree (can we?) on the point that there is some credible evidence of “inappropriate diagnosis”, as shown by three studies referenced above that show a higher risk for the diagnosis of ADHD in young-for-grade children (or lower risk for old-for-grade children): this information should be in the main article, maybe briefly, and can be more elaborated on in the satellite article. A second controversy is the topic of overdiagnosis per se: can we agree to make a statement that this is, first of all, a valid topic, something that is being discussed when ADHD is addressed, an item of concern? The 2007 study by Sciutto and Eisenberg [17] is founded on the premise that there is a common perception that AHDH is overdiagnosed. Assuming there is no overdiagnosis, there is also evidence of significant variation in the diagnosis - this is, indeed, brought out in the article, but not explained. Another issue is the steep increase in medical therapy in the 90s that has been documented (Zuvekas et al, 2006 [18]) which, in turn, may be related to a perception of overdiagnosis. Let me add another controversy, the recent finding that medical therapy has been reported to have failed to show long term benefits (but, instead, treated subjects ended up shorter) - the reference is in the article only to indicate that subjects later have problems "regardless of treatment" (Molina et al, 2009 [19]). Ekem ( talk) 02:08, 10 September 2010 (UTC)
How about phrasing it this way:
The quoted sentence is from the authors, not me. I plan to return to Molina et al later. Ekem ( talk) 13:43, 13 September 2010 (UTC)
This
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Some minor spelling errors (e.g., terminal s missing from some plural words) in section on History/Society.
Davsch65 ( talk) 13:15, 21 June 2011 (UTC)
The history section appears to have had some vandalism, see below. Anyone know how to clean this up? Also, the source referenced is just a link to the civil rights act, which is, obviously, off-topic.
However, in 2010, Dr. Taylor Warfield, a scientist at the ADHD research institute in , Missouri, attempted to prove his theory that "ADHD is not a disease, but merely a disorder,"
—Preceding unsigned comment added by 207.22.18.147 ( talk • contribs) 21:02, 9 April 2010 (UTC)
Espoo ( talk · contribs) has twice changed the capitalization and punctuation in spelling the name of the disorder. This is not something worth edit warring over, but my main point is that there is flexibility in how the disorder is spelled. In fact, in the United States (and I presume Canada) the official name for the disorder according the most authoritative source ( DSM-IV) is "Attention-Deficit/Hyperactivity Disorder" with that exact capitalization and punctuation. Other medical diagnostic systems have different ways to capitalize and punctuate. Espoo has sourced his version with NIMH materials and various dictionaries. I personally prefer the medical sources because this is a medical article. In any event, I would like some comment here. Thanks. Cresix ( talk) 23:09, 26 September 2010 (UTC)
OK, so we've agreed to lowercase. The reason seems to be because MOS says to avoid capitalisation unless necessary and because all other diseases and disorders on Wikipedia are lowercase.
But trying to decide whether or not to use a hyphen here can't be resolved that easily, and it can't really or shouldn't be decided on the basis of a consensus because it's not a question of style. We should go by what the majority of carefully edited texts do (attention deficit hyperactivity disorder).
Whether or not to use a hyphen in a normal compound modifier is usually a style issue and often the cause of senseless and petty fights (often along ENGVAR lines or between generations). A hyphen in a normal compound modifier is only rarely necessary to prevent misunderstanding (e.g. "little-celebrated paintings" to prevent "little celebrated paintings" from being misunderstood or at least momentarily misread as celebrated paintings that are little).
ADHD is not a (or the) hyperactivity disorder characterised by attention deficit. Only if that were the case, would the spelling "attention-deficit hyperactivity disorder" be correct. ADHD is a disorder usually characterised by both attention deficit and hyperactivity and rarely characterised by only one of these two behaviors. If we try to make a single term out of all that, we get the long but plain-English expression: "attention-deficit and hyperactivity or attention-deficit or hyperactivity disorder". (As you can see, i'm far from being an enemy of the hyphen. Each of these hyphens could be left out without causing confusion, but they help the reader, and i'd definitely prefer a hyphen even in the short term "attention-deficit disorder".)
Various spellings such as "attention deficit-hyperactivity disorder" and "attention deficit/hyperactivity disorder" try to use a slash or a hyphen (or an en dash) to indicate that the term "attention deficit" does not modify the term "hyperactivity" or the term "hyperactivity disorder" and to indicate, on the contrary, that the terms "attention deficit" and "hyperactivity" express a parallel relationship or alternatives.
But the majority of medical and other carefully edited publications nowadays use "attention deficit hyperactivity disorder" without any hyphen or slash. I think it's because they've decided that "a-d h d" would be illogical and wrong (as explained above) and "a d/h d" and "a d-h d" are very hard to parse and would be misread and misunderstood, probably as something chaotic such as "a disorder affecting attention and characterised by deficit or hyperactivity" and "a disorder affecting attention and characterised by 'deficit hyperactivity'" respectively. By not using a hyphen or a slash, the most common (and apparently most modern) spelling "attention deficit hyperactivity disorder" elegantly avoids misleading the reader (and the public). So what looks like sloppiness (many people, including myself, prefer using hyphens in compound modifiers even when not necessary) is in fact less confusing or illogical. -- Espoo ( talk) 21:55, 13 October 2010 (UTC)
The International Reading Association Guide to Style and Usage, the Encyclopaedia Britannica, the Centers for Disease Control and Prevention, the DSM-IV-TR, the National Institute of Neurological Disorders and Stroke, and the Mayo Clinic use the hyphen. The National Institute of Mental Health, the American Academy of Child and Adolescent Psychiatry, the Attention Deficit Disorder Association, ADDitude magazine, and Children and Adults with Attention Deficit/Hyperactivity Disorder do not use the hyphen. From this admittedly small sample, it appears that while academics are split and possibly lean slightly toward using the hyphen, advocacy groups may prefer no hyphen. rouenpucelle ( talk) 23:44, 1 July 2011 (UTC)