May 13, 2021
Myth: The ADHD diagnosis is very much "in the eye of the beholder."
This is one of many ways in which the ADHD diagnosis has been ridiculed in the popular media. The idea here is that because we cannot diagnose ADHD with an objective brain scan or a blood test, the diagnosis is "subjective" and subject to the whim and fancy of the doctor making the diagnosis.
Fact: The ADHD diagnosis is reliable and valid.
The usefulness of a diagnosis does not depend on whether it came from a blood test, a brain test, or from talking to a patient. A test is useful if it is reliable, which means that two doctors can agree on who does and does not have the disorder, and if it is valid, which means that the diagnosis predicts something important to the doctor and patient, such as whether the patient will respond to a specific treatment. Many research studies show that doctors usually agree about who does and does not have ADHD. This is because we have very strict rules that one must use to make a diagnosis. Much work over many decades has also shown ADHD to be a valid diagnosis. For details see: Faraone, S. V. (2005). The scientific foundation for understanding attention-deficit/hyperactivity disorder as a valid psychiatric disorder. Eur Child Adolesc Psychiatry, 14, 1-10. The short story is that the diagnosis of ADHD is very useful for predicting what treatments will be effective and what types of problems ADHD patients are likely to experience in the future.
Myth: ADHD is not a medical disorder. It's just the extreme of normal childhood energy
Mental health professionals use the term "disorder" to describe ADHD, but others argue that what we view as a disorder named ADHD is simply the extreme of normal childhood energy. After all, most healthy children run around and don't always listen to their parents. Doesn't the ADHD child or adult simply have a higher dose of normal behavior?
Fact: Doctors have good reasons to describe ADHD as a disorder
The idea that the extreme of normal behavior cannot be a disorder is naïve. Consider hypertension(high blood pressure). Everyone has blood pressure, but when blood pressure exceeds a certain value, doctors get worried because people with high values are at risk for serious problems, such as heart attacks. Consider depression. Everyone gets sad from time to time, but people who are diagnosed with depression cannot function in normal activities and, in the extreme, are at risk of killing themselves. ADHD is not much different from hypertension or depression. Many people will show some signs of ADHD at some times, but not all have a "disorder." We call ADHD a disorder not only because the patient has many symptoms, but also because that patient is impaired, which means that they cannot carry out normal life activities. For example, the ADHD child cannot attend to homework or the ADHD adult cannot hold a job, despite adequate levels of intelligence. Like hypertension, untreated ADHD can lead to serious problems such as failing in school, accidents, or an inability to maintain friendships. These problems are so severe that the center for Disease Control described ADHD as "serious public health problem."
Myth: The ADHD diagnosis was developed to justify the use of drugs to subdue the behaviors of children.
This is one of the more bizarre myths about ADHD. The theory here is that to sell more drugs, pharmaceutical companies invented the diagnosis of ADHD to describe normal children who were causing some problems in the past.
Fact: ADHD was discovered by doctors long before ADHD medications were discovered.
People who believe this myth do not know the history of ADHD. In 1798, long before there were any drugs for ADHD, Alexander Crichton, a Scottish doctor, described a "disease of attention," which we would not call ADHD.ADHD symptoms were described by a German doctor, Heinrich Hoffman, in1845 and by a British doctor, George Still, in 1902. Each of these doctors found that inattentive and overactive behaviors could lead to a problem that should be of concern to doctors. If they had had medications to treat ADHD, they probably would have prescribed them to their patients. But a medication for ADHD was not discovered until 1937 and even then, it was discovered by accident. Dr. Charles Bradley from Providence, Rhode Island had been doing brain scanning studies of troubled children in a hospital school. The scans left the children with headaches that Dr. Bradley thought would be relieved by an amphetamine drug. When he gave this drug to the children after the scan, it did not help their headaches. However, the next day, their teachers reported that the children were attending and behaving much better in the classroom. Dr. Bradley had accidentally discovered that amphetamine was very helpful in reducing ADHD symptoms, and amphetamine drugs are commonly used to treat ADHD today. So, as you can see, the diagnosis of ADHD was not "invented" by anyone; it was discovered by doctors long before drugs for ADHD were known.
Myth: Brain scans or computerized tests of brain function can diagnose ADHD.
Someday, this myth may become fact, but for now, and shortly it is a solid myth. You may think this is strange. After all, we know that ADHD is a brain disorder and that neuroimaging studies have documented structural and functional abnormalities in the brains of patients with ADHD. If ADHD is a biological disorder, why don’t we have a biological test for the diagnosis?
Fact: No brain test has been shown to accurately diagnose ADHD.
ADHD is a biologically based disorder, but there are many biological changes and each of these is so small that they are not useful as diagnostic tests. We also think that there are several biological pathways to ADHD. That means that not all ADHD patients will show the same underlying biological problems. So for now, the only officially approved method of diagnosing ADHD is by asking patients and/or their parents about ADHD symptoms as described in the American Psychological Association's Diagnostic and Statistical Manual
Organic farming aims to protect biodiversity, promote animal welfare, and avoid using pesticides and fertilizers made from petrochemicals. Some pesticides are designed to target insects’ nervous systems but can also affect brain development and health in larger animals, including humans.
Many people believe organic food is healthier than conventionally produced food, which might be true for certain foods and health factors. But does eating organic food during pregnancy impact the chances of a child developing ADHD or autism spectrum disorder (ASD)?
In Norway, researchers can use detailed national health records to study these connections on a population-wide level, thanks to the country’s single-payer healthcare system and national registries.
The Norwegian Mother, Father, and Child Cohort Study (MoBa) invites parents to participate voluntarily and has a 41% participation rate. The study includes:
For this research, a team tracked 40,707 mother-child pairs from children born between 2002 and 2009. They used questionnaires to measure how much organic food mothers consumed during pregnancy. ADHD and ASD symptoms in children were assessed using validated rating scales.
The final analysis included:
The researchers adjusted for factors like maternal age, education, previous pregnancies, BMI before pregnancy, smoking and alcohol use during pregnancy, birth year and season, and the child’s sex.
The researchers concluded that eating organic food during pregnancy has no meaningful effect on the likelihood of a child developing ADHD or ASD. They stated, “The results do not indicate any clinically significant protective or harmful effects of eating organic food during pregnancy on symptoms of ADHD and ASD in the offspring. Based on these findings, we do not recommend any specific advice regarding intake of organic food during pregnancy.”
Infertility affects about one in six couples worldwide. To address this, medical experts have developed Assisted Reproductive Technologies (ART), including In Vitro Fertilization (IVF) with or without Intra-Cytoplasmic Sperm Injection (ICSI).
Some research suggests that children conceived through ART might have higher rates of intellectual disabilities, cerebral palsy, cancer, and neurological issues compared to children conceived naturally. However, studies looking at a possible link between ART and ADHD have produced mixed and conflicting results.
Until now, there hasn’t been a meta-analysis examining the connection between ART and ADHD. A South Korean research team has conducted the first systematic review and meta-analysis on this topic. Their final analysis included eight studies with a total of over ten million participants, comprising six cohort studies and two cross-sectional studies.
The research focused on two types of studies:
Both types of studies are observational, meaning they don’t involve controlled experiments and can be influenced by confounding factors. So they can document interesting associations, not causality. The studie were mostly large-scale national studies and used clinical ADHD diagnoses.
The researchers concluded that while there may be a small association between ART and ADHD, the effect is minimal, and the results are influenced by differences in study designs. They advised interpreting these findings with caution, noting, “The limited effect size and inherent heterogeneity underscore the need for cautious interpretation.”
Periodontitis, commonly known as gum disease, is a condition where the gums become inflamed. If untreated, it can cause the gums to pull back from the teeth, exposing their base, which may eventually lead to loose teeth or tooth loss. While this condition mostly affects adults, it’s also common among teens who don’t floss or brush their teeth properly.
Until now, only a few small studies have looked at a possible link between ADHD and gum disease. A team in Taiwan recently conducted a nationwide study to explore this connection.
Taiwan has a universal health insurance program, introduced in 1995, that provides medical care to nearly all (99.7%) residents. The Taiwan National Health Research Database collects and oversees all insurance claims, making it an excellent resource for large-scale studies.
The researchers used the database to identify teens aged 12 to 19 with ADHD (diagnosed by a psychiatrist) who had no history of gum disease between 2001 and 2011. These teens made up the ADHD group. They matched each ADHD participant with four teens who didn’t have ADHD or gum disease, creating a control group. The groups were matched by age, gender, enrollment date, family income, place of residence, and other health conditions (like obesity, diabetes, smoking, depression, and substance use).
All diagnoses of gum disease were confirmed by board-certified dentists.
The study included:
The researchers concluded that teens with ADHD have a higher risk of developing gum disease later on, even after accounting for other risk factors like smoking, diabetes, and depression. They stated, “ADHD is an independent risk factor for developing periodontitis.”
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