Thank you, Dr. Pies for lending your prestige and experience to a subject that, for too long has been ignored by the leading psychiatric organizations. In fact, I am a living testimony of your long-lasting commitment to this topic because in 2004 (when you oversaw PT) I could publish a commentary about the ADHD false epidemic. A year before I questioned (also in PT) the validity of what I consider a pseudo-diagnosis: Oppositional-Defiant Disorder and mentioned that by, for example, calling oppositional-defiant a child with Social Anxiety Disorder, who refuses to attend school (because does not want to be around people), simply shift the data from one diagnosis to another but does not increase the overall number of individuals affected with a mental illness.
Both, the APA and AACAP have turned their heads away from voices like mine when we have cried foul because we see school teachers making the ADHD diagnosis and sending a mother to get a Rx of an amphetamine drug with the “diagnostic proof” provided by a behavioral scale that was never intended to be a diagnostic tool. Just yesterday, I evaluated (for a Second Opinion) a student with tics, rituals and obsessions that have been taking 30 mg of mixed amphetamine salts because “his teacher diagnosed him with ADHD.”
You stated that psychiatry is a relatively young field and it is true, but what would happen if gastroenterology was a brand-new specialty and doctors specialized in gastric problems were hearing parents “I am here because Johnny’s teacher diagnosed him with gastritis and suggested that I should get a prescription for omeprazole?”
Finally, I would like to cite an angle that it is hardly ever mentioned. School districts get more federal money if they provide special services to students with ADHD and Autism Spectrum disorders (ADS). By the way, under the DSM-IV these 2 diseases could not be diagnosed together (for very logical reasons) but the APA decided to buy into this colossal blunder and now a child with obsessions, as part of the ADS is labeled with ADHD because (like the patient I saw yesterday) he or she gets distracted by the noises and disruptive behaviors of other students or is struggling to get everything perfect.
Manuel Mota-Castillo, M.D.
Chair and Residency Program Director, Department of Psychiatry
Burrell College of Osteopathy Medicine
Chairman of Psychiatry, Memorial Medical Center
Las Cruces, New Mexico.
Manuel @ Wed, 2016-11-16 18:45
My thanks to Dr. Mota-Castillo for his spot-on comments re: inappropriate "diagnosis" by people with little or no medical or mental health training. This can certainly lead to inflated and inaccurate determinations of disease frequency and even to a bogus "epidemic."
Also, Manuel, I think you are right to decry the misapplication of the term "attention deficit/hyperactivity disorder" to people whose attention problems are secondary to an underlying disorder whether it be autism, bipolar disorder, or some other primary disorder in which attention is impaired.
In my view, you are also pointing to a broader, cultural problem, in which "everybody is an expert", and in which "direct to consumer" advertising continually bombards our patients who, of course, come to us completely convinced that they need whatever brand of medication they saw hyped on TV!