Attention-deficit/hyperactivity disorder controversies

In the past several years, attention deficit-hyperactivity disorder (ADHD) has received considerable attention from both the lay public and the medical and psychological communities. It has become one of the more controversial of the psychiatric disorders. There are several factors that contribute to this phenomenon. 

Spencer, X, Biederman, J., Wilens, T.E. and Earaone, S.V. (1998d) Adults with attention-deficit/hyperactivity disorder a controversial diagnosis. J Clin Psychiatry 59 59—68. 

Stubbe, D.E. Attention-deficit/hyperactivity disorder overview. Historical perspective, current controversies, and future directions. Child Adolesc. Psvchiatr. Clin. North Am. 9, 469-479, 2000. 

One of the most controversial CNS-acting drugs in contemporary society is methylphenidate (Ritalin ). This drug is structurally related to amphetamine and is a mild stimulant that has abuse potential similar to amphetamine. Methylphenidate is classified as a Schedule II controlled substance. It is effective in the treatment of narcolepsy and attention-deficit hyperactivity disorder (ADHD). Its use in ADHD has caused the greatest controversy. 

In Part II, we consider some of the postnatal costs of those influences and examine the strong evidence that the prenatal environment is related to various behavioral dysfunctions or anomalies and to deficits in intelligence. The chapters in this part cover fetal alcohol disorders, transsexuality, developmental disabilities such as attention deficit hyperactivity disorder (ADHD), autism, and psychosis, as well as the emotional frameworks that give rise to a few other mental disorders. The important question of individual IQ is also addressed, including the controversies about its measurement in IQ tests (what are such tests Do their scores signify anything How is their reputed significance used ) and the extent to which the prenatal environment comes into play in the variance of IQ. 

Methylphenidate is a mild stimulant prescribed to individuals (usually for children, and sometimes controversially) who have behavioral problems characterized by hyperactivity and short attention span. The National Institute of Mental Health estimates that approximately 3-5 percent of the general population has attention-deficit disorder (ADD) or attention-deficit hyperactivity disorder (ADHD). The administration of methylphenidate to children diagnosed with hyperactivity and/or attention-deficit disorder can have a calming effect on the children and can enable them to focus on schoolwork. Methylphenidate is also used to treat narcolepsy, a sleep disorder characterized by a permanent and overwhelming feeling of sleepiness and fatigue. 

---