The Disappearing Disease

Here’s another good joke for you. Much ADHD apparently vanishes before the first year is out. As a headline in Internal Medicine News puts it, Kids Diagnosed With ADHD Often Remit.

In fact, it can be pretty fleeting. Analysis of serial assessments of more than 8,000 U.S. children and adolescents for attention-deficit/hyperactivity disorder (ADHD) showed that the diagnosis often did not persist after follow-up of 1 year or longer, J. Blake Turner, Ph.D., said at the annual meeting of the American Academy of Child & Adolescent Psychiatry.

Has “often” taken on a different meaning from the one it used to have? You mean kiddy ADHD doesn’t automatically lead to adult ADHD in the vast majority of cases? Perhaps your doctors aren’t being scrupulous enough at doing their jobs.

“It troubles me that the [ADHD] phenotype looks so unstable,” commented Dr. Daniel S. Pine, chief of the Section on Development and Affective Neuroscience at the National Institute of Mental Health. “A lot of people are struggling with the threshold for [diagnosing] ADHD. This is a very different conceptualization of ADHD; we don’t usually think of it as something that’s gone in 2 years. If this is [children having] a transient reaction to stress, I don’t want to talk about it [in] the same way as clinical ADHD.

Stress reaction or ADHD, ADHD or stress reaction. Isn’t this a lot like gazing at an optical illusion? Sometimes you see the attractive girl, and sometimes you see the old crone. It’s not an optical illusion though; it’s an illusion of pseudo-science, and speaking of stress reactions, stressed out parents and teachers.

Additional analysis showed that lost ADHD diagnoses usually did not occur as a small change in an initially marginal diagnosis. Patients who changed from having ADHD to not having it lost five ADHD symptoms, on average. And the remitters and nonremitters all had a similar pattern of disease severity at their initial diagnosis. Patients’ age had no association with whether or not an ADHD diagnosis disappeared. And patients who received treatment had a higher likelihood of retaining their ADHD diagnosis at follow-up than did those who did not receive treatment, possibly because the patients who were treated generally had more chronic ADHD.

Either that or the “symptoms” of the “disease” turn out to be “side effects” of the drugs used to treat the “disease”.

If you’re looking for another reason why patients who receive treatment might have a higher likelihood of retaining their diagnostic label than those who don’t receive treatment, well, there is also the investment factor. People without a bill of goods, as opposed to true believers and suckers, aren’t picking up the tab. Ignorance, as the expression goes, is bliss, and this especially true where knowledge is knowledge of personal folly.