Date of this Version


Document Type

Journal Article

Publication Details

Citation only

Thomas, R., Mitchell, G., & Batstra, L. (2013). Attention-deficit/hyperactivity Disorder: Are we helping or harming? BMJ.

Access the journal

© Copyright The Authors, 2013

This works is licensed under a Creative Commons Attribution 3.0 License.




Prevalence and prescribing rates for attention-deficit/hyperactivity disorder (ADHD) have risen steeply over the past decade, partly in response to concerns about underdiagnosis and undertreatment.1 2 But although clinicians have become better at recognising, diagnosing, and treating children with ADHD, recent US data showed that 86% of children diagnosed with ADHD are described as having “mild or moderate” disorder,3 and some diagnosed without fulfilling diagnostic criteria for ADHD.4 Mental health diagnoses are vulnerable to overdiagnosis because decisions are based predominantly on observed or self reported behaviours and interpretations of the severity of certain behaviours and whether they should be described as abnormal are subjective. There are no definitions in the UK, US, or Australian guidelines or in DSM-5 that quantify mild or moderate ADHD (box 1).5-7 We argue that the overdiagnosis of ADHD resides within the clinical subjectivity of impairment.



This document has been peer reviewed.


To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.