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April 28, 1999

Treatment of Attention-Deficit/Hyperactivity Disorder

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(16):1490-1491. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-16-jbk0428

To the Editor: The American Medical Association (AMA) Council on Scientific Affairs has concluded that ". . . there is little evidence of widespread overdiagnosis or misdiagnosis of ADHD [attention-deficit/hyperactivity disorder] or of widespread overprescription of methylphenidate."1

Psychiatrists Marzuk and Barchas2 state, ". . . the most significant conceptual shift (from DSM-III-R [Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition] to DSM-IV [Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition]) was the elimination of the rubric organic mental disorders, which had suggested improperly that most psychiatric disorders . . . had no organic basis." Herein, they assume but do not prove that "most psychiatric disorders" have an organic basis. Goodwin3 writes, "Physicians are consulted about the problem of alcoholism and therefore alcoholism becomes . . . a disease." Later, he acknowledges "a narrow definition of disease that requires the presence of a biological abnormality."

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