Attention deficit hyperactivity disorder controversies

Attention deficit hyperactivity disorder (ADHD) controversies include concerns about its causes, perceived overdiagnosis, and methods of treatment, especially with the use of stimulant medications in children. These controversies have surrounded the subject since at least the 1970s.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the leading authority in the US on clinical diagnosis and psychological behavior published by the APA in 2013, ADHD is a neurodevelopmental disorder with a prevalence rate in most cultures of about 5% in children and 2.5% in adults. Today, the existence of ADHD is widely accepted, but controversy around the disorder has existed since at least the 1970s. Adult ADHD continues to be a source of debate. According to the DSM-5, symptoms must be present before age 12, but it's not uncommon for ADHD to continue into adulthood. Parents and educators sometimes still question a perceived overdiagnosis in children and the effectiveness of treatment options, especially stimulant medications. However, according to sociology professor Vincent Parrillo, "Parent and consumer groups, such as CHADD (Children and Adults with Attention Deficit Hyperactivity Disorder), tend to support the medical perspective of ADHD."

The pathophysiology of ADHD is unclear and there are a number of competing theories.

Frequently observed differences in the brain between ADHD and non-ADHD patients have been discovered, but it is uncertain if or how these differences give rise to the symptoms of ADHD. Results from various types of neuroimaging techniques suggest there are differences in the brain, such as thinner regions of the cortex, between individuals with and without ADHD.

Although ADHD is said to be highly heritable and twin studies suggest genetics are a factor in about 75% of ADHD cases, it has been argued that ADHD is a heterogeneous disorder caused by a complex interaction of genetic and environmental factors and thus cannot be modeled accurately using the single gene theory. Authors of a review of ADHD etiology in 2004 noted: "Although several genome-wide searches have identified chromosomal regions that are predicted to contain genes that contribute to ADHD susceptibility, to date no single gene with a major contribution to ADHD has been identified.", although many further studies have occurred since. The Online Mendelian Inheritance in Man (OMIM) database has a listing for ADHD under autosomal dominant heritable conditions, claiming that multiple genes contribute to the disorder. As of 2014, OMIM listed 6 genes with variants that have been suggested to contribute to ADHD.

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