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Yes, there are bad doctors, and there are cursory or improper diagnoses, but that does not make the valid diagnoses any less valid, or the invalid diagnoses any

Yes, there are bad doctors, and there are cursory or improper diagnoses, but that does not make the valid diagnoses any less valid, or the invalid diagnoses any more valid. All doctors, from radiologists to orthopedic surgeons, are told not to self-diagnose, and psychiatric conditions are the easiest to improperly self-diagnose, even for trained professionals (which most people on HN are not). On top of that, ADHD is one of the most difficult conditions to properly diagnose. Unlike more overt disorders, like schizophrenia, the symptoms are less clear-cut, and unlike more visible disorders, like (true) OCD[0], the symptoms usually lie two or three layers deep, making it easy to confuse the cause of the symptoms if you're not careful. There exist differential diagnoses for this purpose (disambiguating the cause of the symptoms); most people just don't have them done, because they're incredibly expensive (several thousands of dollars), as they're very time-intensive on the part of the doctor. That said, the entire claim which precipitated this discussion - that ADHD is somehow related to sleep deprivation - is completely preposterous. ADHD is perhaps inappropriately named, yes, but that suggestion is like saying that the cure to depression is to "stop being sad". [0] I say "true" to distinguish clinical obsessive-compulsive disorder from the casual use of the term (eg, "oh man, my OCD kicked in when I saw Comic Sans mixed with Papyrus").

randallsquared 14y ago
> Yes, there are bad doctors, and there are cursory or improper diagnoses, but that does not make the valid diagnoses any less valid, or the invalid diagnoses any more valid. It calls into question, somewhat, whether there actually are any valid diagnoses, if a disease is well-known to be very commonly diagnosed improperly.
- btilly 14y ago
  In the case of ADHD there happens to be sufficiently good evidence of real cases, along with brain scans showing what is happening inside of the brain, that we can be very confident that the disorder is real. However if a random person claims to have it, we may not be confident that they were correctly labeled.
_delirium 14y ago
> That said, the entire claim which precipitated this discussion - that ADHD is somehow related to sleep deprivation - is completely preposterous. There's quite a bit of research on the subject, and researchers don't generally consider a relationship preposterous. It's reasonably well established that sleep disturbances and sleep deprivation can at least exacerbate the symptoms of ADHD. Some research suggests that they may also be a risk factor for developing the condition in some cases, or alternately (depending on unresolved questions about etiology) that a differential diagnosis is needed to distinguish non-sleep-related ADHD from symptoms related to sleep disorders. The diagnoses do empirically seem to co-occur quite frequently, which is one factor driving the research, but the mechanisms aren't well understood. Nature published a short review of the (very large) literature on the subject last year: J. Cassof et al., Sleep patterns and the risk for ADHD: a review, Nature 2012(4): 73-80.

randallsquared 14y ago

> Yes, there are bad doctors, and there are cursory or improper diagnoses, but that does not make the valid diagnoses any less valid, or the invalid diagnoses any more valid. It calls into question, somewhat, whether there actually are any valid diagnoses, if a disease is well-known to be very commonly diagnosed improperly.

btilly 14y ago
In the case of ADHD there happens to be sufficiently good evidence of real cases, along with brain scans showing what is happening inside of the brain, that we can be very confident that the disorder is real. However if a random person claims to have it, we may not be confident that they were correctly labeled.

_delirium 14y ago

> That said, the entire claim which precipitated this discussion - that ADHD is somehow related to sleep deprivation - is completely preposterous. There's quite a bit of research on the subject, and researchers don't generally consider a relationship preposterous. It's reasonably well established that sleep disturbances and sleep deprivation can at least exacerbate the symptoms of ADHD. Some research suggests that they may also be a risk factor for developing the condition in some cases, or alternately (depending on unresolved questions about etiology) that a differential diagnosis is needed to distinguish non-sleep-related ADHD from symptoms related to sleep disorders. The diagnoses do empirically seem to co-occur quite frequently, which is one factor driving the research, but the mechanisms aren't well understood. Nature published a short review of the (very large) literature on the subject last year: J. Cassof et al., Sleep patterns and the risk for ADHD: a review, Nature 2012(4): 73-80.