Comment by adadadadadad | Hacker News Reader

Comment by adadadadadad | Hacker News Reader

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If you look into how the criteria is chosen its very arbitrary. And this descriptive diagnosis where you pick from list A and B is extremely bizarre from a common sense standpoint. And there is no brain imaging or genetic markers available.

> The number of criteria required for a diagnosis of ADHD has been set arbitrarily in DSM-5. No scientific justification has been presented nor method used for deciding how many criteria should be required

> https://www.frontiersin.org/articles/10.3389/fsoc.2022.81476...

and...

> For the case of ADHD specifically, this is translated to: “if an individual has attention deficit hyperactivity disorder it is because he is inattentive, disorganized and hyperactive-impulsive, and if an individual is inattentive, disorganized and hyperactive-impulsive it is because he has ADHD.

> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9871920/

It's important to be aware that each percentage point is hundreds of millions of dollars.

The set of symptoms are not arbitrary, but are connected logically, by each being the result of a deficit in some type of executive function. ADHD is broadly a disability of executive function.

Executive function is historically entirely a psychological concept, although there is starting to be some biological understanding which came later (e.g. which brain regions are involved, etc.).

> The number of criteria required for a diagnosis of ADHD has been set arbitrarily in DSM-5. No scientific justification has been presented nor method used for deciding how many criteria should be required.

Erm.. welcome to psychiatry ?

There is nothing bizarre (or unique to ADHD) about picking from a list of precise, agreed-upon criteria to form a mental health diagnosis. It's how the entire field works, and it's actually a huge step forward from the times when each therapist made up their own definitions.

In the absence of definite imaging or genetic markers for most illnesses, building consensus on criteria and thresholds in a reference manual (the DSM) is the next best possible way to end up with objective, useful and standardized definitions.

Not having a blood test for an illness doesn't mean it isn't real.

> It's important to be aware that each percentage point is hundreds of millions of dollars.

You don't need to resort to conspiracy theories once you understand the above.

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