Talk:Attention deficit hyperactivity disorder/Archive 27

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Summary of symptoms

The NIMH gives "People with ADHD show an ongoing pattern of three different types of symptoms: Difficulty paying attention (inattention), Being overactive (hyperactivity), Acting without thinking (impulsivity)"

This has been summarized as "Problems paying attention, excessive activity, difficulty controlling behavior"

This is much better IMO than "inattention and hyperfocus, hyperactivity, emotional dysregulation, excessive mind wandering, behavioural self-regulation"

I am not even sure what "behavioural self-regulation" implies... Doc James (talk · contribs · email) 05:05, 20 January 2019 (UTC)

Because this is not common symptomatic terminology anymore. you are focusing on "controlling" and "problems". This wording states what they are. We can leave out behavioral self regulation if you're worried about it. But this states it in what many organisations have been advocating for for some time and it is the most up to date. we don't have to defer to the NIMH when they are out of date and in my opinion stigmatising' E.3 (talk) 21:59, 20 January 2019 (UTC)

The Spanish have a whole page on Hyperfocus on wiki. This page as it stands, deferring to the NIH, focuses on difficulties and is stigmatising to patients. the language has evolved, the USA does not control the language. E.3 (talk) 22:04, 20 January 2019 (UTC)

"inattention and hyperfocus" - these symptoms are together in the most uptodate resource. It allows patients to see what in fact happens. They don't just have attention deficit, their mind is wandering because they are hyperfocused on the thing that matters to them. If they're forced to focus on what outsiders consider to be their deficit of attention, they may have emotional dysregulation. So I strongly propose that we stick with this less stigmatising terminology as it is the most up to date consensus statement available. E.3 (talk) 22:22, 20 January 2019 (UTC)

The terminology of the new text is overly complicated. The prior wording was supported both by the DSM5 and the NIMH. Thus restored it.

How is the DSM5 "not common symptomatic terminology anymore". Additionally ADHD is more common in children. The EU source you have used is about adults. We have an article specifically for adults Adult attention deficit hyperactivity disorder.Doc James (talk · contribs · email) 00:59, 21 January 2019 (UTC)

With respect to "emotional dysregulation" it is “an associated feature that support the diagnosis” it is not a criterion for classifying individuals as it lacks specificity, occurring in many other mental health conditions.

As such it should be discussed in the body of the text rather than the lead IMO. In the body we state "show their emotions without restraint" Doc James (talk · contribs · email) 01:09, 21 January 2019 (UTC)

@Doc James:I disagree that it is more common in children than in adults. it is for many a lifelong disorder. we do not need to say the word "problem" when describing symptoms, when the EU does not. Can we change "attention deficit" to "inattention"? How do we get "hyperfocus" in there? This is the first time it has been in a major consensus statement. IMHO the DSM and ICD will follow. EU did it first. emotional dysregulation and hyperfocus are core symptoms of ADHD. perhaps the most defining. E.3 (talk) 09:26, 21 January 2019 (UTC)

It is more common in children than in adults. Lots of references support this including many in this article. It can be a lifelong disorder yes. We could use "difficulty paying attention" rather than "problems paying attention" Doc James (talk · contribs · email) 17:38, 21 January 2019 (UTC)

DSM-5 is not able to keep up with terminology, as we see they had a whole debate about "addiction" vs "dependence" for the DSM-3 - what did that achieve?. it is not what the DSM is for, the DSM is for slow steady modifications of best practice years and years after it is common practice. Encyclopedias do not have to follow the DSM, we often don't. If we have consensus statements evolving the terminology, we defer to them. United States linguistics does not control the language of English. E.3 (talk) 09:32, 21 January 2019 (UTC)

DSM plays a large roll in determining terminology. Our roll is to summarize common practice. Doc James (talk · contribs · email) 17:38, 21 January 2019 (UTC)

"differences in executive function to other people" is not very specific and is very poorly understood. The prior text was better. Doc James (talk · contribs · email) 18:11, 21 January 2019 (UTC)

Thanks for your help. Happy as it stands, bit by bit. Just people with ADHD often focus on the words we use. This is exactly why the EU consensus statement neutralises it a lot more than the DSM. DSM will follow, but they're not even planning a text revision at the moment as far as I understand.because they've stuffed so many things up around internet addiction disorder and the others, they will probably become redundant within 5 years, something new will come along. The language often follows wikipedia, rather than the other way around, several studies have shown this. E.3 (talk) 12:08, 22 January 2019 (UTC)

The DSM is a fairly foundational textbook for the entire profession of psychiatry. So doubt it is going away. Doc James (talk · contribs · email) 17:39, 26 January 2019 (UTC)

words

I firmly think that inattention > difficulties with attention hyperactivity is better than dificulty controling behaviour. People with ADHD that i've treated prefer the french/ spanish terms "troubles with attention and or hyperactivity". cos they dont want to be "disordered". We can destigmatise this page and still be in wiki rules. what do we think?— Preceding unsigned comment added by E.3 (talk • contribs) 14:00, 27 February 2019 (UTC)

pairing inattention with hyperfocus

The EU consensus statement does that for a reason. Because it isnt a deficit of attention, it is poorly regulated attention. and sometimes, when well managed, their hyperfocus achieves things (hit and miss admittedly). Its the latest consensus statement and it is very well worded and i think we should follow it, cos its definitely wikipedia rules.— Preceding unsigned comment added by E.3 (talk • contribs) 14:07, 27 February 2019 (UTC)

emotional dysregulation

Changed the first few paragraphs. Many citations, and the EU consensus statement (admittedly adult) - in my experience as a clinician and as a patient. The emotional dysregulation is the most profound thing for us neurodiverse people, theres no current meds that help with it proven scientifically. But we have to have emotional dysregulation in some form in the start of the wiki article, its not just a supporting feature. It is the main horribly complex symptom that we can actually legitimise scientifically, solely cos of the EU consensus statement for wiki. and as we know, without access to doctors like @Doc james: or myself, just reading these things when they are proven can be lifechanging, just knowing theres a name for what youre feeling. Thanks, pete E.3 (talk) 13:52, 27 February 2019 (UTC)

That did not ping me.

Why did you remove the DSM5 and the NIH? Both are perfectly fine sources.

The EU ref is also just about adults and we have a page on Adult ADHD Doc James (talk · contribs · email) 05:15, 28 February 2019 (UTC)

OK thanks. Yes sorry removing the sources was unintentional. Can we work on "difficulty controlling behaviour" first, and how can we bring in emotional dysregulation in your opinion @Doc james:? in my opinion it should be in the introduction. E.3 (talk) 05:04, 1 March 2019 (UTC)

Mental disorder and neurodevelopmental disorder

ADHD is a mental disorder of the neurodevelopmental type. Not sure why the fact that it was a mental disorder was hidden? Doc James (talk · contribs · email) 18:11, 21 January 2019 (UTC)

Ok theres some that think its purely neurodevelopmental, I'm one of them, to disclose. But thats Ok. can we change mental to psychiatric I'm happier with that. "psychiatric disorder" sounds more neutral to "mental disorder". I want to make it more like the latest statement. "Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness." E.3 (talk) 03:49, 22 January 2019 (UTC)

neurodevelopmental disorders are psychiatric or mental disorders. Doc James (talk · contribs · email) 17:35, 26 January 2019 (UTC)

I am referring to the euphemism treadmill here when i prefer psychiatric to mental. Of course open to any and all discussion. E.3 (talk) 05:05, 1 March 2019 (UTC)

Additions removed, no justification

Someone has cut without justification a sectional fix and an addition that I made to this page. This paragraph in particular has proven contentious, it needs absolutely to stand:

Many successful or well-known individuals such as the chef/entrepeneur Jamie Oliver and the athlete Michael Phelps have publicly stated in written or video interviews that they are diagnosed or self-diagnosed as ADHD sufferers and that the associated collection of traits has been influential in their careers, with impulsivity therefore appearing as creativity and a lack of attention to others being susceptible to presentation as a strong and independent individual character.

I am accustomed to scientific writing however for wikipedia we need to remember that a general audience will be reading, in particular the ADD page will be read by newly diagnosed sufferers, often kids. For them to understand the disorder and the behaviours associated with it examples of actual people that they have heard of or can easily read further about should be valuable. The fact that a highly decorated olympic athlete, in particular, is happy to acknowledge being affected by the condition is valuable information that can help an ADHD sufferer or parent avoid a sense of defeatism in relation to the condition. If someone is unhappy about the sources I have used they can google for some more: just deleting is not a positive contribution.

I re-organised the sectioning of the article becautse "Society" was a subsection of "Causes". This implicitly makes the claim that Society causes ADHD, a bold step and one which should be made explicitly if at all.

To have a separate section "And Society" or "In society" makes more sense, and also provides a home for the paragraph I added, which could be considered as a stub inviting further contributions. JoshBerryman (talk) 21:36, 2 March 2019 (UTC)

Hi JoshBerryman, I removed the paragraph you added because it is the 5th paragraph in the lead. Generally per WP:LEAD the lead is kept at 4 paragraphs.

About the Causes/Society sections, I think it said some ADHDs may come from the social reason and there is some theory (social construct theory of ADHD) supporting this. The society is not the only causes for ADHD. There are other ADHD causes.

There is "Society and culture" section in other diseases (Ex Mental disorder). The "Society and culture"section is not in this article now. However, "Society and culture" appeared several times in the talk page and talk archives.--Wolfch (talk) 13:20, 3 March 2019 (UTC)

Hi Wolfch, yes I took onboard the four paragraph rule following your edit and moved it, thus creating a society section. Then someone else just deleted it again with no explanation. It now looks like an edit war according to the scripts which monitor these things, so I need somebody else to fix the page or I will be seen as a troll. Would you be up to creating a Soc+Cult section and adding the paragraph under it?

If you really want to keep some of the discussion of Society as a "cause" also, then you can split the section and leave behind this social-construct stuff. Personally I don't think it holds water to claim that the idea of ADHD being definable as a social construct (everything is definable as a social construct if you have time on your hands) is the same as evidence of ADHD being caused by society but honestly I am focused at the moment on making this one tiny improvement of being permitted to mention the list of celebrity sufferers. Can you take care of this fix?

JoshBerryman (talk) 13:33, 3 March 2019 (UTC)

Hi JoshBerryman, I saw your edit for adding separated "In Society" section. The manual of style for medical article is in Wikipedia:Manual_of_Style/Medicine-related_articles. The "In Society" section is not in the list. How about check the previous discussion about "Society and culture" section of ADHD first and then edit?--Wolfch (talk) 13:54, 3 March 2019 (UTC)

Hi Wolfch yes a search through the archives of the talk page indicates that a Society and Culture section used to exist and there was some back-and-forth about changing its name, the last mention of the section was in 2009 https://en.wikipedia.org/wiki/Talk:Attention_deficit_hyperactivity_disorder/Archive_13. Nobody ever gave an argument (in the talk pages) for deleting it, but it has disappeared all the same. The next step for you (remember, I can't edit because I have already done so, and further edits will look like an edit war) is to create a section called "Society and Culture" (or whatever other title conveys this concept that you are happy with) and insert the appropriate paragraph, plus whatever you think appropriate to move from the "Society" subsection of "Causes". JoshBerryman (talk) 08:50, 4 March 2019 (UTC)

I found a version with section "Society and culture" [1]. There were 2 sub-section "Controversies" and "Media commentary" within. There was also "Cause/Society" section/section in it. I am not sure why "Society and culture" disappeared (I need to check). but I will not add "society" section just because there was a version with section "Society and culture".--Wolfch (talk) 12:37, 4 March 2019 (UTC)

Its OK Wolfch Nobody is suggesting that you revert to the 2014 version (although actually the Soc&Cul section there is fine as far as these things go). Nor is it mere reverence for the past which is leading me to suggest that this section should exist. I will summarize once more the state of affairs, using bullet points for clarity:

• Earlier I added a mention (with sources) of famous sufferers, together with appropriate sources and some discussion. This is valuable content as it helps a non-scientific audience to form a picture of the characteristic traits associated with ADHD. Further, this is valuable in providing positive role models for sufferers, who may form an excessively negative self-image following diagnosis.

• This was deleted, someone was unhappy with the sources (initially I had cited wikipedia, but we all know the problems with that). I re-inserted with more sources, the best I could find was interviews (one video interview, one in an online magazine).

• After re-inserting the text it disappeared again, someone was unhappy with there being 5 paragraphs in the introduction, therefore it needs its own section.

• I re-inserted it as its own section (incidentally fixing aberration that "society" is listed as a cause of ADHD, there is now plenty of genetic and biochemical evidence, if ADHD is caused by society this is true in no useful sense).

• The addition disappeared again and I received a message, probably from a bot, to the effect that I am now considered to be in an edit war and should build consensus here on the talk page.

• Conversation to date on the talk page has produced no objection to re-inserting the text a final time.

Ideally, to avoid triggering the edit-war script, somebody else should now make the addition (looking at you Wolfch) however I am happy to attempt it myself if nobody has anything further to add. Comments should be relevant to the content in this paragraph, below:

"""Many successful (or at least well-known) individuals such as the chef/entrepeneur Jamie Oliver and the athlete Michael Phelps have publicly stated in written or video interviews that they are diagnosed or self-diagnosed as ADHD sufferers and that the associated collection of traits has been beneficial to them in their careers, with impulsivity being reframed as creativity and a lack of attention to others being presented as a strong and independent individual character."""

Pokerplayer513 made the most recent deletion of the content, part of a wholesale reorganisation of the page, perhaps explaining the lack of justification made in that edit. Overall I notice that the page has been very "hot" lately, I am not sure what to do about trying to stabilise it at a high level of quality. — Preceding unsigned comment added by JoshBerryman (talk • contribs) 14:20, 4 March 2019 (UTC)

Everydayhealth is a really poor source. As are youtube videos. We need high quality secondary sources. Doc James (talk · contribs · email) 04:46, 6 March 2019 (UTC)

This text

Generally per WP:LEAD the lead is kept at 4 paragraphs. This was dropped in as the second paragraph yet we already have a paragraph discussing the diagnosis. And the fourth paragraph already discussing the controversy.

This looks like original research "The DSM-V does not address the emotional dysregulation of the ADHD diagnosis to the extent many expert opinions and studies indicate it should do."

Were does this reference support that? https://www.ncbi.nlm.nih.gov/pubmed/?term=28837827 Please provide exact quotes because I am not seeing it.

Doc James (talk · contribs · email) 05:13, 28 February 2019 (UTC)

Text in question

The diagnosis has consistently come under criticism for decades. In many experts opinion including the European 2019 consensus statement on ADHD, it is a complex diagnosis and the emotional components of the disease, variously termed "emotional dysregulation" or other constructions, are consistently the hardest to treat as opposed to inattentive or hyperactive/impulsive behaviours which respond to medication consistently. The DSM-V does not address the emotional dysregulation of the ADHD diagnosis to the extent many expert opinions and studies indicate it should do.

References

Emotional dysregulation is a symptom but not widely accepted as a core symptom. I think we can mention it but it should be secondary to the core symptoms. Doc James (talk · contribs · email) 07:58, 1 March 2019 (UTC)

do you think we can put it in the infobox. Also, "hyperactivity" "inattention" are more commonly understood words and we can cite most guidelines saying them. I don't think "difficulty controlling behaviour" is appropriate terminology? E.3 (talk) 14:06, 1 March 2019 (UTC)

We write the leads expeciallity in easier to understand language

Hyperactivity = excessive activity

Inattention = difficulty paying attention

Impulsivity = difficulty controlling behavior

Doc James (talk · contribs · email) 16:10, 1 March 2019 (UTC)

Impulsivity is a well understood english term that is not equivalent to "difficulty controlling behaviour", a term entirely invented by wiki editors. The article on impulsivity does not call it "difficulty controlling behaviour". It is a WP:POV term that has been invented, and has no place in the introduction of the article. E.3 (talk) 13:34, 10 March 2019 (UTC)

Okay changed to "behavior without regards to consequences" Doc James (talk · contribs · email) 03:54, 11 March 2019 (UTC)

Thanks, yes that terminology is better than "difficulty controlling behaviour" in terms of WP:POV. However I do fail to see for that particular term why we cannot use a simple, well understood, english word. 23 million results on google for impulsivity, used in all major dictionaries as an adjective, and the actual term used in all WP:MEDRS compliant references. It should be impulsivity rather than inventions of wiki editors. 2405:6E00:2E40:9600:B401:A8DD:A292:8C7 (talk) 09:15, 11 March 2019 (UTC)

Above comment my own. E.3 (talk) 09:17, 11 March 2019 (UTC)

No comment from editors, good justification, I'll change to impulsivity based on the above rationale E.3 (talk) 12:25, 22 March 2019 (UTC)

Have simplified. We should try to write the leads in more accessible language per WP:MEDMOS. Doc James (talk · contribs · email) 10:31, 23 March 2019 (UTC)

A mental disorder of the neurodevelopmental type & ADHD's assoication to Parkinson's disease

What does that mean? A mental disorder of the neurodevelopmental type. It's a neurodevelopmental disorder. Don't confuse people. ADHD is associated with Parkinson's disease. I would know I have them both(in my 30's) There is plenty of literature that supports my refs. Why are they being deleted? — Preceding unsigned comment added by 68.34.121.200 (talk) 16:47, 10 July 2019 (UTC)

Actually, it is not clear whether it is the medication used to treat ADHD that elevates the risk of developing Parkinson’s disease or whether it is ADHD itself, see this reference.--Literaturegeek | T@1k? 23:10, 10 July 2019 (UTC)

Digital media use?

Digital media use isn't really a condition in itself, is it? Maybe reformulate to something like "excessive digital media use" or "pathological digital media use" based on the contents of the article "Digital media use" links to? — Preceding unsigned comment added by 128.72.153.63 (talk) 18:20, 17 July 2019 (UTC)

Unclear references

This text was trimmed in part because the refs were unclear and in part because they are likely primary.

" Antipsychotic medications represent an increasingly common treatment for ADHD. ^{[39] [40]} These medications are non-FDA indicated for ADHD, some evidence from clinical trials support a potential role in management of treatment-resistant ADHD. Antipsychotic medications improve severe behavior disturbances ADHD, such as aggression.^{[41] [42]} However, they are only indicated after a patient does not respond to sufficient trials of both stimulant medication classes (methylphenidate and mixed amphetamine salts). ^{[41] [42]} Further, unlike stimulants, antipsychotics have common and serious side effect profiles and associated adverse events, such as weight gain and even unexpected death. ^{[43] [44]} "

Doc James (talk · contribs · email) 20:33, 30 July 2019 (UTC)

Issues

This "While treatment may improve long-term outcomes, it does not get rid of negative outcomes entirely."

Was changed to

"While treatment may improve long-term outcomes, it does completely mitigate negative outcomes entirely."

Which of course changes the meaning entirely. Doc James (talk · contribs · email) 21:18, 13 August 2019 (UTC)

People with ADHD tend to score low on IQ exams?

Where did you get this information? This is horrible and furthering the stigma that goes with ADHD in our society. Many people with ADHD are famouly genius, like Thomas Edison was according to Thomas Hartman and Jo Palladinno (Hartman, 2). Thanks! Hartmann, T. (2003)The Edison Gene: ADHD and the gift of the hunter child. Richmond, VT: Park Street Press. — Preceding unsigned comment added by Jeskalana77 (talk • contribs) 04:24, 16 September 2019 (UTC)

The source for the information can be found in the article, all information in regards to IQ exams appears to be properly referenced. Greyjoy ^talk 06:10, 16 September 2019 (UTC)

Text that supports

What text supports this "DEaths 5,500 (2015) "?

References

Doc James (talk · contribs · email) 02:40, 3 October 2019 (UTC)

I think there needs to be a bit of cleanup as evidence changed significantly in 2018/9

https://www.sciencedirect.com/science/article/pii/S0924933818301962#sec0110 seems to be saying it best. Some things that we need to consider is "long term efficacy is unclear, symptoms etc. I just changed the infobox and let the long time collaborators work on it with what they can find from the consensus statement if they agree. — Preceding unsigned comment added by E.3 (talk • contribs) 23:45 19 January 2019 (UTC)

I agree that ADHD page needs thorough check.

--Mladovesti (talk) 08:29, 27 October 2019 (UTC)

Conflict of interest in DSM-5

I tried to add this information as I think it's quite important to know that criteria for ADHD has been widened from DSM-4 to to DSM-5 (which lead to colossal overdiagnosis of normal behaviour in kids) and it could be connected to conflict of interest of the DSM panel members.

Among the work group advisers of DSM-5 for ADHD, 78% disclosed links to drug companies as a potential financial conflict of interest.

Best wishes, --Mladovesti (talk) 08:29, 27 October 2019 (UTC)

References

Unclear if source supports claim on executive function deficits

Under prognosis, the article reads:

"

But learning disorders and executive function deficits do not seem to respond to ADHD medications.

"

But the cited source mentions something like this only in a (to me) ambiguous diagram, figure 6 in the source, and elsewhere says:

"General cognitive ability is not responsive to ADHD pharmacotherapy; however, some data suggest that atomoxetine can modestly improve dyslexia and that stimulants and atomoxetine yield modest improvements in behavioural measures of executive functioning as well as performance on executive memory, reaction time and inhibitory control tasks."

My best understanding is that figure 6 in the source is talking specifically about executive functioning deficits from co-morbid conditions, and the last quotes section contradicts the article's claim about executive function deficits not responding to medication, but it seems very unclear. Kloddall (talk) 01:02, 28 November 2019 (UTC)

Add alternative views

There seems to be a number of qualified doctors that have an alternative view on ADHD. I think it is worth considering adding their conclusions in the last section. I did not want to add before talking, as I see this topic as very binary in whether it is a medical vs social condition. It seems important that the symptoms are very broad (18) and their only needs a small number to be diagnosed (5)?

Thomas Armstrong, Ph.D., The Myth of The ADHD Child -- https://www.institute4learning.com/resources/articles/why-i-believe-that-attention-deficit-disorder-is-a-myth/ Richard Saul, ADHD Does Not Exist -- https://time.com/25370/doctor-adhd-does-not-exist/

(86.11.51.106 (talk) 06:53, 5 February 2020 (UTC))

Huh

User:Nyttend backup what are you wondering about? Brain imaging shows differences in the parts of the brain that light up. Doc James (talk · contribs · email) 12:41, 15 May 2020 (UTC)

"Brain imaging supports that conduct disorder and ADHD are separate conditions" There's no verb in this sentence that really makes sense to me, aside from "are" at the end. If this means that brain imaging gives support to the conduct disorder (or to the conduct disorder and ADHD), I don't understand how "are separate conditions" fits in, and I figured that the wording could somehow be improved. Nyttend backup (talk) 12:46, 15 May 2020 (UTC)

Mental disorder

ADHD is classified as a mental disorder. Not sure why this was removed? Doc James (talk · contribs · email) 10:46, 26 May 2020 (UTC)

Text

"It impacts executive functioning related to organization and planning"

Not in this ref https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

Here is the quote from the DSM 5 "Page 61 ADHD may exhibit cognitive problems on tests of attention, executive function, or memory"

Adjusted to match

Doc James (talk · contribs · email) 10:59, 26 May 2020 (UTC)

Awareness ribbon color

Is it orange or purple, or are both used? The Orange ribbon page and the List of awareness ribbons both need independent references for this. Anyone know of a source for the ribbon color that is independent from the groups that use them? Amousey (they/them pronouns) (talk) 23:14, 29 July 2020 (UTC)

Honestly, never heard of an awareness ribbon for ADHD. Probably best that way. – The Grid (talk) 01:30, 16 September 2020 (UTC)

Update new edition book references

Would it be beneficial to update some of the references? I recognized some references for a few academic books have new editions. It may not change the information but it might've changed since this is a growing research area. Ehunter0711 (talk) 21:27, 1 October 2020 (UTC) Ehunter0711 15:23 1 October 2020 (MST)

Recent literature is typically better Xurizuri (talk) 02:47, 18 December 2020 (UTC)

ADHD in Women

Hi, I am very interested in creating an ADHD in Women article. A lot of research has been done on this topic and more girls/women are getting diagnosed. I feel that the importance of an article to summarise the research for women considering diagnosis or recently diagnosed and their friends/family (and let's be honest, their health care providers too) is increasing because the numbers of people to whom it is relevant is increasing. However, I've got some problems

1. I myself have ADHD and therefore have issues with follow-through. I need others to help because I will just peter out without others to get me going.
2. I have a biased view on the topic because I am a woman with ADHD and a disability advocate.
3. I am used to writing about ADHD in an academic context and may not be able to write in an accessible way.
4. I am new on wikipedia and don't know a lot of things (e.g. how one creates a new article).

I have also posted this to the psychiatry, psychology and autism WikiProjects.

Thoughts? Xurizuri (talk) 03:29, 25 December 2020 (UTC)

ICD-11

Given that the ICD-11 has been out for a while and changed to match the DSM-5 definition of ADHD,[2] the article should be updated to reflect that. I frankly don't know where to begin. And it raises the question of whether the separate ADD and hyperkinetic disorder pages will continue to be relevant for much longer, given that countries have begun switching from ICD-10 to ICD-11. (NB: for anyone that hasn't looked at ICD before, it doesn't really list symptoms in the way the DSM does - you're not just missing them) Xurizuri (talk) 08:22, 31 December 2020 (UTC)

7 types of ADD in future DSM-6?

There are more than 3 types of ADD (ADHD), for certain. It seems that there are 7 different types, including Overfocused ADD:

not "Inattentive", not necessarily Hyperactive nor Impulsive,  thus, the DSM-5 does not include that type of disorder

Overfocused ADD expresses by trouble shifting attention, by nto loops of negative thoughts, inflexibility, etc, but can hyper focus in any matter of interest, and might superb memory skills, thus, might be the best student at school Ronmar24 (talk) 20:47, 28 October 2020 (UTC)

@Ronmar24: I'm not sure what your point is. Are you suggesting an edit to the article? Edits require reliable sources. Since DSM-6 isn't even being written now, I don't think you're going to find any support for adding this to the article. If you're just chatting about your opinion, please note that article talk pages are only for discussion of improvements to the article. Sundayclose (talk) 21:00, 28 October 2020 (UTC)

The supposed "7 types of ADHD" are made up by Daniel Amen and not supported by any experts on the disorder. Dr. Amen has been known to present false information as fact. 3llieb0p (talk) 20:33, 14 January 2021 (UTC)

Could ADHD be semi-protected (or similar)?

What it says on the box. The article gets a lot of IP edits, most of which get reverted uncontroversially. Most are in good faith so it's not vandalism, but I would argue it is disruptive. Of the last 100 edits (since 10:18, 22 September 2020), 22 were by IPs or unconfirmed editors. 17 IP/unconfirmed edits have been removed fully, and only 5 were kept in at least some part. One IP started an edit war, and while I didn't check literally all of them, only two of the IP edits that I did check were obvious vandalism. If 17 uncontroversial reverts were done in approx 3 months, then that means that there's about one uncontroversial reverting of an IP edit per ever 5 days. I don't know how this compares to other pages, but imo it's not great given that this is a fairly high-trafficked health article and a lot of the edits are adding opinions, blog references, or disproven claims. ADHD gets more views than related conditions/symptoms autism spectrum, epilepsy, anxiety disorder, dyslexia, dementia, major depression and substance abuse, although slightly less than autism and substantially less than bipolar disorder.

The article also used to be semi-protected, but I can't find any mention on the archives to the protection being removed. I do think I figured out what happening though:

• Last semi-protected edit request, 11 December 2015. At this point, it must've definitely still been semi-protected.
• Page gets full protected for 24h due to edit warring, 25 March 2016 (here's the edit from history: [3] idk how to wikilink these). I don't know how the protection things work, but my theory is that setting this protection removed the indefinite semi-protect, which then didn't get reinstated.
  • The next edit, 2-ish hours later, was by DumbBOT (edit history, difference from previous edit [4]). As this bot's job is to remove inactive protection templates from pages, it's highly likely that the semi-protect was gone by this point. And the timing suggests it was that full-protect edit.
• After this point, there have been no more semi-protected edit requests. The first IP edit after the last request was 9 days after the 24h protect ended, 4 April 2016 [5]. By this point the semi-protect was definitely gone.
  • As a point of interest, this IP edit was good faith and uncontroversially removed.

Another option besides semi-protection I believe would be pending changes protection. --Xurizuri (talk) 07:38, 13 January 2021 (UTC)

@Xurizuri: The Pending changes information is in Wikipedia:Pending changes, the request page in on Wikipedia:Requests for page protection. I think it is ok to request Pending changes for this page.--Wolfch (talk) 11:01, 13 January 2021 (UTC)

It's been a few weeks since I posted this, if no one here has any issues then I'll request pending changes within the next couple of days. --Xurizuri (talk) 10:15, 6 February 2021 (UTC)

"Positive aspects" section not based on actual science

There are several things wrong with this section.

• Creativity is linked to ADHD.

This is false and the sources linked here are questionable at best. One of them is a paper on "positive aspects of ADHD among famous people" which mentions right off the bat that this data is NOT based on patients with ADHD, but on "famous people who potentially have ADHD were analyzed to understand better, the life-long progression of ADHD".

A second source linked is about entrepreneurs with ADHD symptoms, not diagnosed patients.

• A 2020 review found that creativity is associated with ADHD, particularly divergent thinking and quantity of creative achievements.

The review linked here does not say this at all, what it does say is that, "Most studies find evidence for increased divergent thinking for those with high ADHD scores (subclinical) but not for those with the disorder (clinical). The rates of creative abilities/achievements were high among both clinical and subclinical groups." AKA, again, not about patients diagnosed with the disorder. This review is linked multiple times in this section.

I find this incredibly misleading, this information is presented as fact, when the sources are faulty and these "positive aspects" have not been proven. I am hesitant to edit the article myself, because I am new to Wikipedia editing. I am curious if this can be rectified so the spread of this misinformation presented about the disorder can be limited.

Thank you. 3llieb0p (talk) 20:48, 14 January 2021 (UTC)

Wait, is Custardowheelamhain also your account? I made the revert before seeing this talk page entry. If anything, the sentence would need a rewrite as it seems to be a broad statement to make with 3 sources. – The Grid (talk) 22:58, 14 January 2021 (UTC)

it is not. 3llieb0p (talk) 13:28, 16 January 2021 (UTC)

This is false – and what source do you have to support that categorical statement? Regarding the limited existing sources, the solution is to look for others – I had a very quick search and found these: 1, 2 3, 4, 5. @The Grid: the statement is moderated by the preceding sentence, which notes that research in this area is in its infancy (the positive traits of ADHD is a new avenue of research, and is therefore limited). The bigger issue in my mind is the entire following paragraph's reliance on a single source, the review 3llieb0p is concerned about. They're right that this review is more nuanced that the section it supports, which needs a slight rewrite to better reflect it. However, the report does not say that contradictory data for those clinically diagnosed demonstrates the lack of a link, and it suggests this could be due to the negative effect of other aspects of the disorder: "among individuals with creative professions there is a higher rate of offspring of individuals with ADHD. This offspring is non-affected but do share genetic and environmental factors with those who have ADHD. Thus, the offspring might have the right etiological baggage for increased creativity, but are not hampered by the disorder (Kyaga et al., 2013)". Its overall conclusion is clear about the existence of some kind of link: "A focused research agenda will improve our understanding of the link between creativity and ADHD, generating a more complete picture of the issue at hand." Jr8825 • Talk 01:16, 15 January 2021 (UTC)

As the person that originally wrote the section, I would agree that additional sources are required and that the wording could better reflect that there is inconsistency. There is a fair amount of evidence to show some link between ADHD and creativity, I just didn't spend the time to chase down all the nuances.

User:Sundayclose could you clarify why you removed the statement on biological links to creativity for not being supported by the review? It is one of the central themes of the review. It's one of three topics mentioned in the title, and this is the highlights of the article as given by them:

Highlights

•The link between divergent thinking and ADHD might depend on the impairment associated with ADHD. •ADHD is not associated with increased convergent thinking. •Psychostimulants do not have a negative effect on creativity as is often believed. •Neuroscience of ADHD and creativity points to overlapping mechanisms.

•Evidence on strengths of ADHD is relevant because this may lead to increasing the self-views and quality of life of people with ADHD.

Actually, would everyone be comfortable if I reworked the section to reflect these highlights? The first point there especially is a good way of summarising that when impairment goes up, the boost to creativity may not be as present/useful. And the last point helps explain why the field of study matters at all. --Xurizuri (talk) 03:53, 15 January 2021 (UTC)

The Hoogman review article does not state that creativity is linked to ADHD. It states that creativity may be associated with ADHD symptoms but is not associated with the disorder of ADHD itself. This is a medical article, and we don't go beyond what the sources explicitly state. There is a difference between the symptoms and the actual (diagnosed) disorder. Please don't make edits based on the abstract and highlights. If you actually read the source and understand what it says, it is clear that it does not conclude that ADHD is linked to creativity. As for the issue of biological links, again we don't go beyond what the source says. The source calls for more research on neurological areas that may shed light on relationship between creativity and ADHD, but it doesn't say that there are "similar genes and areas of the brain identified as important in both" ADHD and creativity. Sundayclose (talk) 04:09, 15 January 2021 (UTC)

I did read it, thanks. Moreover, the abstract is definitely still a part of the article. It's in fact a summary of the article, the exact thing we aim to do. Further, I was wondering if the highlights would be acceptable wording for inclusion in the article, not saying that it's a perfect summary of its findings.

I misunderstood the meaning of your edit summary - I thought you meant that the article didn't address biology in any depth and so shouldn't be included. I didn't relish the idea of doing word counts, so I used the title and the abstract to demonstrate that it was covered. With your clarification as to why you removed it, you are right that I should go through the article in full again. Given this, on reflection I did choose wording that implies something slightly different to what the review states, but that doesn't necessitate immediately deleting it rather than changing the wording to be more accurate, and then also accusing me of wilful incompetence.

Towards the goal of a corrected statement, these are the within-article conclusions re: biology so that people w/o a subscription can participate. I did exercise some amount of selectiveness bc I'm not sure how much of subscription-locked content we're allowed to reproduce but I did try to choose the most relevant statements regardless of my viewpoints, and of course I may have missed some statement. If you believe that I didn't include something important, please add it. \\\\ "All of the above is only indirect evidence of an overlap between brain regions (PFC, striatum, amygdala, etc.) and brain networks (default mode and executive network) involved in ADHD and creativity." \\\\ "Given all this genetic evidence, the mechanism of potential overlap between genetic factors associated with creativity and ADHD deserves our attention." \\\\ "We also shed our light on evidence from a neuroscience perspective (neuroimaging and genetics) suggesting candidate systems that should be studied further." \\\\ "similar dopaminergic candidates have been linked in separate studies to both creativity and ADHD. What remains unanswered is, if variation in dopaminergic genes provide for direct links between creativity and ADHD. For neuroimaging, alterations in the ADHD brain and brain regions linked to creativity have been identified, but despite overlap in associated regions and mechanisms, no studies have directly linked the ADHD brain and the creative brain." \\\\

Given these, I propose the statement, 'there is some limited evidence that a biological overlap between ADHD and creativity may exist; this requires further study to support or disprove.' What changes would you (or anyone else interested) want to make to that? If you still do not want to include any statement about biology even though it is a significant focus of the article, is there an additional reason why? --Xurizuri (talk) 07:29, 16 January 2021 (UTC)

I would personally also like there to be more sources that explain what these types of thinking are and how they are related to ADHD. The majority of the section is still based on one source (Hoogman article). From the section, "they tend to have diffuse attention, allowing rapid switching between aspects of the task under consideration; flexible associative memory, allowing them to remember and use more distantly-related ideas which is associated with creativity; and impulsivity", there should be sources linked to show that ADHD patients often have these attributes. Furthermore, the paragraph on entrepreneurship is also lacking in sources, there are only 3 linked and one of them is that paper on famous people with potential ADHD. This paper should not be a source on this article.

It's also confusing that the section is named "positive aspects" when a possible struggle with convergent thinking in ADHD patients is mentioned in the same paragraph, and I'd like to propose the title to be changed - something about a possible link to creativity, perhaps?

This body of research is incredibly limited and I think the section should reflect that. As Dr. Barkley (an expert on ADHD) has said in 2014, "This does not mean that some people with ADHD are not creative, for some surely are. It means that such creativity, among many other psychological abilities, comes not simply by virtue of the person having ADHD. Cherry-picking cases of creative people who have ADHD is not evidence of such a link." There is no conclusive evidence as of yet, and we shouldn't insinuate there is on an encyclopedial website that all can see. 3llieb0p (talk) 13:43, 16 January 2021 (UTC)

@Xurizuri: I didn't accuse you of "willful incompetence". I asked you to take a closer look at the article and base your edits on the entire article instead of the abstract and highlights. It seems to me that you have indicated you didn't do that ("I should go through the article in full again"), but if you interpret your own comment as my accusation of willful incompetence, you are assuming you can read my mind.

"That doesn't necessitate immediately deleting it rather than changing the wording": No it doesn't necessitate it, but it doesn't forbid it either; I prefer that you rewrite your own edits rather than asking someone else to do it since you know what you are trying to say.

Regarding your suggested edit, there is a difference between stating that there is evidence vs. stating that the issue "deserves our attention". That distinction is a fundamental aspect of science. Correlation does not imply causation. For example, in many societies race is associated with socioeconomic status. That association may deserve further study, but it is not "evidence" that one's race per se is a reason for economic disparities. Make the statement without any unnecessary assumptions: "Further study is needed on possible overlap in genetic factors and brain regions associated with both ADHD and creativity."

I agree with 3llieb0p that the header "positive aspects" is inaccurate. Sundayclose (talk) 17:02, 16 January 2021 (UTC)

I'm stepping down from this one. I am starting to realise that I'm not great at summarising things, and this article isn't necessarily the best place for me to practise. I will go with what youse agree on for how creativity is discussed. --Xurizuri (talk) 08:49, 23 January 2021 (UTC)

@3llieb0p:, I didn't realise that it would be necessary to have additional references when all the information is given in the one review. I also thought it was better to have shorter descriptions of the types of thought so that there wouldn't end up being a huge section on something that isn't well-researched. If there's a need/desire to have more explanation on it, would it be appropriate to leave it there, or would it be better to have a deeper explanation elsewhere (at a guess, maybe a mechanism section? Or cognition?). I'm not saying any of this to disagree or anything, but because I'm very much still new and getting used to the conventions of WP. Have I understood what you were saying? --Xurizuri (talk) 09:17, 23 January 2021 (UTC)

MOS:MED#Diseases or disorders or syndromes says that a content section on "research directions" is suggested. Given the relative youth of this particular area, should we create a research directions section and move positive aspects into there? I would definitely more readily characterise it as a research direction than as a well-established part of ADHD presentation. It'd need to be rewritten to be more appropriate for such a section of course, but it needs to be rewritten anyway. --Xurizuri (talk) 08:49, 23 January 2021 (UTC)

I have tried my hand at some editing. I changed the title (as @Sundayclose: agreed with me it was inaccurate) and the text to represent what we talked about here. I didn't really know what to do with the section on entrepreneurship, it feels out of place to me and I would like an opinion on that. I would agree with @Xurizuri: that adding a section on research direction would be useful, so topics like positive traits that have not been researched thoroughly aren't prone to getting read as definite conclusions. Research into ADHD is going many directions (some that I personally don't agree with, but this isn't the article on my opinion :p) and it might be good to reflect that in the article. This disorder is still a widely debated topic. 3llieb0p (talk) 12:19, 27 January 2021 (UTC)

Looks like an improvement to me. I'm wondering whether "but not with the disorder of ADHD itself" could do with a slightly fuller explanation (i.e. those whose symptoms fully meet the criteria for diagnosis) to make things clearer for the reader, but perhaps it's clear enough already. @3llieb0p: I agree the short para on entrepreneurship seems a little odd, but at first glance it looks to have decent sources. It might simply be a case of poor wording, e.g. some people with ADHD are interested in entrepreneurship. Jr8825 • Talk 15:36, 27 January 2021 (UTC)

@Jr8825: I agree with you on both points. I don't know if "i.e. patients with subclinical symptoms of ADHD" or "patients not diagnosed with said disorder, merely exhibiting symptoms" would suffice, I might see what the review says about these patients. On the poor wording in the entrepreneurship section: I found it difficult to rewrite this, I personally completely disagree with what's being said and I don't want that to be noticeable in my writing, so I mostly left it alone and tried to make it sound less like all people with ADHD are interested in entrepreneurship - which led to said poor wording. Any ideas on how to improve that are welcome. 3llieb0p (talk) 01:17, 30 January 2021 (UTC)

@3llieb0p:, @Jr8825:, subclinical in the context of this research meant "not diagnosed with said disorder, merely exhibiting symptoms". Subclinical is a slippery term, in research (like this one) it often means "we couldn't be fucked finding people that were diagnosed, so we found people with symptoms", but the more correct meaning is someone that is close to meeting, but does not meet, the diagnostic criteria. For the entrepreneur part, the word patients probably isn't appropriate - it implies they're being treated for ADHD which isn't true. Also, I'm similar to you 3llieb0p on the entrepreneur stuff, I actively don't care about this area of research lmao. If we do create a research section, is there anything else that needs to go in there? From within this article, I think #Bio-marker research (assuming it hasn't advanced as a field since that part was written) is a potential candidate. In general, there's always a collection of possible treatments and screening/diagnostic tools being researched (off the top of my head, I think there's video game treatments being trialled?). Fyi, I'm currently using schizophrenia for examples when I'm struggling to understand something on MOS:MED, as it's a featured article. --Xurizuri (talk) 10:15, 6 February 2021 (UTC)

Glad to know I'm not alone in regards to the section on entrepreneurship. I was tempted to remove it entirely, but I don't want to make such a large change without agreement from other (more experienced) editors, @Sundayclose: could I get your opinion on this? I feel it has little to do with the actual disorder and might be misleading, as this research is mostly based on people having traits associated with ADHD, not actual patients suffering from it.

@Xurizuri: all I know about those video game treatments is that a recent one had little evidence to speak for its effectiveness (and looked poorly made on top of that), but it's been a while since I looked into that so don't quote me on it - there might be good ones out there. I do think it's important that if a possible treatment is listed, that it has proper backing and something to show it might be worthwhile. There've been some (questionable) ADHD treatments/diagnostic methods that I've had people in my community mention, but when I looked into them there was little evidence and mostly a lot of money to be made off the backs of people in need. I can't think of any research directions that could go on there off the top of my head - most of the reading I do is about things that aren't effective, lol. And I wanted to say thank you for working on this, looking back at my initial post I might have been a little harsh. 3llieb0p (talk) 14:08, 11 February 2021 (UTC)

@3llieb0p:, no worries! It wasn't my best work, and deeply unscientific additions are common on this article.

The FDA approved a video game to market itself as a treatment for ADHD [6] but the FDA regulates in ways I don't really understand, and some other countries wait to see what the effects of treatments are in the US before approving them themselves, because the FDA is on the lax end of requiring evidence. Assuming this isn't one of the cases where "FDA-approved" just means "it won't kill you", then to me approval by the FDA of one game and by no one else would mean video games to treat ADHD fall into "science says its maybe real". But it depends on what's appropriate for such a section - should we rely on what secondary sources describe as avenues of research, use an established WP criteria if one exists, or develop one ourselves? --Xurizuri (talk) 09:59, 20 February 2021 (UTC)

Hunter/gatherer theory

I don't know how recent this addition was, but a section has been added to the Genetics heading about evolution and the hunter/gatherer theory. This theory has little basis and it contributes to the already highly stigmatised status of this disorder.

To quote Professor Stephen Faraone, acclaimed ADHD expert and president of the World Federation of ADHD: A study of genetic data shows that the frequency of genetic variants associated with ADHD has steadily decreased since Paleolithic times. This means that having ADHD has caused problems for people for tens of thousands of years. See: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32451437/

I have gone ahead and removed the part where the infamous Ariaal study is quoted, as this is usually the only evidence given for the supposed benefits ADHD would have had during hunter/gatherer times, when the study barely even mentions attention and hyperactivity. The study itself wasn't even referenced.

If a section about Evolution is added, I feel it should also include information from the genomic analysis study above, and not just focus on the supposed positives ADHD would have had. It's misrepresentative. --3llieb0p (talk) 12:18, 30 July 2021 (UTC)

Oh boy, that seems like a good call. My first instinct with evolutionary psych is to turn around and walk away rapidly. I know there is some research interest in evolutionary theories for ADHD, but as evolutionary psych generally does, it's remained largely theoretical and not super empirical. This is the best I could find in the way of a recent systematic review of evolutionary psych/ADHD: [7] It only does natural selection-based theories, but tbf that is what evolutionary psych mostly discusses. The review essentially found little to nothing of worth in the literature. My "vote" is to axe the paragraph, or at most have a sentence saying there's research interest. I'm going to make the "research directions" section we talked about previously, so hey maybe it could go into that bucket. -Xurizuri (talk) 05:07, 22 August 2021 (UTC)

Hmm, I've just had a look at the sources... I'm going to cut the paragraph. The first is a review, but not a systematic one. It's also actually about the evolutionary role of prenatal stress contributing to psychopathology, and ADHD is only mentioned as one of many conditions. And every part of this is a wild jump. The second is an experiment that appears to assume that only men ever have ADHD, and doesn't provide any statistical analysis of their results (unless evolutionary psych has wildly different rules for reporting than the rest of psych? Anything's possible I guess). The third is a review, but not systematic and not published in a particularly good journal. I'd barely call it a review. An extended introduction with some untested hypotheses. All 3 are also at least a decade old. They don't meet the requirements for MEDRS and as I said before, I was struggling to find recent high quality articles on this. --Xurizuri (talk) 10:53, 25 August 2021 (UTC)

Lead section citation

Currently, the following sentence is in the encyclopedic voice and has no citation:

For a diagnosis, the symptoms have to be present for more than six months, and cause problems in at least two settings (such as school, home, work, or recreational activities)

This seems like it should say "Under the DSM" or "Currently, the accept medical definition requires" or something appropriate. It should also cite a source. Thoughts? Chris vLS (talk) 05:16, 26 August 2021 (UTC)

Content in the lead does not need sourcing as the lead simply summarizing the information in the body (which I would hope IS sourced of course). And as far as I know, both the ICD-10 and DSM-5 require the symptoms to have lasted for 6 months. However, the ICD-10 only states that they have to cause problems in at least one setting; the DSM-5 requires problems in at least two settings. So for that reason, I would be fine with adding something like "Under the DSM-5" to that sentence.--Megaman en m (talk) 10:51, 26 August 2021 (UTC)

DSM-5 has 2+, and ICD-11 requires "multiple situations or settings" (aka 2+). ICD-10 doesn't specify, but is arguably no longer relevant. All three have the 6 month requirement. I reckon we should leave the statement with no additional caveat. @Chrisvls:, in my view the statement "for a diagnosis" does the same thing as "the accepted medical definition requires" - both come down to what the medical definition of ADHD is. And yep to Megaman en m, WP:LEADCITE - generally you only really need to cite potentially controversial statements and anything that isn't sourced. It's sourced in the article, so kicking goals there, and it's fairly non-controversial in terms of what people get upset about with ADHD. --Xurizuri (talk) 10:10, 27 August 2021 (UTC)

Medication efficacy dispute

Hi! There's been enough reverts now that I think we need to switch to a discussion. In particular, I'll ping @Medhekp: and @Jr8825:. Firstly, please stop reverting edits for now, it will make the page unstable and make it harder to figure out what to do. So, I did the second edit, so I'll start things off by explaining why. It would be great if you could each talk through your own reasoning for edits too. For the edit regarding atomoxetine, I know a fair amount about how the medications work and how (relatively) new the research into ATX is, so I was surprised that there was a meta-analysis supporting it as the most effective. That would genuinely be very exciting. However, when I was reading the article, I noticed that the article doesn't really support that conclusion. It's more accurate to summarise as there's not enough low-risk-of-bias RCTs to be able to effectively compare treatments in this way. Further, it explains that while atomoxetine has some evidence of higher clinical response, it unfortunately consistently has a higher attrition rate. The article itself also has some red flags. Giving the moderate/high heterogeneity of results, it was arguably inappropriate to interpret any results of the network meta-analysis. It was definitely inappropriate that they included RCTs with a high risk of bias. They may also have broken other rules of NMAs, but they don't actually report on them - which is, again, inappropriate. For a description of the requirements for NMAs, please see NICE's Guide to the Methods of Technology Appraisal. I also noticed that the article took many years to get published, which suggests that journals had issues with the article. The authors first performed the search in 2015, then again in 2017 and 2018. The review was not published until 2021. It should not take 6 years. The review also only included English-language articles, which is concerning for its cross-cultural applicability. All that doesn't make it a bad article necessarily (statistical analyses are rarely done or reported well), but it does mean that the article isn't able to knock stimulants off their very well-supported pedestal. All major English-language guidelines recognise stimulants as the most effective treatment. When I assessed the article, I concluded that it would be more appropriately used to update the paragraph which discusses atomoxetine. Please let me know your thoughts! And obviously, anyone else feel free to chime in. (P.S. I'm not always great at checking back on talk pages in a timely fashion, please ping me if you would like me to respond.) --Xurizuri (talk) 11:19, 31 August 2021 (UTC)

@Xurizuri: thanks for the message. I also skim read the review and felt it didn't support a conclusion that stimulants aren't the "most effective". I agree it doesn't say there are the most effective, but its evidence that atomoxetine is associated with better clinical response is tentative (the key take-away of the review is that all the trials were susceptible to bias) and it also points out the higher discontinuation rates – perhaps because of this, at no point does it make a overall statement about whether stimulants are more or less effective than atomoxetine. There are also the issues with methodology and its protracted publication process you point out, which also weaken it as an individual source. On the other hand, there are a range of strong sources which recommend stimulants as the first-line medication, the current NICE guidelines immediately come to mind. Looking at the current source for that sentence, the widely-cited 2018 Castells systematic review, I can see that it doesn't adequately support the statement that amphetamines are the "most" effective; it says there is evidence they are effective but the evidence is low quality. What it doesn't do, however, is attempt to use this low quality evidence to compare stimulants and other medications. I'll switch out that source the NICE guideline shortly. Jr8825 • Talk 18:04, 31 August 2021 (UTC)

@Xurizuri: I always thaught that in bio-medical article in wikipedia as long as the ref is MEDRS we could use it for making a claim about it. So the question is about the reference not being of quality so for you, are you saying that Plos article is not MEDRS ? Cause we 3 agree that it calls into question the fact that stimulant are the best pharmacotherapy. The thing is, if you are viewing the article as not being MEDRS we should continue the discussion in the following page talk https://en.wikipedia.org/wiki/Wikipedia_talk:Identifying_reliable_sources_(medicine) Medhekp (talk) 07:55, 3 September 2021 (UTC)

Thank you both for pinging! @Medhekp: I'm definitely happy to get some more opinions on the article's reliability, although that should be done at WP:Reliable sources/Noticeboard. First though, WP:MEDRS does say that claims need to accurately reflect current knowledge - that's what my pedestal argument was in reference to. Even if the article did support the claim, it does not reflect current consensus. I also didn't say the article calls into question whether stimulants are the best pharmacotherapy, and it's a stretch to say that @Jr8825: did either. The article draws no real conclusions about stimulants as a class, so it doesn't support the claim. I'll reply here with the link to the discussion about the source reliability once I've made it. --Xurizuri (talk) 10:05, 3 September 2021 (UTC)

After thinking it through, I realised a more appropriate venue is the NPOV board, because this is primarily a WP:UNDUE issue. The discussion there is at Wikipedia:Neutral point of view/Noticeboard#ADHD medication. --Xurizuri (talk) 10:53, 3 September 2021 (UTC)

Merger proposal (Social construct theory of ADHD into Attention deficit hyperactivity disorder controversies)

It's been suggested that I leave notice of the discussion I've started on merging two articles related to this one over here! If you are a user experienced with merging articles, please feel free to lend a hand should the vote be in its favor. — VariousDeliciousCheeses (talk) 09:34, 4 October 2021 (UTC)

How the part where it says people with ADHD have lower IQ

this is incorrect!!!! I have ADHD because all symptoms show and I have to take medicine for it and everything like Cyproheptadine and Atomexetine and Vyvanse and Dexmethylhyphenidate and I am in school and am in Visions classes (basically the smart classes). In fact, most people in my classes would say I am the smartest one in the class. I don't know my IQ, but I do know that it's gotta be high. Therefore, this is incorrect. — Preceding unsigned comment added by 2600:8805:3E1E:2E00:FD49:4ECB:BEC9:F721 (talk) 20:44, 9 November 2021 (UTC)

Firstly there is a diferance between the individual member of the group and the group average. Secondly this is actuly quite expected if you look at the IQ test that where used in articles analyzed in the meta analysis cited in the article. Most of these used eiter WAIS or WISC, both tests have sub scores that measure working memory and processing speeds. Both working memory deficencies and reduced processing speeds are seen as markers of ADHD*. Whilst the different sub scales do differ amongst all members of the population the low scores on working memory and processing speeds are seen as markers for ADHD, and are by many clinicians used in diagnosing ADHD (inatentive subtype) in childeren without behavioural problems. EirikRS (talk) 12:20, 3 December 2021 (UTC)

"However, for some, there may be potentially serious side effects"

This part of the lead seems like an overly severe summary of the sources which are cited, so I'm going to cut it down to just "there may be side effects". I've skim read the sources provided. The clause before, "treatment with stimulants is effective for at least 24 months", sums up the main criticism they have of stimulants, that their efficacy may decrease over time (the evidence is still weak, though). The other main criticism is their potential for abuse, which the articles say is somewhat reduced by new developments in medications. I can't see any discussion of negative side effects in the Arnold et al. source; the Wigal source says this: "Although relatively safe, both stimulants and atomoxetine have class-related warnings and contraindications and are associated with adverse effects that require consideration when prescribing ... although they are considered safe and effective drugs, they have the potential for abuse and may not be appropriate for some patients with comorbidities"; Parker et al. focus on effectiveness over time, and only mention side effects briefly: "as a result of clinical (ie, adverse side effects) and personal decisions (ie, a desire to withdraw), some participants were unable to adhere to long-term treatment arms"; the NICE source provided is outdated and has been superseded by the 2018 NICE guidance, section 1.7.20 summarises "considerations when prescribing ADHD medication" and I can't see anything indicating a high chance of "severe" side-effects, just an extended discussion about balancing risk-gain and careful management. Jr8825 • Talk 16:11, 3 December 2021 (UTC)

I agree with your change. The lead should briefly summarize important information, and it should not alter the general consensus of the sources cited in the article. Sundayclose (talk) 17:11, 3 December 2021 (UTC)

ADHD and exercise

I'm new, so hope I'm doing this right! There is quite a bit of info on exercise improving ADHD symptoms, but the 2021 World Federation of ADHD International Consensus Statement says this:

"A meta-analysis of ten studies (300 children) found exercise was associated with a moderate reduction in ADHD symptoms, but had no significant effect after adjusting for publication bias (Vysniauske et al., 2020). Another meta-analysis found no significant effect of exercise on either hyperactivity/impulsivity (4 studies, 227 participants) or inattention symptoms (6 studies, 277 participants), but significant reductions in anxiety and depression (5 studies, 164 participants) (Zang, 2019)."

I'd suggest changing the statements on exercise, or at least adding some reference to the above. RapturousRatling (talk) 23:56, 6 January 2022 (UTC)

On a related note, the consensus statement is an up-to-date source of 200+ evidence-based conclusions, approved by 80 authors from 27 countries and 6 continents and endorsed by 300+ more people who have read it and agree (names and affiliations in supplemental document). So it might be worth comparing its conclusions with the contents of this article and potentially making adjustments as necessary, as some stuff may be out of date. As I'm new I don't want to just go ahead and make changes myself! — Preceding unsigned comment added by RapturousRatling (talk • contribs) 16:49, 7 January 2022 (UTC)

RapturousRatling Go ahead its a good idea to add this kind of info for getting a more nuanced view of exercice on ADHD symptoms. As you are new to this I suggest to you this site for simplicity of adding a source when editing https://citer.toolforge.org/ Medhekp (talk) 00:06, 8 January 2022 (UTC)

Medhekp Ok, thanks for the tip. A thing I should mention though is I am diagnosed with ADHD and idk if that is a conflict of interest (I checked the COI guide page but didn't find anything clearly applicable). Is it still ok for me to make edits, having declared that, or better leave it for someone else? RapturousRatling (talk) 17:16, 12 January 2022 (UTC)

@RapturousRatling: thanks for being upfront, and it's good you're aware of the COI guidance. The biggest COI issues tend to be around companies people have financial interests in, or family members/ancestors. Editors frequently work on articles that affect them such as topics relating to their country or region. As long as you adhere to WP:NPOV and are careful to avoid WP:ADVOCACY there's shouldn't be a problem, so I suggest going ahead. Just be extra careful about avoiding edit conflicts and following the sources – basically, make sure you're doing the things you should be doing on any page. I've contributed to this page in the past with no issue. I declare I have ADHD on my user page both for transparency and because it affects my editing style, but I don't believe that's strictly necessary. Jr8825 • Talk 18:20, 12 January 2022 (UTC)

@Jr8825: OK, thanks! Will try get around to it soon (ADHD lol :D) RapturousRatling (talk) 12:29, 15 January 2022 (UTC)

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 September 2021 and 18 November 2021. Further details are available on the course page. Student editor(s): KHR9.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 14:58, 16 January 2022 (UTC)

Orphaned references in Attention deficit hyperactivity disorder

I check pages listed in Category:Pages with incorrect ref formatting to try to fix reference errors. One of the things I do is look for content for orphaned references in wikilinked articles. I have found content for some of Attention deficit hyperactivity disorder's orphans, the problem is that I found more than one version. I can't determine which (if any) is correct for this article, so I am asking for a sentient editor to look it over and copy the correct ref content into this article.

Reference named "Lancet2012":

• From Measles: Moss WJ, Griffin DE (January 2012). "Measles". Lancet. 379 (9811): 153–64. doi:10.1016/S0140-6736(10)62352-5. PMID 21855993. S2CID 208794084.
• From Dyslexia: Peterson, Robin L.; Pennington, Bruce F. (May 2012). "Developmental dyslexia". Lancet. 379 (9830): 1997–2007. doi:10.1016/S0140-6736(12)60198-6. PMC 3465717. PMID 22513218.

I apologize if any of the above are effectively identical; I am just a simple computer program, so I can't determine whether minor differences are significant or not. AnomieBOT⚡ 06:08, 5 May 2022 (UTC)

• I believe User-duck has addressed this. Is that correct? --Xurizuri (talk) 01:04, 10 May 2022 (UTC)

"Behavioural issue" vs "deliberate misbehaviour"

There is disagreement or controversy in certain regions or among certain people, regarding the nature or origin of ADHD. The article currently uses the term "behavioural issue" to describe the point of view of those who believe that ADHD is not a mental disorder; however, using the words "behavioural issue" for this purpose is fundamentally inaccurate. Everyone on both sides of the controversy already agrees that the whole thing is an issue of behaviour, because the symptom list is primarily a list of behaviours, and without those behaviours there would be little or nothing to discuss. The only people who can possibly see ADHD as NOT a behavioural issue are those who consider those behaviours normal, and therefore not an issue. Since everyone already (necessarily) believes ADHD is a behavioural issue if they believe it's an issue at all, the words "behavioural issue" cannot legitimately be used to distinguish one side of the controversy from the other. The question cannot be "Is it behaviour?", because no one can claim it isn't. The controversy is over the SOURCE of the behaviour, and it appears that the possible sources are "mental disorder" or "personal choice". TooManyFingers (talk) 16:51, 12 May 2022 (UTC)

If "behavioural issue" is not intended to mean what it says, but instead is being used as a sort of code for "an issue that is reliably cured by punishment", then that should be made explicit. TooManyFingers (talk) 18:13, 12 May 2022 (UTC)

Merging Diet and attention deficit hyperactivity disorder

Diet and attention deficit hyperactivity disorder largely just replicates content in the Attention deficit hyperactivity disorder article. The diet page discusses 3 topics:

• There is no evidence to support diet changes as treatment - covered under Attention deficit hyperactivity disorder#Environment and Attention deficit hyperactivity disorder#Diet
• Food colouring and additives - covered under Attention deficit hyperactivity disorder#Environment and Attention deficit hyperactivity disorder#Diet
• Sugar - covered under Attention deficit hyperactivity disorder#Environment
• Omega-3 fatty acids - covered under Attention deficit hyperactivity disorder#Diet

The diet article does expand on the food additives, but it does so with some possible original research and mostly non-MEDRS. There also isn't much more to say about diet outside of what is already on the diet article, and the extra information that does exist is actually already under Attention deficit hyperactivity disorder#Diet. Therefore, I propose that Diet and attention deficit hyperactivity disorder is merged into Attention deficit hyperactivity disorder#Diet. Very little (if any) content would need to be copied, so it would have almost no impact on the Attention deficit hyperactivity disorder article. --Xurizuri (talk) 01:22, 10 May 2022 (UTC)

completed merge due to lack of objection (t · c) buidhe 00:48, 29 May 2022 (UTC)

"Some" individuals

In the first paragraph, it says: "Some individuals with ADHD also display difficulty regulating emotions and have executive dysfunction." It should be "Individuals with ADHD..." as these symptoms are part of ADHD, as the sidebar correctly lists them. There is no ADHD without executive dysfunction (some consider it *the* core deficit) and emotional dysregulation is a core symptom . The word "some" is inaccurate. Perhaps it should even say "Core symptoms of ADHD also include..."

It already says in the article that ADHD comes from an impairment of executive functions: "The symptoms of ADHD arise from a deficiency in certain executive functions (e.g., attentional control, inhibitory control, and working memory)." The fourth citation of that also addresses it directly. I think the existing citations can serve to prove that these are core symptoms of ADHD, not just symptoms that "some" people with ADHD have.

It appears that it is also discussed in Russell Barkley's book for clinicians which I think should count as WP:MEDRS: Attention-Deficit Hyperactivity Disorder, Fourth Edition: A Handbook for Diagnosis and Treatment. I'd be interested in looking into that source more if people think it qualifies.

Megaman_en_m reverted the change.

References

Jhartzell42 (talk) 01:42, 28 June 2022 (UTC)

The DSM5-TR doesn't make mention of emotional dysregulation in its diagnostic criteria, the only overarching core criteria it lists are inattention and hyperactivity/impulsivity. I can see that emotional dysregulation is mentioned in the literature as being a significant component of ADHD, but to say that ALL people with ADHD have it is a big leap. Do you have an authoritative source that directly claims that all people with an ADHD diagnosis have trouble with emotion regulation?--Megaman en m (talk) 04:28, 28 June 2022 (UTC)

Thank you for your response Megaman en m!

I had removed the word "some" in my edit because it seemed like the least intrusive way to fix the sentence. But I can see your objections to that edit. I made the claim very strong, especially with regards to emotional dysregulation. I do, however, still think the sentence as stands is inaccurate (with regard to executive function) and misleading (with regard to emotional dysregulation). Perhaps we can find a better way to clarify.

Separating the two:

I think the "executive function" claim is outright wrong, because "a deficit in executive function" is not a symptom, but rather the cause of ADHD. Later in the article, we see that expanded upon in this sentence with four citations: "The symptoms of ADHD arise from a deficiency in certain executive functions (e.g., attentional control, inhibitory control, and working memory)." That is to say, a deficit in executive function is a cause -- or rather the cause -- of the core symptoms of ADHD, rather than a symptom that only some individuals with ADHD have. It is not a symptom at all. Would you object to an edit that replaced the mention of executive function in the introduction with a sentence to the same effect as that sentence from the body of the article, or perhaps the exact same sentence? As it stands, this is a discrepancy between the lead and the body of the article.

For emotional dysregulation, I still think the sentence is misleading and should be worded more strongly. https://pubmed.ncbi.nlm.nih.gov/23082740/ is already cited. It says "Empirical studies have confirmed a high prevalence of this psychopathological feature in adults with ADHD that compares to the frequency of the ADHD core symptoms, inattention, hyperactivity and impulsivity." While technically, that makes the sentence with "some" still plausible, I think given that the prevalence is comparable to the core symptoms from the diagnostic criteria, using "some," while perhaps technically accurate, is misleading. Perhaps "ADHD symptoms arise from a deficiency in executive function [or "in certain executive functions"], and also commonly include emotional dysregulation." This is very similar to the wording of the relevant sentences in the body of the article, and I think it is much less misleading.

I suspect I could find a citation to then elevate "commonly" to "typically" for emotional dysregulation, but I would have to spend some time looking for such a citation and then I would make a separate edit which would include the citation I found.

Jhartzell42 (talk) 06:46, 28 June 2022 (UTC)

I just want to clarify I'm not the person who put through the edit again. I think that removing the word "some" does not in fact imply "all," and I do think it's better without the word "some," but I'd rather find a wording that makes everyone happy. Jhartzell42 (talk) 08:35, 28 June 2022 (UTC)

I put through a new edit that I think resolves all potential issues with either wording of the original sentence, with or without "some."

Jhartzell42 (talk) 08:46, 28 June 2022 (UTC)

You made your point, I have no more objections.--Megaman en m (talk) 13:22, 28 June 2022 (UTC)

Has anyone looked at incorporating this International Consensus Statement?

https://www.sciencedirect.com/science/article/pii/S014976342100049X?via%3Dihub Trantüte (talk) 21:58, 12 August 2022 (UTC)

Thanks for suggesting this, it sounds like a helpful source. Is there anything in the consensus statement that you think isn't properly reflected in the article? (The more specific the suggestions, the better!) Jr8825 • Talk 16:47, 24 August 2022 (UTC)