Irresponsible Science Journalism on Swedish ADHD Report
Here we go again.
The Swedish Council on Health Technology Assessment has recently released a report on topics that included the reliability of tests used for ADHD diagnosis in Sweden. The basic gist of the report is that many of the tests have limitations if used exclusively alone, but that the current of practice of using many different rating scales together with critical clinical assessment is acceptable. The report says that (p. 26, my translation):
The diagnosis of children and young adults with ADHD is today carried out with the aid of several different rating scales, which each by themselves alone lacking scientific evidence. The rating scales are filled out by parents, teachers and the young adult it pertains to. We have not evaluated how the weighting between these different informants look. To make the diagnosis today, it requires additionally a clinical evaluation and an evaluation of the level of disability in the child/adult.
In conclusions, the results show that none of the diagnostic tests that have been evaluated can be used by itself to make the ADHD diagnosis. Instead, this report supports the current practice, that the foundation for the diagnosis is the clinical evaluation and that the diagnostic tests for ADHD should be used as a basis for the gathering of information that is then evaluated by the clinician.
Guess how Swedish media carried the story? By falsely claiming that little science supported the ADHD diagnosis. The sad part of this story is that the “Sveriges Radio” is a popular public radio station, and not some marginalized crackpot network. The journalist behind the story was in other words guilty of irresponsibly making sensationalist science journalism, bordering on anti-psychiatry, and confusing the valid scientific discussion with how to make diagnostic tools better with the pseudoscientific nonsense of anti-psychiatry. The comment section of the article is already bogged down by crackpots.
First rule of doing and reading science journalism: always read the original paper or report.
ADHD denialism is unfortunately rather common, so I thank you for sticking up for science on this particular topic, as I happen to have been diagnosed with ADHD only a few years ago, and I’m receiving treatment for it now. If only I had known about it years ago when I was younger, my life might have been much less troubled. Unfortunately, this kind of denialism had kept the reality of ADHD obscure even from myself, having been a lifelong science enthusiast, but who nevertheless had an over-simplified view of ADHD (called ADD previously).
It came as a big shock to me when a colleague pointed out I fit the list of symptoms of ADHD. My first thought was, “What?! That makes no sense!” But when I actually started to look into the actual symptoms and signs of ADHD I realized how well it identified all of the major issues that had been affecting me since childhood. The more I learned about ADHD the more I found that the popular ideas about it are very frequently dead wrong.
I was still self-skeptical about it, so when I went for an assessment, I was careful to pay attention to how my psychiatrist made his evaluation. To my great relief, he spent a great deal of time trying to identify *other* possible causes for my issues, such as bipolar disorder, depression, anxiety, PTSD, schizophrenia, etc. It was only after *eliminating* these possibilities as being the primary cause (I was also diagnosed with anxiety and depression as ‘co-morbid’ secondary issues related to ADHD) did he finally explain how my responses clearly indicated ADHD as the primary issue. He barely even looked at the diagnostic screening questionnaire which he had me fill out in the waiting room.
The clinical assessment is rightfully the primary method of diagnosis, and a competent psychiatrist or psychologist, with experience identifying ADHD and ruling out other possible explanations, is the best way to get an accurate diagnosis. Diagnostic screening tools are useful to help people decide whether they should get an appointment for an assessment, but by themselves they are simply not yet adequate for a complete diagnosis.
Shame on the reporter for portraying the standard (and standard for several years so far) as being unsupported by science.
Shame indeed.
Thank you for sharing your story!
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