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ADD News News from around the world about ADD/ADHD, other disorders, and some rather bizzarre & strange stories.

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  #16  
Old 01-06-14, 08:51 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

Quote:
Originally Posted by Stevuke79 View Post
How is a disease defined other than by a collection if symptoms?
If you can't do a blood, urine or fecal test for it, it's not a 'real' disease! Duh!


Personally, I think these dr.s just have a body fluids fetish.

My sis has RA, the only way that is diagnosed is eliminating all the diseases they have physical tests for based on the symptoms, if those are negative, then the diagnosis is based on the symptoms. No one has ever doubted her diagnosis. Though I can tell by her attitude that she doubts mine.
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  #17  
Old 01-06-14, 08:56 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

The most unfortunate thing about this article, though, is that when you google the doctor's name, you get at least five pages of "ADHD is not real" hits. People remember that.
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  #18  
Old 01-06-14, 09:14 PM
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Re: ADHD does not exist according to Neurologist Richard Saul


One of the fallacies that articles like these are based on is that other neurological diseases like autism, schizophrenia, depression etc, have biological markers.

When we have a biological marker or empirical test for a neurological condition, it's the exception, not the rule.
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Old 01-06-14, 09:35 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

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Originally Posted by Stevuke79 View Post

One of the fallacies that articles like these are based on is that other neurological diseases like autism, schizophrenia, depression etc, have biological markers.

When we have a biological marker or empirical test for a neurological condition, it's the exception, not the rule.
Are you saying that there are known biological markers for autism, depression and schizophrenia?

Or are you saying that the idea there are such biological markers is a fallacy?

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  #20  
Old 01-06-14, 09:48 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

I think SteveUke was probably thinking of biomarkers that work for diagnostic purposes. We've found lots of biomarkers for lots of things that clearly exist as problems, but not enough definitive ones to make a test that tells us "Yep, this is what you've got!"
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  #21  
Old 01-06-14, 10:03 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

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Originally Posted by Stevuke79 View Post
How is a disease defined other than by a collection if symptoms?
By identifying its cause or direct evidence thereof. For example, in viral diseases, finding a high level of the virus, or a high level of antibodies to that virus.
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  #22  
Old 01-06-14, 10:06 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

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Originally Posted by Amtram View Post
I think SteveUke was probably thinking of biomarkers that work for diagnostic purposes. We've found lots of biomarkers for lots of things that clearly exist as problems, but not enough definitive ones to make a test that tells us "Yep, this is what you've got!"
Exactly.

Quote:
Originally Posted by Lunacie View Post
Are you saying that there are known biological markers for autism, depression and schizophrenia?
Or are you saying that the idea there are such biological markers is a fallacy?
What Amtram said.

We do not have definitive and consistent biological markers for most neurological disorders. There are a few, but they are the exception. People got very excited when we were able to identify anorexia on a brain scan. In July of 2013 there was a big deal about a protein that could some day be used to identify depression with a blood test. But for most of them, while we may have identified potential biological markers, they are weak, subjective, inconsistent and clinically useless.

A lot of these articles talk about how ADHD is diagnosed a list of questions and interviews with a psychiatrist, and how that isn't scientific. They're hoping you'll assume that for most neurological disorders it's different.
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  #23  
Old 01-06-14, 10:07 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

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Originally Posted by dvdnvwls View Post
By identifying its cause or direct evidence thereof. For example, in viral diseases, finding a high level of the virus, or a high level of antibodies to that virus.
Right, so that's my point. We don't have anything like that for most neurological disorders. Even something as ostensibly "empirical" as ALS.
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Old 01-06-14, 10:36 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

Even though neuro-pyschological testing can't be used to diagnose ADD directly, it is used to eliminate some conditions with similar symptoms.

Just as a physical and having blood samples taken can eliminate conditions with symptoms similar to ADHD.

Even though guidelines state symptoms usually appear between the ages of 6 and 12, it seems like doctors are too quick to diagnose. I've seen an article about schools screening the entire student body for ADHD that have resulted in many misdiagnosed students. The school district actually had to pay fines as a result.

A direct relationship exists between "qualified professionals" challenging the validity of ADHD and the media's coverage of escalating ADHD diagnosis and medication. It's become a "hot topic" for all the wrong reasons. Media covers it because it's controversial and pulls in viewers, not necessarily because it's factual.

This creates more stigma for those with ADHD and is responsible for the attitude that "everyone is a little ADHD." How else did the masses get to be experts?!?
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  #25  
Old 01-07-14, 02:03 AM
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Re: ADHD does not exist according to Neurologist Richard Saul

Well definately an indepth diagnostic process is important.

Maybe there are "borderline" cases.

But I can tell you many serious cases of ADHD either go unrecognized or untreated.

For me, I mean the real motivation to access for ADHD, and get potential treatment, is if the person has serious functional difficulties that effect the quality of their lives and their ability to manage their lives.

The physical actuality of ADHD is well established, but we do not yet have the science to peak directly into the brains of single individuals and directly measure their neurotransmitter levels and level of brain functioning. But I do believe that in most peoples lifetimes, this will change significantly. Do NOT underestimate how the science is advancing, it iS advancing.

I know 3 main people that have been formally diagnosed with ADHD, and most certaily are full blown ADHD. For various reasons, including stigma, social pressure, and the lack of guidance by doctors, NONE of these people are receiving treatment whatsoever.

Literally in these people it is easy to see how their core ADHD traits impact their life. Especially impulsive and lack of motivation and focus on medium and long term goals. ALL OF THEM have suffered dramatic and consistent disadvantage due to impulsive behavior governing the direction of their lives.

Oh another person, separate from those, is a good friend of mine. She is very, very ADHD in all respects. But she is over 60, and she admits and knows that she fully meets ADHD criteria, but she won't seek treatment. She has lived her whole life in such a way, her disorganization is notorious. She doesn't know who she would be if she were different, even knows she does struggle quite dramatically.

Her daughter actually is yet another person diagnosed with ADHD. But in her early 20's her doctor found out she sometimes smoked marijuana and refused to continue to prescribe stimulant medication (she had a successful job and relationship).

Within 2 years of stopping the medication she fell into heavy alcoholism. She went to a new doctor who does not consider ADHD, and just prescribes her antidepressants which do not work at all. Its a few years later and she is a SEVERE, life threatening chronic alcoholic, she drinks 7-8 bottles of wine every day, and gets severe shakes and withdrawal if she goes without. Her alcoholism is KILLING HER. Her psychiatrist will not even try new medications, he has literally said "she does not want to improve or change", and has described her as a nuisance patient and blatantly told her he is on the verge of refusing to see her any more. He could not give a ****.

The truth is full blown ADHD in conjunction with co-related emotional problems can DESTROY peoples entire lives. Most the people I know with ADHD do not want to hear it. I know people with serious emotional problems (severe) that are not ADHD. I don't know why, but none of these people want to accept a medical model for their difficulties. I don't really understand why.

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Old 01-07-14, 03:19 AM
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Re: ADHD does not exist according to Neurologist Richard Saul

The cause "Poor sight, lack of sleep and a feeling of "life is getting the best of them"

Then new glasses, a nap and a better outlook may be a cure. Alright I'll give it a whirl!
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Old 01-07-14, 10:17 AM
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Re: ADHD does not exist according to Neurologist Richard Saul

Fraser

Some points:

Quote:
The problem with the ADHD diagnosis is that it consists of nothing more than a quick evaluation and multiple choice questionnaire. (which I assume parents fill out on behalf of their children)
The current protocol (at least for children-for adults a similar method is usually used) involves a survey of behaviors for school and home which then are compared with others of that age group to get a percentile ranking of the individual compared with other children in respect to ADHD symptoms.

Quote:
The issue is that the list of symptoms that make up ADHD can quite easily be caused by other factors. Other possible factors seem to be getting ignored more and more these days, which may be a resulting factor in the steep increase in ADHD diagnosis(es) over the last decade.
A good assessment has to rule out other causes of the behaviors, it is part of the diagnostic protocol.

Quote:
There's no doubting that ADHD is a very real disorder, but there is also no doubting that it quite probably gets diagnosed a lot, when other possible factors are generally over looked.
According to the research I have read overall the current diagnostic protocol is really pretty consistent and accurate as compared to any other proposed methods.

Quote:
Co~rrect. But the diagnosis you're seeking, will generally be the diagnosis that you get.
I have not found that to be the case with experienced clinicians. With ADHD, very often the patient has researched it out and has a pretty good idea of what is going on so the clinician is then verifying the patient's suspicions.

Quote:
For example, if you have difficulties with concentration, memory and motivation and you request to be evaluated for ADHD, then you'll get a diagnosis for ADHD, because the questionnaire is based on the symptoms you have, not the actual cause of the symptoms.
Fraser, at this time we have no way of getting to the "actual cause of the symptoms". For all its faults, the current protocol is the best we have and works reasonably well.

Quote:
If you have difficulties with concentration, memory and motivation and you request to be evaluated for Depression, then you'll end up with a diagnosis for depression, because again, the questionaire is based around the symptoms you have, instead of getting to the core cause of the symptoms.__________________
What you are missing, a good assessment also involves a family and personal history. This is where other issues are normally picked up. Also, a good psychological battery can help do the same thing.

Quote:
It's not always a matter of a diagnosis you're seeking (i should have been clearer on that), but sometimes its down to the diagnosis your GP wants to give you, despite them being incorrect themselves.
This is true and sometimes a GP does not always do a through assessment. It often appears that the UK has a particular problem with diagnosing ADHD.


Quote:
The problem i'm trying to point out here is that too many of these so called "tests" aren't really tests at all. Because the questions contained in these tests could apply to a multitude of different disorders and the same questions could be found in evaluation questionnaires of multiple disorders.
The surveys are to allow us to compare the level of symptoms of one individual with the general population. Generally we look for symptoms to be in the top 5-10% as compared to the general population. The further below that, the less likely it is that the person will be diagnosed as ADHD.

Quote:
It's no wonder people with ADHD are often misdiagnosed with depression or vice versa. The questionnaires are more or less the same.
The symptoms of depression and inattentive ADHD are similar. It is usually the history that differentiates them.


Hope this helps you understand a little better assessment for ADHD. I can see and understand why you think as you do but it is not quite the way it works.

Take care,

Dizfriz
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  #28  
Old 01-07-14, 12:42 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

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Originally Posted by dvdnvwls View Post
By identifying its cause or direct evidence thereof. For example, in viral diseases, finding a high level of the virus, or a high level of antibodies to that virus.
That's exactly right once you've gotten past the symptom checklist. Even with diseases that have an identifiable, testable cause, you need to know the symptoms to know what to test for. You can have two different bacteria that cause almost identical symptoms except for one extra, subtle one that occurs only in infection from the second bacteria. And you test for the first, and it shows the patient isn't sick!

Symptomology comes before testability. So right now with psychiatric disorders, we're still at the symptomology stage. That doesn't mean there won't ever be testability, but because ALL disease started off being evaluated by symptoms, it's incorrect to state that a disease doesn't exist because all we know are the symptoms.

Just trying to clarify - because the overwhelming public opinion is that symptoms alone don't indicate disease, but that's simply not true.
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Old 01-07-14, 01:04 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

Testing eliminates causes for symptoms after they are identified.

It goes back to a thorough evaluation. Physical, blood work, neuro-psychological testing, inventories, questionnaires and most importantly patient and family history.
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Old 01-07-14, 01:05 PM
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Re: ADHD does not exist according to Neurologist Richard Saul

I love how he includes the comment that medications are used to try to improve performance at school

They aren't used to try to improve, they are used to try to repair. Improving implies that a baseline of acceptability is there already when it usually is not if medication is proscribed. Just speaking from personal experience, I had almost all Bs and Cs before my doctor proscribed me my medication, and they they all jumped to As and Bs.
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