Starting with the diagnostic threshold, then you can go back to the several others.

Isn't it true that ADHD is diagnosed whenever there is "significant impairment" - just as any DSM dx?  And can you tell us or identify the standard for establishing "significant impairment"?


BTW, you cited to the ICD.  Is in fact, ADHD a disease, ie, with any organic etiology?  

Can you identify ANY etiology for ADHD?  Please do.


BTW, it's pretty lame of you to complain about other people when you bag out of questions.  You have no substance.

there is one definitive diagnosis.  My answer was strictly outlined below - IF you don't like my answer then I guess you don't like my answer.  But answer you - I did.  

WRT etiology - you did not ask that originally.  We don't have a specific etiology for many diseases.... but yet we can (and do) diagnose them,  and we can (and do) provide treatment for them.  Sometimes knowing the etiology of a disease (including metal disorders) is of absolutely no help in the treatment (example?  Thallasemia, Sickle cell anemia, Ehlers-Danlos I-IV, and so on).  These are all diseases for which effective treatments are lacking - but for which we have detailed information about the cause of the disease.

since YOU are fond of the DSM for diagnostic purposes... what is the code for conservatism.... since you have stated that it is a mental disorder.

-- Modified on 10/20/2007 11:48:34 PM

Instead of relying solely on science, psychiatrists and psychologists need to apply a certain amount of imagination and artistry if they are to be effective diagnosticians and therapists.  This is especially true of AD/HD and the other ASDs,  even though they are neurologically based.

I may not know a lot about medical science or other areas of psychiatry and psychology, but I'm pretty much an expert on the ASDs.



-- Modified on 10/21/2007 12:02:30 AM

"there are few diseases for which...there is one definitive diagnosis."

Bullshit.  EVERY organic abnormality has an independent, identifiable marker.  

QUESTION 1:  Please specify the  organic abnormality involved in ADHD.

When you can cope with that, we'll go to the next question.

The fact that some diseases have been identified for which no treatment has been established does not make the reverse logical, ie that we have treatments for unidentified diseases.  That is precisely the problem in ADHD - we have learned that low doses of methylphenidate has an  oddly calming effect on the behavior of most children, but we have no fucking idea why, and primarily because (WELL NO SHIT) behavior is influenced by an impossible variety of factors that we can neither investigate nor comprehend.

"Imagination and artistry"?   You mean, making stuff up as they go along?   Which colon should they be pulling this information out of?

Do you think they should be able to explain WTF they are doing?   Or is this sort of like Picasso, you know it when you see it?

I'm a little tired of hearing that some dx is the result of a "neurological chemical imbalance" and on cross-examination, finding out that is assumed because somebody (anybody) thinks there is a problem, and in fact, there is no evidence in this or any other case of any neurological chemical imbalance, and indeed, whether it is a problem at all is a matter of opinion or definition.  

Part of the problem is (a) we haven't defined normal balances, BUT (b) THE CRITICAL PROBLEM IS THAT we haven't defined normal behavior, and that is what gets back to my original point, that behavior (normal or not) is a POLITICAL issue, and medicine is inserting itself into politics, by claiming knowledge that it doesn't have, and substituting BS instead.

WTF is this supposed to mean?

"But does Jack0 the adult?"

"go to the primary source, the DSM, and show me the clinical diagnostic standards."

Instead, you got off on some ramble of your own about how ADHD COULD be diagnosed, and eventually got around to citing the ICD-9, without explaining why you aren't using the 10th edition, or what link you use.

I don't care what YOU think MIGHT be done.  I want to know the codified & generally accepted standard of care, as set out in the psychrinks' Bible, the DSM.

I want to know what is the generally accepted standard here, and I want a citation to authority - I don't want endless circular bullshit.  I've told you where to get it.  Do you disagree with the clinical diagnostic standards of the DSM??

AND MEANWHILE, just to keep you entertained, I asked about how the diagnostic threshold of "significant impairment" is identified.  I get tired of repeating questions over & over while you wander in circles, and then accuse others of "lacking substance".

BTW, did you actually read the post?  What substance are you lacking, comprehension or just attention?



-- Modified on 10/21/2007 4:10:10 AM

Your statement "EVERY organic abnormality has an independent, identifiable marker" is not true.  Currently most markers for various cancers (particularly GI in origin) can indicate more than one condition (inflammation, cancer or other abnormality) and more than one tissue type involvment.  CA19-9 is currently "a" marker that gives a positive correlation with PC however, it also correlates well with both other cancer types as well as with other conditions of the Pancreas.  

Most reputable researchers and clinicians rely on MUTIPLE markers and various diagnostic tests for a definitive diagnosis.... but then again - you a lawyer.  so you would not know that.

This is the difference between a legal answer - and a practical medical answer.

in English, "a" or "one" is regarded as a lesser included subset of "many" or "multiple".

So let's get back to the issue here, if we can, and tell me, what organic abnormality can be causally connected to ADHD?

What organic issue do you look for to identify ADHD?

Or you can just admit there isn't one.

so when you're exercising your imagination and artistry, do you ever think about how the fuck you're going to explain yourself?

Or is this something that is non-reproducible, ie your own unique vision?  

So while you're thinking about that one, why don't you tell us exactly what neurological chemical imbalance is involved in ADHD.

Or, if you want, take your choice, tell us what neurological chemical imbalance is involved in clinical depression, or in SAD.

if you knew shit about them, you'd be linking me immediately, and rattling off precise criteria, instead of wandering around.

In fact, your most consistent characteristic is the non-responsive answer, which is a minor variant of thread hijacking.   Your posting patterns lead me to believe your experience with these subjects is as a patient.

and find out what it IS.

I'm looking for the codified standard of care from the DSM.  What precisely is the dxer looking for?

Don't feed me general shit about considering the patient history.   What's he looking FOR?!  A party admission?  "You caught me Doc, I infected myself with ADHD deliberately."

Stop wandering around and evading the question - I have a 9th grader who can find these answers in 10 minutes with her Science Fair skills.

And you're still working on describing how the dx threshold of "significant impairment" is identified.  I really & truly want to hear that one, because it will open a lot of eyes around here.

if you know ADHD, can you tell us what it is?

Once we deal with the specific, then we can move to the general patterns.

does any of this sound familiar?
http://www.nlm.nih.gov/medlineplus/obsessivecompulsivedisorder.html

However, since you asked: Attention deficit disorder is characterized by inattention, hyperactivity and impulsiveness. It is the most commonly diagnosed disorder in children. The National Institute of Mental Health estimates that 3-5% of all children have ADHD.  Although ADD/ADHD is most commonly diagnosed in childhood, symptoms can last into adulthood. Some problems associated with ADHD are poor performance in school, inconsistency in work, emotional immaturity, and social difficulties.

Hopefully this and the link clears all this up for you Jack.  Oh, and by the way, Lawyers are not among those qualified to either diagnose or treat ADHD.

I think not.  

Are they they standard of care?  I think not.

Are you answering the questions?  My lawyer says that you are non-responsive.  He already has a ruling from the bench, that the witness is directed to ANSWER THE FUCKING QUESTION!!!!

Do you agree with the clinical diagnostic standards set out in the DSM?  In this case, for ADHD?

Do you really think you have any substance here?   I think you are not one to be judging, where you consistently evade simple questions.

however, pioneering work by Bert Vogelstein in the 80s provided that at least 3 mutations were necessary for a cell to head down an oncogenic path.... but hey....  you knew that ---- right?


By the by - nice cut and paste.

not an exclusive one

ANY marker.

Which can also be precluded by other analysis of the clinical dx stds.