As debates over overdiagnosis and underdiagnosis intensify, experts emphasise the importance of precise assessment and personalised treatment in managing ADHD in children and adults.
Attention-deficit/hyperactivity disorder is often discussed in polarised terms, but the more useful question is not whether it exists. It is how reliably it is identified, and how carefully children and adults are supported once concerns arise. The Saudi outlet “Asharq Al-Awsat” reported that this debate has sharpened again after a British documentary questioned whether ADHD has been overdiagnosed, while a Riyadh-based specialist warned that scepticism about excess diagnosis should not be confused with proof that the disorder itself is invented.
That distinction matters because ADHD is widely recognised as a neurodevelopmental disorder, yet it cannot be confirmed with a blood test or brain scan. According to the Mayo Clinic, diagnosis depends on a full clinical assessment, information from more than one setting, and standardised rating scales, rather than a single laboratory marker. Nature Reviews Disease Primers likewise describes ADHD as a complex condition with a strong genetic contribution, minor brain differences at the group level, and wide variation in symptoms and associated conditions.
The concern raised by clinicians is not only overdiagnosis but also underdiagnosis. As Asharq Al-Awsat reported, rising referrals in Britain, Canada and the United States may reflect greater awareness, especially among adults who were missed earlier in life, but it may also include rushed assessments that rely too heavily on symptom checklists. Mayo Clinic says a proper evaluation should take account of developmental history, behaviour across different environments, and other possible explanations for inattention or impulsivity.
Schools and family life also shape how difficulties appear. Small changes in the classroom, such as reducing distractions, breaking tasks into shorter periods and allowing movement breaks, may help some children manage better. But those adjustments are not a substitute for treatment when ADHD is genuinely present. The broader literature also points to a multimodal approach: behavioural support, educational adjustments and, when appropriate, medication, all tailored to the person’s age and needs.
The treatment debate has become more nuanced as well. A recent review in PubMed noted that stimulant medicines remain important, but newer non-stimulant options such as atomoxetine and viloxazine are expanding the choices available to clinicians. Another review in a child and adolescent psychiatry journal said ADHD care is moving towards more personalised models, combining medication with behavioural strategies and, in some cases, digital tools or other emerging therapies. Even so, experts continue to stress careful monitoring because medicines can help some patients while causing side effects or misuse risks in others.
The clearest conclusion from the current evidence is that ADHD should neither be dismissed as a fashion nor applied as a casual label. The sharper challenge is to distinguish ordinary variation in attention and activity from a pattern that is persistent, impairing and present across settings. That means better assessment, more context, and less haste. In the end, the goal is not to decide whether every restless child has a disorder, but to make sure the children and adults who truly need help are identified and treated properly.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
