The Construction of Psychiatric Diagnoses: The Case of Adult ADHD

Abstract

Psychiatric diagnosis is notoriously pliable. In recent years new diagnoses such as social anxiety disorder, premenstrual dysphoric disorder and hypoactive sexual desire disorder have been fashioned and promoted by the pharmaceutical industry (Moynihan & Cassels, 2005; Tiefer, 2006; Koerner, 2002) and older diagnoses such as melancholia or neuraesthenia have either withered away or, as in the case of depression and bipolar disorder, have expanded beyond recognition (Healy, 2006a). Whereas there was once a stigma attached to having a psychiatric label, since the 1990s, drug company funded publicity, and professionally sponsored disease awareness campaigns, such as the UK’s Defeat Depression Campaign or Australia’s beyondblue initiative, have successfully eroded this for many diagnoses. People now frequently arrive at a doctor’s office requesting a particular psychiatric label and its associated drug treatment. That is to say, we have recently seen the development of an entirely new, and historically unprecedented, class of psychiatric diagnoses — like PTSD and Asperger’s Syndrome — diagnoses that patients actively want to have.