Give Me Your Tired, Your Poor, Your Distracted ...

AS A PHYSICIAN I WAS VERY INTERESTED in Edward Shorter’s September 1998 article “How Prozac Slew Freud.” But as a pediatrician I was disappointed in his parting shots at the diagnosis of attention deficit hyperactivity disorder.

Yet it’s Shorter’s observation that ADHD “is virtually unknown elsewhere” that your magazine’s readers might enjoy pondering. We now know that this genetic disorder is not just a disease of children but can continue into adulthood as well. ADHD mostly involves a triad of impulsivity, distractibility, and hyperactivity, but it can also hamper social skills and quicken a sense of boredom. Might this be the reason the United States consumes 90 percent of the world’s Ritalin? Could it be that restless, easily bored adults with hampered social skills (and thus less restricting social commitments) might have tired of the Old World and impulsively emigrated to the New? And if enough affected adults intermixed in this new breeding ground, couldn’t this result in the highest incidence of ADHD in the world?

So don’t bother “asking British psychiatrists what they think about ADHD.” Their patients’ ancestors were perfectly satisfied to stay put in Britain!