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Saturday, 6 August 2016



                                               THE HISTORY OF ADHD

The first example of a disorder that appears to be similar to ADHD was given by Sir Alexander Crichton in 1798. Crichton was a Scottish physician who was born in Edinburgh in 1763. In 1785, he received his M.D. from the University of Leiden, The Netherlands (Palmer and Finger ; Tansey ). He then decided “to undertake a European medical tour” (Tansey , p. 243) and practiced in hospitals in Paris, Stuttgart and Vienna (Tansey ). In his clinical practice, Crichton observed many cases of insanity and became increasingly interested in mental illness (Palmer and Finger ). In 1798, he published “An inquiry into the nature and origin of mental derangement: comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects”. In this work of three books, he demonstrated observations of clinical cases of mental illness (Palmer and Finger ). Up until the end of the eighteenth century, when Crichton published his inquiry, it was uncommon to focus on mental issues from a physiological or medical perspective (Palmer and Finger ). Crichton mentioned that at the time there were only two other authors who had “written fully on the subject of Mental Diseases” (Crichton , pp. ii–iii, cited by Palmer and Finger ).






                                                 ADHD EUROPE


Despite what certain critic’s claim Attention Deficit Hyperactivity Disorder (ADHD) is not a novel phenomenon constructed during the 1980’s in the USA, rather it appears to be the result of an accumulation of research findings and clinical observations over the course of more than two centuries. During that time the condition has been known by numerous pseudonyms, influenced by zeitgeists, and strengthened by diverse inter- and intra-field debates.  It is important to remember that this discussion represents only a very brief overview of some of the pertinent dates and events in ADHD history. From the disorders humble beginnings as characters in literature through its numerous reinventions to modernity’s appreciation of ADHD as a condition characterised by differential manifestations of inattention, hyperactivity, and impulsivity.
Ancient ADHD History
It would be difficult, if not impossible, to note every literary reference to behaviours potentially attributable to ADHD, however, certain instances it would be remiss not to mention. The earliest character suffering from a malady of attention appears in a play (King Hennery VIII, circa 1613) by William Shakespeare, perhaps unsurprising given his uncanny ability to understand and portray human nature and mental illness. ADHD type symptoms appear in a number of other academic and medical literature before a German doctor, Heinrich Hoffman, coined the term Hyperkinetic Syndrome, and wrote a children’s story which clearly describes some of these behaviors,
“Fidgety Phil, he won’t sit still, he wriggles, and giggles … The naughty restless child growing still more rude and wild” (Stewart,1970, p. 94).
As Ilina Singh (2008) sensibly asserted, the mere presence of characters demonstrating ADHD like symptoms in antiquated literature does not support the validity of a medical diagnosis.  However, the use of inductive reasoning as a precursor to scientific method is unarguably of merit in, if not central to, empirical pursuits. But such observations do refute arguments from the likes of Conrad (1976) who suggested that modern society created the problem or was medicalizing normal behaviours. If this were true then what were Shakespeare and Hoffman reacting to ... I wonder???
Timeline of ADHD
1613    William Shakespeare’s play King Hennery VIII
1798    ‘Mental Restlessness’ (Critchton)
1809    ‘Observations on Madness and Melancholy.’ (Haslam)
1845    ‘Hyperkinetic Syndrome’ and ‘Fidgety Phil’ (Hoffman)
1902    ‘Deficits in Moral Character’ (Still)
1908    ‘Minimal Brain Damage’ (Tredgold).
1913    ‘Partial Moral Dementia’ (Stein)
1917    Post-encephalitis behavioural disorders
1931    ‘Hyperkinetic child’ (Winnicott)
1934    ‘Hyperkinetic Disease’ (Kramer – Pollnow)
1937    Charles Bradley study of Benzedrine.
1940    ‘Minimal Brain Damage’.
1957    ‘Hyperkinetic’ Impulse Disorder / Behaviour Syndrome
1960    ‘Minimal Brain Dysfunction’
1968    ‘Hyperkinetic Reaction of Childhood’ in the DSM-II
1972    V. Douglas’s research on inattention
1977    ‘Hyperkinetic Syndrome of Childhood’ in the ICD -9
1980    ‘Attention Deficit Disorder’ (ADD)  in the DSM-III
1987    ADHD in the DSM-III-Rremoved sub-typing




Greumach MacFothaidh Family Therapy was used decades ago in Scotland to deal with this problem ( note, I did not say 'treat') as it is a family problem not a neurological problem. If it was neurological than psychosocial approaches would not work.
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Thomas Leonard how long ago was ADHD known about, Greumach MacFothaidh? When did you first start diagnosing it, and how?
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Greumach MacFothaidh Well, as the Irishman would say, 'I wouldn't start from there!' I was trained in Fam Therapy in the 1960's under the Children & Young Persons Act 1920 (? Actual year of enactment ) and it had a massively reducing impact on children and teens having to be taken to Juvenile Court as being in need of care and protection. However, I think Americans thought of ADHT and neurological causes and so FT fell out of fashion and local authorities saved money doing it and left it to Medicine to foot the bill with medications.

Early history of inattention and hyperactivity

The current conceptualization and clinical characterization of ADHD has evolved through a complex and diverse historical trajectory dating back to Greek times[]. Prior to the distinct personality types described by Galen (131-201 AD), which are only vaguely related to the current definition of ADHD[], Hippocrates (460-375 BC), almost universally considered the father of modern medicine, provided the earliest report of a condition that appears to be comparable with what is currently identified as ADHD[]. Approximately in 493 BC, he described patients who had “... quickened responses to sensory experience, but also less tenaciousness because the soul moves on quickly to the next impression”[]. Hippocrates attributed the condition to an “overbalance of fire over water” in the patients bodily humors and prescribed as a remedy for such “overbalance” lots of water and a bland diet, barley rather than wheat bread, fish instead of meat, water drinks, and many natural and diverse physical activities[].

More from Greumach:

Quite so, but in practice Britain generally adhered to the psychosocial model in recent, modern times. The medical establishment for children used the psychosocial model in the main, eg the Family Therapy model was used extensively first by Psychiatric Social Work by Anna Freud at the Hampstead Child Guidance Clinic, the Royal Edinburgh Hospital Child & Adolescent Psychiatry, Gaskell House PSW Unit, Manchester, Southern General Hospital PSW Unit and the Royal Hospital for Sick Children, Glasgow. FT was a 'buzz' thing in the 1970's. Only much later did the medical model be adopted from the USA in large part, despite the cost, but it was seen as 'cost effective' for hospital statistics.

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