By Peter C. Gøtzsche

In this provocative piece, Professor emeritus Peter C. Gøtzsche, a leading critic of biological psychiatry, dissects the epidemic of overdiagnosis in conditions like ADHD. Drawing on insights from Allen Frances and other sources, he argues for a societal shift away from hasty labelling and towards understanding contextual factors. This article challenges the status quo and calls for action to protect patients from unnecessary harm.

On 14 December, there were two interesting letters in The Guardian about overdiagnosis in psychiatry.¹

Psychiatrist professor Allen Frances, previous chair of the American Psychiatric Association’s DSM-IV taskforce, which developed the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders in 1994, stated:

“Rates of reported psychiatric diagnoses have exploded recently due to a combination of:

1) confounding stress and distress with mental disorder;

2) ignoring the context in which symptoms occur;

3) the rise of internet self-diagnosis;

4) loose and fuzzily defined diagnostic criteria;

5) careless diagnosis (especially by GPs who have too little time to know their patients);

6) big pharma marketing; and

7) tying benefits too closely to diagnosis rather than level of functioning.

The result is a wasteful misallocation of scarce resources. The worried well and mildly symptomatic receive harmful, unnecessary treatments – while patients with severe illness are deprived of the treatment and services they desperately need.”

I wrote in my first psychiatry book, Deadly Psychiatry and Organised Denial,² that Allen Frances believes the responsibility for defining psychiatric conditions needs to be taken away from the American Psychiatric Association and he argues that new diagnoses are as dangerous as new drugs: “We have remarkably casual procedures for defining the nature of conditions, yet they can lead to tens of millions being treated with drugs they may not need, and that may harm them.”³ Frances noted that DSM-IV created three false epidemics because the diagnostic criteria were too wide: ADHD, autism and childhood bipolar disorder.

However, in the other letter, Natasha Fairbairn, who works in a primary school as a learning support assistant for special educational needs and disabilities, announced that “ADHD UK estimates that there are 2 million people in the UK with undiagnosed ADHD. Statistically, we are underdiagnosing ADHD, rather than overdiagnosing it.”

This incredible naivety is highly useful for the drug industry that sells amphetamine-containing or amphetamine-like drugs for ADHD, a kind of state-approved narcotics on prescription. I explain in my book that many children qualify for the diagnosis simply because they are talented and therefore bored and cannot sit still in poorly disciplined classrooms, or because they have emotional problems generated at home.

The Impact of Birth Month on ADHD Diagnosis

Since we are talking about degrees of development and not a brain disease, we would expect more of those children born in December to have an ADHD diagnosis and be in drug treatment than those born in January in the same class, as they have had 11 fewer months to develop their brains. This is exactly the case. A Canadian study of one million school children showed that the prevalence of children in treatment increased pretty much linearly over the months from January to December, and 50% more of those born in December were in drug treatment.⁴ This study shows that if we approach the children with a little patience that allows them to grow up and mature, fewer would receive drugs.

However, the diagnosis arises primarily from teacher complaints and parents are often told that their kid cannot come back to school unless he or she is on an ADHD drug. A general practitioner told me that a schoolmistress had sent most of her pupils for examination on suspicion of ADHD; clearly, she was the problem, not the kids.

As soon as the kids are branded with ADHD, it relieves everyone of any responsibility or incentive to redress the mess they have created. We have decided as a society that it is too laborious or expensive to modify the kid’s environment, so we modify the kid’s brain instead. This is cruel.

The Flawed ADHD Tests and Broader Implications

When I lectured for lay people or healthcare professionals and asked them to try the foolish WHO test for adult ADHD,⁵ it never failed that between one quarter and one half tested positive.

So, in essence ADHD means: All Dudes Have the Disorder. I recently wrote the article, “The Pandemic of Fake Psychiatric Diagnoses.”⁶ Why don’t we arrange huge demonstrations in the streets announcing that we must stop the madness? The patients are less mad than their psychiatrists.⁷ We must protect them.

1. Letters: Wes Streeting is right to examine questions of overdiagnosis. The Guardian, 14 December 2025.
2. Gøtzsche PC. Deadly psychiatry and organised denial. Copenhagen: People’s Press; 2015.
3. Moynihan R. A new deal on disease definition. BMJ 2011;342:d2548.
4. Morrow RL, Garland EJ, Wright JM, et al. Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children. CMAJ 2012;184:755-62.
5. Kessler RC, Adler L, Ames M, et al. The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005;35:245-56.
6. Gøtzsche PC. The Pandemic of Fake Psychiatric Diagnoses. Brownstone Journal 2025;Sept 17.
7. Gøtzsche PC. Are psychiatrists more mad than their patients? Mad in America 2025;May 6.

About the author

Professor emeritus Peter C. Gøtzsche is a Danish physician, medical researcher, and former leader of the Nordic Cochrane Center at Rigshospitalet in Copenhagen. Born on 26 November 1949, he holds a Master of Science in biology and chemistry (1974) and is a qualified physician (1984) and specialist in internal medicine. He co-founded the Cochrane Collaboration, contributed to the development of the Cochrane Handbook for Systematic Reviews of Interventions, and is the author of numerous meta-analyses and systematic reviews. He has authored numerous reviews and books critiquing the pharmaceutical industry and psychiatric practices, including Deadly Medicines and Organised Crime and Deadly Psychiatry and Organised Denial.