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Fifteen-minute consultation: To prescribe or not to prescribe in ADHD, that is the question
  1. Annie Swanepoel
  1. Elysium Healthcare, Borehamwood, UK
  1. Correspondence to Dr Annie Swanepoel, Elysium Healthcare Ltd, Borehamwood WD6 1JN, UK; annie.panzer{at}


Attention-deficit hyperactivity disorder (ADHD) is fraught with controversy. Some clinicians believe it is a biological neurodevelopmental disorder which should be treated with medication. Others are adamant that ADHD is a social construct in which children, who have suffered developmental trauma, are medicalised. Evolutionary science may help us find a solution to this dichotomy by seeing ADHD as an example of an evolutionary mismatch in which children with ADHD are caught in a school environment that does not suit their natures. By considering how to improve the ‘goodness of fit’ between the child and their environment, clinicians can be more flexible in finding solutions that are ethically sound.

  • ethics
  • child psychiatry
  • neurodevelopment
  • school health

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.