Abstract
ADHD questions the idea of cognitive " normality " and our societal responses to human diversity. Medically defined as a neurodevelopmental disorder, it affects 5 % of children and 2-3 % of adults. It is a long-lasting combination of inattention, hyperactivity and impulsivity, with a functional impact modulated by age, gender and environmental demands. Its variability, underpinned by multiple trajectories and neurobiological mechanisms, invites us to go beyond a purely categorical reading. The neurodiversity paradigm complements the medical framework with a social and political perspective. It sees ADHD as a variation in cognitive functioning, with strengths and weaknesses whose expression depends on context. ADHD is seen as a condition calling for reciprocal adaptations between the individual and his or her environment : not a deficit to be corrected, but a difference to be supported. Interventions, between recognizing difficulties and valuing singularities, articulate personalized therapeutic and psycho-educational approaches. Ethical issues (equitable care, de-stigmatization) call into question our educational and professional representations and standards. This tension between medical and social models is linked to a wider societal issue : how can we accommodate neurodiversity and difference ? Beyond tomorrow's psychiatry, our response will shape our very conception of inclusion and humanity.
Cédric Galera
Cédric Galera is Professor of Child and Adolescent Psychiatry at Bordeaux University and a hospital practitioner at Charles-Perrens Hospital and Bordeaux University Hospital. With a doctorate in epidemiology, he heads the youth health team at INSERM 1219. His work focuses on understanding the epidemiology of mental health in young people, the long-term consequences of childhood psychiatric disorders (anxiety, depression, attention deficit disorder, hyperactivity) and early risk and protective factors (social inequalities in health, biomarkers, exposure during pregnancy, climate change and mental health). He is an expert for the European Commission, a member of the European ADHD guideline group and a research associate in Canada.
