In 2006, scientists from the University of Newcastle, NSW who were hosting a conference on disease mongering described a new condition called Motivational Deficiency Disorder (MDD). Although the report was published on 1 April and the team included a neurologist called Dr Leth Argos, some were fooled by this hoax, although a reader wrote to say he had discovered the condition some years earlier, but could not be bothered to write it up. The authors were using humour to make a very serious point. They feel that modern medicine is plagued by an epidemic of poorly denned conditions, which overlap with normal human behaviour and are often described by three-letter abbreviations (TLAs). Furthermore, they feel that the pharmaceutical industry has deliberately fostered this trend by developing and promoting medicines to treat these fictitious or grossly exaggerated conditions. Paediatrics is not exempt from accusations of disease mongering (see Table 1 for possible examples). Who defines what is and what is not a disease? The World Health Organization (WHO) asserts they should. The WHO was founded by treaty as a specialised agency of the United Nations in 1948 and its 193 member states have agreed to use the International Classification of Diseases (ICD) developed by the WHO. We are up to ICD-10, and ICD-11 is due in 2014.
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