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Psychiatrist warns of overdiagnosis in children and links teen cannabis and meth use to increased psychosis risk
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Summary
Dr. Sally Satel told a congressional roundtable that autism and ADHD diagnoses have broadened and that more rapid prescribing has outpaced behavioral interventions; she also cited studies suggesting adolescent cannabis and methamphetamine use increase risk of psychosis.
Dr. Sally Satel, a practicing psychiatrist and senior fellow at AEI, told the subcommittee that diagnostic criteria shifts and clinical practice patterns have expanded the populations labeled with disorders such as autism spectrum disorder and ADHD.
She cited CDC prevalence estimates — "In 2023 ... 1 out of every 36 children had autism" — and said some conditions are being overdiagnosed or labeled when social and developmental supports might better address distress. Satel argued that applied behavioral analysis and other nonpharmacologic therapies are time‑consuming but effective and that clinicians too often turn quickly to medication.
Satel also discussed substance‑related pathology. She said methamphetamine use is producing more hospitalizations for drug‑induced psychosis and pointed to a large cohort study reported in JAMA Health Forum that found adolescent cannabis use associated with higher risks of later bipolar disorder and schizophrenia symptoms.
Satel acknowledged that severe mental illness remains under‑resourced, recommending better integration of psychiatric, social‑work and vocational services for those patients while avoiding unnecessary medicalization for others.
