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A. Baughman Jr. MD

Neurology & Child Neurology (board certified)

Fellow, American Academy of Neurology

1303 Hidden Mountain Drive

El Cajon, CA 92019

619 440 8236 (phone)

619 442 1932 (fax)

Letters Editor, JAMA                                                         
November 5, 2002

515 N. State Street

Chicago, IL 60610

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also to: fax 312 464 5824



Developmental Trajectories of Brain Volume Abnormalities in Children and
Adolescents With Attention- Deficit/Hyperactivity Disorder.
  F. Xavier Castellanos, MD ; Patti P. Lee, MD; Wendy Sharp,
MSW; Neal O. Jeffries, PhD; Deanna K. Greenstein, PhD; Liv S. Clasen, PhD;
Jonathan D. Blumenthal, MA; Regina S. James, MD; Christen L. Ebens, BA; James
M. Walter, MA; Alex Zijdenbos, PhD; Alan C. Evans, PhD; Jay N. Giedd, MD;
Judith L. Rapoport, MD

To the Editor:

CHADD, funded by Ciba/Novartis, maker of Ritalin, calls ADHD a brain
disease.  NIMH researchers, Castellanos included, dominate CHADD’s 
“national professional advisory board” and sanction the “disease”

Nasrallah [1] scanned (CT) adult males treated for childhood
hyperactivity and concluded: “cortical atrophy may be a long-term adverse
effect of this treatment.”

Despite the fact that all subject-groups were stimulant-treated,
researchers—mainly from the NIMH–continued to represent the brain atrophy
[2-16] as proof that ADHD was a disease, avoiding the study of drug-naïve

In 1996, Castellanos [16] stated:  “A replication study with
stimulant-naïve boys with ADHD is under way.”  Such a study never

At the 1998, Consensus Conference,  Swanson (presenting) and
Castellanos [17] summarized: “Recent investigations provide converging evidence
that a refined phenotype of ADHD/HKD (hyperkinetic  disorder) is
characterized by reduced size in specific neuroanatomical regions…” 

Baughman asked [18] :  “Dr. Swanson, why didn’t you mention that
virtually all of the ADHD subjects in the neuroimaging studies have been on
chronic stimulant therapy and that this is the likely cause of their brain

Swanson:  “…this is a critical issue…I am planning a study to
investigate that.” 

With the “epidemic” 4.4 million, the final statement of Consensus
Conference Panel [19], read:  “…we do not have an independent,
valid test for ADHD, and there are no data to indicate that ADHD is due to a
brain malfunction.”

From Readers Digest, January, 2000
[20]:  “Castellanos and his group found three areas of the brain to be
significantly smaller in ADHD kids…Some critics claim that such brain
differences…might actually be caused by Ritalin…To address this, Castellanos
has now embarked on another study, imaging the brains of ADHD youngsters who
have not been treated with drugs.”    . 

Why then, did Castellanos
co-mingle treated and un-treated ADHD subjects?

Why the Castellanos failure to
reference Bartzokis [21] who found brain atrophy in amphetamine addicts,
suggesting, that stimulants, not the never-validated disease, ADHD, causes the
brain atrophy?

Subjects were said to have
DSM-IV [22]-defined, ADHD.  How could this be true when the study spanned
1991-2001 and the DSM-IV was not published until 1994? 

On March 1, 2000, Castellanos
[23] wrote me: “The anatomic MRI study you asked about …was begun approximately
4 years ago; it is approaching completion.”  Nineteen-ninety-six, not
1991?  When was it changed?  Why? 

Pam [24], wrote:  “If each emotion is not physiologically
distinctive, there can be no biological marker for each type or subtype of
emotional pathology …the preponderance of research contributed by biological
psychiatry up to the present is questionable or even invalidated by the
criticisms just made.”

Here, is the essence of the fraud of “biological psychiatry”: no matter
how troubled or troublesome the individual, there are no physical
abnormalities/diseases– And yet psychiatric research applies every bio-medical
technology, as if there were; the stuff of their pseudo-scientific literature,
referring to their every entity as a “disease.”  

The irony is that they do find subtle, real, brain, abnormalities in
almost all such patients!  But these are not due to ADHD, ODD, PTSD, or
any other DSM, invented disease–they are due to the few or several psychiatric
drugs such persons are invariably put on the moment they become psychiatric

Castellanos has not proved that ADHD is a real disease, or that the psycho-stimulants
are not the cause of the brain atrophy.  He will not prove a thing until
he renounces the pseudo-science of “biological psychiatry.”

Not a single psychiatric “disease” has been validated as such.  The
physical complications of psychiatric conditions can only be due to their



Fred A. Baughman Jr., MD



1.     Nasrallah H, et al [1986] Cortical
atrophy in young adults with a history of hyperactivity in childhood. 
Psychiatric Research,  1986;17:241-246.

Hynd GW, Semrud-Clikeman M, Lorys AR, et al. Corpus callosum morphology
in attention-deficit hyperactivity disorder: morphometric analysis of MRI. J
Learn Disabil.

3.      Giedd
JN, Castellanos FX, Casey BJ, et al.Quantitative morphology of the corpus
callosum in Attention deficit hyperactivity disorder.Am J Psychiatry.1994;151:665-669.

4.      Semrud-Clikeman
M, Filipek PA, Biederman J, et al. Attention-deficit hyperactivity disorder:
magnetic resonance imaging morphometric analysis of the corpus callosum. J
Am Acad Child Adolesc Psychiatry.

5.      Baumgardner
TL, Singer HS, Denckla MB, et al. Corpus callosum morphology in children with
Tourette syndrome and attention deficit hyperactivity disorder. Neurology. 1996;47:477-482.

6.      Lyoo IK,
Noam GG, Lee CK, et al. The corpus callosum and lateral ventricles in children
with attention-deficit hyperactivity disorder: a brain magnetic resonance
imaging study. Biol Psychiatry.1996;40:1060-1063.

7.      Hynd GW,
Semrud-Clikeman M, Lorys AR, et al. Brain morphology in developmental dyslexia
and attention deficit disorder/hyperactivity. Arch Neurol.1990;47:919-926. 

8.      Filipek
PA, Semrud-Clikeman M, Steingard RJ, et al. Volumetric MRI analysis comparing
attention-deficit hyperactivity disorder and normal controls.Neurology.1997;48:589-601. 

9.      Hynd GW,
Hern KL, Novey ES, et al.Attention deficit hyperactivity disorder and asymmetry
of the caudate nucleus.J Child Neurol.1993;8:339-347.

10.  Castellanos FX, Giedd JN,
Eckburg P, et al.Quantitative morphology of the caudate nucleus in attention
deficit hyperactivity disorder.Am J Psychiatry.1994;151:1791-1796.

11.  Aylward EH, Reiss AL, Reader
MJ, et al.Basal ganglia volumes in children with attention-deficit
hyperactivity disorder.J Child Neurol.1996;11:112-115.

12.  Castellanos FX, Giedd JN,
Berquin PC, et al.Quantitative brain magnetic resonance imaging in girls with
attention-deficit/hyperactivity disorder.Arch Gen Psychiatry.2001;58:289-295.

13.  Berquin PC, Giedd JN, Jacobsen
LK, et al.The cerebellum in attention-deficit/hyperactivity disorder: a
morphometric study.Neurology.


14.  Mostofsky SH, Reiss AL,
Lockhart P, Denckla MB.Evaluation of cerebellar size in attention-deficit
hyperactivity disorder.J Child Neurol.1998;13:434-439.

15.  Baumeister AA, Hawkins
MF.Incoherence of neuroimaging studies of attention deficit/hyperactivity
disorder.Clin Neuropharmacol.2001;24:2-10. 

16.  Castellanos FX, Giedd JN, Marsh
WL, et al.Quantitative brain magnetic resonance imaging in
attention-deficit/hyperactivity disorder. Arch Gen Psychiatry.1996;53:607-616.

Swanson J, Castellanos FX. Biological Basises of Attention
Deficit Hyperactivity Disorder. Invited presentation at the NIH, Consensus
Development Conference on ADHD, November 16-18, 1998.

Baughman FA (invited participant). Quote from videotape, NIH,
Consensus Conference on ADHD, November 16, 1998.

Final Statement of the Panel of the NIH, Consensus Conference
on ADHD, November 18, 1998.

John Pekkanen.  Making Sense of Ritalin (interview with
FX Castellanos). Readers Digest, January, 2000:159-168.

Bartzokis G, Beckson M, Lu PH, Edwards N, Rapoport R, Wiseman
E, Bridge P.  Age-related brain volume reductions in amphetamine and
cocaine addicts and normal controls: implications for addiction research. Psychiatry Res. 2000.10;98(2):93-102.

American Psychiatric Association.  Diagnostic and
Statistical Manual of Mental Disorders, 4th edition. 
Washington, DC. 1994.

Castellanos, FX.  Personal correspondence to Fred A
Baughman, Jr., March 1, 2000.

 Pam A.  A critique of the scientific status of
biological psychiatry.  Acta Psychiatrica Scandinavica.  1990;82
(Supplement 362):1-35.


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