Understanding Attention Deficit Hyperactivity Disorder (ADHD) Fred Baughman, MD comments: An early diagnosis is a key factor for treatment Media Advisory: To contact Laurence Greenhill, M.D., contact Dacia Morris at (212) 543-5421. On the day of the briefing, call the AMA's Science News Department at (312) 464-2410. WASHINGTON-Because many symptoms
[Fred A. Baughman Jr., MD: FB: symptoms are subjective. An objective abnormality is needed, a "sign" or "signs" without which there is no disease]
of attention deficit hyperactivity disorder (ADHD) may be present in normal children at an early age, it should only be diagnosed after a thorough professional evaluation
[Fred A. Baughman Jr., MD: regardless of the professional doing the evaluation, a physical abnormality = disease is required, without which a disease = illness- sickness cannot be said to exist in that patient]
, according to child and adolescent psychiatrist Laurence Greenhill, M.D. "ADHD is a behavior and cognitive disorder that begins early in childhood and affects between five and eight percent of primary school age children," said Dr. Greenhill, Ruane Professor, Clinical Child and Adolescent Psychiatry, Professor, Clinical Psychiatry, Columbia University; Director, Research Unit on Pediatric Psychopharmacology, New York State Psychiatric Institute; New York, N.Y. Dr. Greenhill spoke today about his recently completed research project in preschool children with ADHD at the American Medical Association's 23rd Annual Science Reporters Conference in Washington D.C.
[Fred A. Baughman Jr., MD: this would be PATS (preschool adhd treatment study) evaluating Ritalin/amphetamine treatment in children with adhd 3-5 years of age]
"The kinds of symptoms we look for include trouble paying attention, being easily distracted, frequently losing things, making careless mistakes or being impulsive. Kids with ADHD often have problems listening, following instructions or finishing work. They may often fidget and squirm in class or leave their seats and run around the room," Dr. Greenhill said.
[Fred A. Baughman Jr., MD: The "science" reporters to whom he was speaking should have realized that the criteria of which Dr. Greenhill spoke could apply to any of their own children; they should have asked, but never do, "Is their an objective means of making the diagnosis?" as in any real disease.]
"Any of these symptoms by themselves may be perfectly normal," he said. "What we look for is a collection of symptoms that interferes with the child's ability to function, either at home, in school or with their friends. It's important to get an early diagnosis because if ADHD is not diagnosed until adolescence it can lead to academic failure, low self-esteem, motor vehicle accidents and an increased risk for substance abuse."
[Fred A. Baughman Jr., MD: suggesting, without doubt, adhd is a disease having the above prognosis, including SUD, substance abuse disorder.]
"ADHD is a very active area of research
[Fred A. Baughman Jr., MD: as if this was evidence it is a disease, a medical entity]
. In the past 10 years, the pharmaceutical industry has grown the ADHD medication treatment market from a several million dollar market to over two billion dollars each year," Dr. Greenhill said
[Fred A. Baughman Jr., MD: this makes it perhaps the biggest health care fraud in history, but does not a thing to validate it as a disease. Where is the first case report of ADHD-the disease. There is none]
. "There has been increasing work on developing new, longer duration treatments that can be administered once a day by the parent."
[Fred A. Baughman Jr., MD: that there are "treatments" does nothing to validate as a disease.]
According to Dr. Greenhill, the most effective way to treat ADHD is through a combination of psycho stimulant medications in the context of behaviorally oriented parent training and behavioral therapy. "ADHD is a real illness
[Fred A. Baughman Jr., MD: no doubt, he is calling it an illness = sickness= disorder = disease, with no evidence whatsoever of an objective abnormality]
, but the good news is that it's treatable, even in children as young as three to five years old," Dr. Greenhill said. "Treatment often includes medication, but medication alone is rarely an adequate or ideal intervention. Children almost always do better with a combination of treatment approaches. Even if the condition is purely biological
[Fred A. Baughman Jr., MD: again, no doubt he is pronouncing it "biological" as in biology gone wrong, biology abnormal, without the least objective evidence in all of the 24 years of DSM defined ADD and ADHD]
, by the time most children get help there are secondary issues-self-esteem issues, school issues and problems in the family. They need help working these issues through to minimize lasting effects. Further, we now know that ADHD actually continues into adulthood for as many as half of the children with the condition." Dr. Greenhill concluded, "ADHD is a common and chronic disorder that does not go away, but our long experience with various medications gives us a very good sense of how best to use them safely with the best possible outcome for the patient." ###
[Fred A. Baughman Jr., MD: Considering the following, which is not near as helpful as it wouild be to have his Pharma income, annually in dollars, we have every right to ask: Is Dr. Greenhill free to pursue science should it lead to conclusions not favorable to his Pharma employers. What does he make as a professor compared to annual income from Pharma? To what extent is he paid for his services, for his opinions by patients, for whom he is supposed to advocate?
Today, just as at the launching of the PATS research, there is not a shred of objective evidence that ADHD is an actual disease. By process of elimination, it can only be the greatest health care fraud in history.]
Editor's Note: Dr. Greenhill has received grant support from Novartis Pharmaceutical, Cephalon Pharmaceutical, Eli Lilly & Co., and McNeil. He has received honoraria from and/or serves on speakers bureaus for Shire Laboratories, Inc., McNeil Pharmaceutical, Eli Lilly & Co., Janssen Pharmaceutical, Cephalon Pharmaceutical, and Novartis Pharmaceutical. Dr. Greenhill has received an honorarium from the American Medical Association to speak at today's briefing. Last updated: Oct 08, 2004 Content provided by: AMA Science News Copyright 1995-2004 American Medical Association. All rights reserved.