Attention-Deficit Hyperactivity Disorder & All Biological Psychiatry as Fraud by Fred A. Baughman Jr., MD, June 29, 2001 (revised 7/1/01, 7802 words)THE AMA COUNCIL ON SCIENTIFIC AFFAIRS
With no proof that ADHD is a disease with a confirmatory, physical abnormality, the ADHD "epidemic," has grown from 150,000 in 1970, to five million in 1997; Ritalin production, in the US, rose 700%, between 1990 and 1997 [1], and, the AMA, Council on Scientific Affairs [2] has seen fit to conclude: " there is little evidence of widespread overdiagnosis or misdiagnosis of ADHD or of widespread overprescription of methylphenidate."
Every patients right of informed consent requires a complete, honest portrayal both of the condition to be treated (including its course, untreated) and of the treatment(s) proposed (and how it/they will alter the course of the condition). Lacking either, the informed consent would be incomplete--invalid. Few, if any, questions about ADHD can be answered without an honest answer to the question: "Is ADHD a disease with a confirmatory physical (including chemical) abnormality, or isnt it?
IS IT A DISEASE OR ISNT IT?
All physicianspsychiatrists included, complete a course of study of diseasepathology. They know, full-well, that it is the physicians first duty, patient-by-patient, to determine whether the patient has an actual disease or does notthe "disease"/ "no disease" determination. We learn that substantial numbers of patients seek help from their physicians for what are "emotional," "psychological," or "psychiatric" symptoms, due to the stresses of everyday life. Such patients have no disease per se (ruled out by finding no abnormalities no pathology, nothing objective, on physical examination, laboratory testing, x-ray, scanning, etc.).
There were few claims by psychiatry in the sixties and seventies, of a biologic basis of psychiatric disorders, i.e., that they were "diseases." Such claims, without scientific evidence, began, in earnest, in the eighties and nineties, with the American Psychiatric Associations Diagnostic and Statistical Manual-III-R (DSM-III-R) [3] and DSM-IV [4]. ADHD has become psychiatrys number one, "biologically-based" "disease."
BIOPSYCHIATRYS INTENT TO DECEIVE
Writing in the Journal of the American Medical Association (JAMA), in 1995, psychiatry spokesmen, Marzuk and Barchas [5] stated: Perhaps the most significant conceptual shift (from DSM-III-R, 1987, to DSM-IV, 1994) was the elimination of the rubric organic mental disorders, which had suggested improperly that most psychiatric disorders had no organic basis.
Notice that these authors have assumed, but not proven, that "most psychiatric disorders" have an organic basis, making it improper for anyone to suggest otherwise. They would shift the burden of proof to those who doubt and question, hardly in keeping with science. What they and the American Psychiatric Association (APA), with its DSM-IV, have done, was to absolve psychiatry of every physicians obligation to make a fundamental, patient-by-patient, "organic"/ "not organic," "disease"/ "no disease" determination. They have absolved themselves, and, anyone wishing to join them in such diagnosing, of having to demonstrate an abnormalitypathology, by way of proving that psychiatric "disorders"/ "diseases" are actual diseases.
In fact, the essential first step in all diagnosis, even in the diagnosis of psychiatric disorders, is to make the fundamental "Is it a disease or isnt it?" determination. This determination is usually made by physicians other than psychiatrists; usually by those referring patients to the psychiatrist (or psychologist, or other mental health professional). What psychiatrists do from that point on, is nothing, more or less, than, semantic classification, based upon subjective symptoms, alone, in patients already-proven to have no disease. The absence of organic disease, over time, stands as the strongest evidence that a patients symptoms are psychogenic.
In 1986, Ross [6], a psychiatrist, chided:
dealing with symptoms or syndromes as if they were specific disease reflects a trend in psychiatry to regard mental illnesses as biological entities But in this surrealistic world of pseudo-entities, the psychiatrist abdicated reality to embrace biological reductionism. In 1990, Pam [7], a psychologist, supposing psychiatrists naïve, sought to impose scientific standards. He wrote:
any studies that do not meet standards for proper research procedures or interpretation of data must not be accepted for publication or, if already published must be discredited within the professional literature the possibility that that emotional experience (love, hate, fear, grief) may be physiologically non-specific gets short shrift If each emotion is not physiologically distinctive, there can be no biological marker for each type or subtype of emotional pathology, and thus most current research would be methodologically inappropriate the preponderance of research contributed by biological psychiatry up to the present is questionable or even invalidated by the criticisms just made.
With research and the peer-reviewed scientific literature substantially or wholly (as in the case of drug-related research) funded by industrywho speaks for science? To what extent are scientific findings muted? Perverted? Are diseases invented where they dont exist? Treatments? Acknowledgments appearing on published articles regarding research funding and sponsorship are wholly inadequate. Readers have every right to detailed knowledge regarding research funding and the researchers, as well. Without such information, informed consent is not fully informed.
PSYCHOPHARMACOLOGY: INVENTED DISEASES, BIG BUSINESS
The American Psychiatric Associations Diagnostic and Statistical Manual has grown from 112 mental disorders in its initial, 1952 edition [8], to 163 in the 1968, DSM-II [9], to 224 in the 1980, DSM-III [10]; 253 in the 1987, DSM-III-R [3], and, 374 in the 1994, DSM-IV [4]. That there is more to the explosion of psychiatric "diseases" than scientific naiveté is obvious. To the extent that such research and its dissemination abrogates informed consent and becomes standard practice, is it not fraud? That it is a joint, psychiatric-pharmaceutical industry strategy is obvious.
An ad placed by "Americas Pharmaceutical Research Companies" in Newsweek, October 7, 1996, read: "A chemical that triggers mental illness is now being used to stop it." Here again, is the "big lie." There is no mental illness with a proven chemical abnormality. In their scheme of things, however, scientific facts are less important, by far, than that the public at large become believers in the "chemical imbalance"chemical "balancer" (pill) view of mental health. When and in which board-room did they meet to adopt their "disease"-"chemical imbalance"-"pill" model of all human emotional distress? Biopsychiatrys researchers are aware that without proven diseases, syndromes (in a medical sense) or phenotypes, that the "disease" and "control" groups are both physically normal and, indistinguishable. They know from the outset that their research is destined to prove nothing and to remain forever theoretical, and, fraudulent.
Pam [7] asks:
how can we account for the tendency to seriously compromise research and review standards within a medical discipline (all of psychiatry, its governing bodies and journals) known for its commitment to the scientific method?
and, ventures an answer: "The sociology of knowledge developed by Mannheim [11] postulates that all intellectual systemsscience includedare influenced by special interest and social considerations; a body of information is never unrelated to a political-economic context "
THE AMA COUNCIL ON SCIENTIFIC AFFAIRS--10 YEARS AGO
In 1989, the same AMA Council on Scientific Affairs [12], evaluated "dyslexia," a.k.a. "specific reading disability," and duly, and scientifically, concluded there was no satisfactory definitionthat it was not a disease. Why, today, in 1998, does the Council fail to provide a forthright, scientific answer to the same question about ADHD? "Is it a disease with a confirmatory physical abnormality, or isnt it?"
What factors have changed which allowed the Council to speak forthrightlyscientifically on the issue of "dyslexia" in 1989, but not on ADHD, in 1998 [2]?
Is industry control in medicine more nearly complete today? How often are scientific conclusions, not friendly to the "bottom line" published? Quashed?
J. Robert Oppenheimer (1904-1967), "father" of Americas first atom bomb, reminds us: "The scientist is free, and must be free to ask any question, to doubt any assertion, to seek for any evidence, to correct any errors."
The changes of diagnostic criteria from DSM-III to DSM-III-R to DSM-IV were changes wrought by consensus, in committee, not changes dictated, as science would have it, by the further reports of observant, scientific physicians or by the findings of basic science researchers investigating already-confirmed (by virtue of a confirmatory, characteristic abnormality), real diseases (or medical syndromes). It must be recognized that research on "diseases," never validated as such, in which subjectsnever proved to be abnormal and distinguishable from normal "controls," is doomed from the outset to prove nothing. When such research is continued, nonetheless, and remains the basis for persistent claims of a biological basisit is deceptive and fraudulent? ADHD, like the vast majority of psychiatric disorders/diseases, was never discovered or validated by demonstration of a confirmatory physical (including chemical) abnormality. Rather, it was invented in-committee at the American Psychiatric Association in 1980 [10] and has been revised on two separate occasions since, in 1987 [3] and 1994 [4].
THE LAMENT FROM BIOPSYCHIATRY
In a 1995 review of the neuro-imaging literature on ADHD, Ernst [13] commented:
"The definition of ADHD has changed over time. This change has contributed to the selection of research samples with differing clinical characteristics, making comparisons among studies difficult samples of children with ADHD who were diagnosed according to DSM-III-R (1987) criteria include children who do not meet DSM-III (1980) criteria."
What Ernst pointed out is that the ADD of DSM-III (1980), the ADHD of DSM-III-R (1987), and the ADHD of DSM-IV (1994) are 3 separate, incomparable entities. Moreover, the ADHD of DSM-IV has been divided (also by consensus-altered diagnostic criteria) into three sub-types: (a) hyperactive-impulsive, (b) inattentive, and (c ) combinednone comparable to the other or, to the ADD of DSM-III (1980) or the ADHD of DSM-III-R (1987). If the neuro-imaging literature for each is separate and incomparable, then the same is true of the literature on biochemistry, genetics, epidemiology, co-morbidity, psychopharmacology, etc. None are comparable, one with the other. Is this science? Why do ADHD experts regularly extol the sheer volume and longevity of their research record, as if this alone, as opposed to particular proofs, were what mattered. For example, the Council Report [2] states: "ADHD is a childhood neuropsychiatric syndrome that has been studied thoroughly over the past 40 years." ADHD, as such, did not appear until the publication of DSM-III-R in 1987. Nor have I mentioned its many pre-DSM-III, 1980, conceptualizations. Consider:
The high frequency of "soft" neurologic findings led to designating the condition "minimal brain dysfunction", with the expectation that a consistent neurologic lesion or set of lesions would eventually be found [14].
Typical of biopsychiatry, "minimal brain dysfunction," circa, 1960-1970, better known by its acronym, "MBD," was, itself, re-conceptualized before "a consistent neurologic lesion or set of lesions," or any lesion, could be found. Nor was it the same or comparable, to any subsequent conceptualizationanother chapter of the research record, down the drain. How much "R" and "D" money in the process?
ADHD: EVERY CHILD A PATIENT
Although devoid of science, the "invention" and "revisions" of ADHD have enjoyed incredible marketplace success. In 1985 there were 0.57 million stimulant prescriptions (nearly all of them for ADHD), and by 1994 there were 2.87 million [15]. One current estimate [1] puts the frequency, today, at 5 million.
I am acquainted with a young father in Tennessee whose son, now 8, and on Ritalin, was one of half of his entire kindergarten class referred for a diagnosis of ADHD. Furthermore, the Drug Enforcement Administrations (DEA), aggregate production quota (APQ) for methylphenidate, the main medication with which to treat ADHD, increased 7-fold from 1990-1997 [1]. Nonetheless, we have the AMA Council on Scientific Affairs concluding "there is little evidence of widespread overdiagnosis or misdiagnosis or of widespread overprescription of methylphenidate." Are their conclusions justified?
ONE PHYSICIANS QUEST FOR AN ANSWER
Diseases are natural occurrences in the plant and animal world. Scientific physicians, veterinarians, botanists, and others observe, describe, and validate the pathology (abnormality), making them diseases. Diseases are not conceptualized in committee or decided upon by consensus, as biological psychiatry would have it. In 35 years as a private practice, adult/child neurologist, making "disease"/ "no disease" determinations daily, I have discovered and described real diseases but have found myself unable to validate ADHD, by whatever name, as an actual disease.
In 1971, I [16] discovered the curly hair-anklyoblepharon (fused eyelids)-nail dysplasia syndrome (CHANDS). Its description was published in the Birth Defects: Original Article Series [16]. In 1979, Toriello, et. al. [17] (myself included) established its autosomal recessive mode of transmission and published our findings in the Journal of Medical Genetics . In 1959, Turcot, et al [18], suggested that the combination of polyposis of the colon with gliomas of the brain was an autosomal recessive trait. In 1969, Baughman, et al, [19] described the second, "confirmatory" example of the glioma-polyposis syndromeTurcots syndrome. Anyone asking whether or not CHANDS exists, whether or not it has been proven to be "genetic" or, whether or not Turcots syndrome exists, can look up the references and access the proofs. Such is the way of medical sciencewith the notable exception of biological psychiatry.
On September 23, 1993, I testified in hearings at the National Institutes of Health (NIH) on National Institute of Mental Health (NIMH) research on ADHD, conduct disorder (CD) and oppositional-defiant disorder (ODD):
If, as I am convinced, these entities are not diseases, it would be unethical to initiate research to evaluate biological interventionsunethical and fatally flawed scientifically. That such unethical, unscientific research has, and is, going on, should be the focus of investigations.
My [20] testimony, and with it all consideration of the fundamental "disease"/ "no disease" issue, was effectively expunged from the 1994 final report. Moreover, they have refused to share with me informed consent documents used in such research which would have had to state how they characterize ADHD, CD and ODD to parents.
AND ALL THE OTHER BIOPSYCHIATRIC DISEASES, TOO?
Regarding their re-conceptualization of psychiatric "disorders" as "diseases, Goodwin, (a former NIMH director) [21], writes: "Physicians are consulted about the problem of alcoholism and therefore alcoholism becomes, a disease." He does, however, acknowledge "a narrow definition of disease that requires the presence of a biological abnormality."
Kety and Matthysse [22] write: " the recent literature does not provide the hoped-for clarification of the catecholamine hypotheses, nor does compelling evidence emerge for other biological differences that may characterize the brains of patients with mental disease."
The Congressional Office of Technology Assessment [23] concludes:
"Mental disorders are classified on the basis of symptoms because there are as yet no biological markers or laboratory tests for them."
Arthur C. Clarke, scientific thinker, author of "2001: A Space Odyssey" reminds us: "Science, unlike politics or diplomacy, does not depend on consensus or expediencyit progresses by open-minded probing, rigorous questioning, independent thought and, when the need arises, being bold enough to say that the emperor has no clothes." Biological psychiatry has "no clothes!" ADHD has "no clothes!" There being no scientific explanations, we must look elsewhere for answers to the epidemic drugging of US schoolchildren in the name of ADHD.
I TRY TO FIND OUT ABOUT ADHD
From 1993 to the present, I have written to leading agencies and researchers, asking to be referred to the one or few articles in the peer-reviewed, scientific, literature that constitute proof that ADHD a disease or syndrome (medical) with a confirmatory, physical abnormality?
On December 24, 1994, Paul Leber, MD, of the FDA responded: " as yet no distinctive pathophysiology for the disorder has been delineated."
On October 25, 1995, Gene R. Haislip of the DEA wrote: "We are also unaware that ADHD has been validated as a biologic/organic syndrome or disease."
On September 1l, 1996, as if unfamiliar with the concept of scientific proof, Joyce Moscaritola, MD, Medical Affairs Vice President, Ciba-Geigy responded: "A comprehensive computer search of the literature yielded several articles which discuss the various hypotheses for the etiology (cause) of ADHD."
Turning to the top ADHD researchers in the country, those at the NIMH, I sent, by Fed-Ex, the following request, individually, to Doctors Peter S. Jensen, F. Xavier Castellanos, Alan J. Zametkin and Judith L Rapoport, all on the same day, November 3, 1995:
"I would like you to direct me, specifically, to those reports in the literature which constitute proof that ADHD is a disease or a syndrome and thus organic/biologic."
The response came not from any one of the four to whom I had directed the questionall purveyors of the proposition that ADHD is a "disease" and that the children are abnormal, but from L. Eugene Arnold, M.Ed., MD, December 8, 1995, after consultation with the four. Not until the final paragraph of a two page letter, replete with 35 references, having nothing to do with my question, did Arnold get to the question: "However, I suspect you are more interested in evidence that ADHD is organic/biologic The evidence here is more nascent (beginning to exist; newly conceived), with exciting new reports at each professional meeting. It is very likely that multiple causes will be established."
This, of course, was a non-answer.
The 1995, Report of the International Narcotics Control Board [24] voiced concern regarding the diagnosis of ADD: The INCB requests the authorities of the United States to continue to carefully monitor future developments in the diagnosis of ADD in children in order to ensure that these substances are prescribed in accordance with sound medical practice, as required under article 9 paragraph 2, of the 1971 Convention.
On June 7, 1996 I wrote to the INCB asking:
With no confirmation that so-called attention-deficit disorder with or without hyperactivity (ADHD) is a disease, a "discrete diagnostic entity" or anything organic or biologic, how could it possibly be sound medical practice?
Replying on July 3, 1996, INCB Secretary, Herbert Schaep, expressed satisfaction with the newly-launched Ciba-Geigy campaign to inform the community about the abuse potential of methylphenidateRitalin, but left the more fundamental question of the validity of a ADD/ADHD as a disease/medical syndrome un-addressed.
Conner, he of the parent-teacher behavior scales, replied on September 15, 1998. He enclosed his April, 1997, article [25]: "Is ADHD a disease?" by way of response. Therein, he summarized:
we see that there is no agreement on a core psychological defect, anatomic locus, neurochemical or genetic basis, or neuropsychological pattern, that is characteristic of ADHD What is wrong with our approach that we should have so little success in identifying a specific marker for the ADHD disease, almost a century after George Still identified the disorder?
On September 15, 1997, I wrote to Director of National Drug Control Policy, General (ret.) Barry R. McCaffrey and Secretary of the Department of Health and Human Services, Donna Shalala, charging: that ADHDthe fraudulent, never-validated, "disease"was fabricated by experts at the National Institute of Mental Health (NIMH)" and that "On no less than four occasions (by registered mail as well) I have asked NIMH experts, Doctors Peter S. Jensen, F. Xavier Castellanos, Judith L. Rapoport and Alan J. Zametkin to refer me to those articles that prove that ADHD is a "disease" (or a medical syndrome) with a confirmatory, characteristic abnormality (pathology).
At long last, I elicited a reply to my questionor so I thoughtfrom the one person, who, more than any other, speaks of and for ADHD and oversees ADHD research in the USPeter S. Jensen, MD, Chief, Developmental Psychopathology Research Branch, NIMH, NIH, Department of Health and Human Services (DHHS). Dr. Jensen urged that I: "note within the pages of the prestigious British journal Lancet an article will soon be forthcoming (James Swanson, et al. [26] ) that reviews all of the biologic evidence for the establishment of ADHD as a bona fide disorder "
What Dr. Jensen failed to state, once again, is whether or not the "soon forthcoming" Lancet article, or any, anywhere in the peer-reviewed literature on ADHD, yet constitutes proof of an abnormality within the childone that can be tested for and found patient-by-patient, one proving that we are not drugging millions of normal children.
On December 5, 1997, I wrote and faxed James M. Swanson, Ph.D., Director, Child Development Center, Department of Pediatrics, University of California, Irvine, and author of the "soon forthcoming" Lancet article:
please send me a copy or reprint of the article referred to by Dr. Jensen in his letter to me of October 12, 1997 (enclosed). Can you cite final, confirmatory proof that ADHD is a disease/medical syndrome with a definite, discernible (patient by patient) physical or chemical abnormality/ marker?
Getting no response from Swanson, I re-sent my original letter (that of December 5, 1997) on January 12, 1998, this time by registered mail. In so doing, I learned that the address I had been using was correct and that the registered letter had been received and signed for. But still, no response to my scientific, collegial inquiry.
Next, Swanson appeared as a substitute speaker at a meeting I was attending in San Diego, that of the American Society for Adolescent Psychiatry, March 5-8, 1998. He spoke, among other things, of the MRI brain scan research of Castellanos, et al [27,28], and Filipek, et al [29], alleged to show brain atrophy in subjects with ADHD, but not in controls.
I spoke from the audience, pointing out that 93% of the subjects in the Castellanos [27,28] studies had been on chronic stimulant therapy, and inquired as to the stimulant status of those in the Filipek [29] study. Swanson acknowledged that Filipek et al [28], also utilized ADHD subjects who had been on chronic stimulant therapyan acknowledgment nowhere to be found in a review of this research either in the in the Lancet article [26] or in the more recent Report of the Council of Scientific Affairs of the American Medical Association [2]. Here, we had strong, replicated evidence that chronic stimulant therapy (methylphenidate, amphetamine) causes brain atrophy, not confirmation of an ADHD phenotype at all, as we were led to believe.
Next--much to my surprise--came the answer to the AD/HD "disease"/ "no disease" question. Swanson (from the tape recording of the session):
"I would like to have an objective diagnosis for the disorder (ADHD). Right now psychiatric diagnosis is completely subjective We would like to have biological testsa dream of psychiatry for many years I think we will validate it. I do not think these drugs are dangerous or addictive when used this way."
"I think we will validate it," he said. At long lastan open, honest, truly scientific appraisal from one within the ADHD industry! At last, I had my answer from Swanson, and from the greater ADHD industry. He thinks they will validate ADHD. What he neglected to say was how he describes ADHD, today, in obtaining informed consent from the parents of children he treats with stimulants and from those of children in their research studies using positron emission tomography (PET) scans, spinal taps and indwelling venous catheters, from which to draw blood drug levels. I have written him requesting a copies. I am still waiting.
On May 13, 1998, F. Xavier Castellanos (NIMH) wrote to me: " I have noted your critiques of the diagnostic validity of ADHD. I agree that we have not yet met the burden of demonstrating the specific pathophysiology that we believe underlies this condition. However, my colleagues and I are certainly motivated by the belief that it will be possible in the near future to do so."
Swanson thinks "we will validate it!" Meanwhile, Castellanos and his colleagues are " motivated by the belief that it will be possible in the near future to do so."
On August 5, 1998 William B. Carey, MD, of the Childrens Hospital of Philadelphia, replied: "There are no such articles (constituting proof that ADHD is a disease). There are many articles raising doubts but none that establish the proof you or I seek."
Barkley [30], implies that brain atrophy characterizes ADHD. He cites MRI studies by Castellanos, et al. [27,28] the first of which showed that "Subjects with ADHD had a 4.7% smaller total cerebral volume," while the second showed: "Vermal (cerebellar) volume was significantly less with ADHD." Not mentioned was the fact, acknowledged in the original report [27], that 93% of ADHD subjects had been on chronic stimulant therapy and, that the same, treated, cohort was used in the second study. No stimulant-naïve group has been shown to have brain atrophy. The brain atrophy is a function of their chronic stimulant therapythe only physical variable.
What does this say about ADHD "science" and "scientists?" NIMH, NIH Publication No. 94-3572, states: "Brain scan images produced by positron emission tomography (PET) shows differences between an adult with Attention Deficit Hyperactivity and an adult free of the disease." Nowhere in their peer-reviewed literature do we find disavowals of their claims of "disease."
TO CURE THE "DISEASE"
There is no physical abnormalitynot in the brain, not anywhere. To put an end to this incredible, iatrogenic epidemic, all mention of ADHD as "neuro-psychiatric," "psycho-pathologic," "neuro-biologic," "biologically-based" or as a "disorder," (implying disease but afraid to forthrightly say so), a "disease" or a "syndrome" must stop, and all mention of the children as "diseased," "abnormal," or as "patients" must stop. This has been the stuff of an immense, multi-billion dollar industry, and it is fraudulent.
We must go back to valuing the children for what they areinnocent, needy, incomplete, loving, omnipotentthe embodiment of all of the potential of human-kind. They need nothing more or less than our patience, love and common sense without endnot victimization by fraudulent diagnoses and brain-damaging drugs in the name of "medicine" and "treatment." If the truth be known, there are no legitimate medical issues here at all.
THE AMA, THE COUNCIL, JAMA, AND ADHD
The AMA and Goldman, et al [2], authors of the Council Report are, no doubt, aware of the influence their report will have on the ADHD field in these times of continued proselytizing and incredible growth of the ADHD/Ritalin/psychotropic drug epidemic and growing doubts as to the validity of it all. Is their mandate to represent science, or have they sided with industry to protect the ADHD "golden goose." I am shocked at their avoidance of the main scientific questionthe "disease"/ "no disease" question.
Armed only with the illusion of a disease, but no proof that a disease (ADHD) exists, or that the children are other than normal, the RECOMMENDATIONS of the AMA [2] are:
1. "The AMA encourages physicians to use standardized diagnostic criteria in making the diagnosis of ADHD, such as the American Psychiatric Associations DSM-IV "
2. "The AMA encourages the creation and dissemination of practice guidelines for ADHD by appropriate specialty societies and their use by practicing physicians "
3. "The AMA encourages efforts by medical schools, residency programs, medical societies, and continuing medical education programs to increase physician knowledge about ADHD and its treatment."
4. "The AMA encourages the use of individualized therapeutic approaches for children diagnosed as having ADHD, which may include pharmacotherapy, psychoeducation (whatever that is), behavioral therapy, etc., etc."
5. "The AMA encourages physicians and medical groups to work with schools to improve teachers abilities to recognize (diagnose?) ADHD and appropriately recommend that parents seek medical evaluation "
6. "The AMA reaffirms Policy 100.975, to work with the FDA and the DEA to help ensure that appropriate amounts of methylphenindate and other Schedule II drugs are available for clinically warranted patient use."RECOMMENDATIONS (5) and (6) are particularly reprehensible. The former (5), further encourages the teachers of the nation to make a diagnosis leading to the prescription of controlled substancesconstituting, in my opinion, the practice of medicine without a license. The latter (6) pushes drugs of addiction, Schedule II drugs, upon a population free of any demonstrable physical abnormality.
Nor are the editors of the Journal of the American Medical Association (JAMA) unaware of the fundamental problem concerning ADHDthe needstill, for a forthright answer to the "disease"/ "no disease" question. In a 1993, letter to the editor of the JAMA [31], I wrote:
"Unlike definite syndromes, such as Klinefelters, Brown-Sequard, and Downs, in which there is a constancy of symptoms and signs (objective), the Diagnostic and Statistical Manual of Mental Disorders, Revised, Third Edition allows any combination of 8 of 14 behaviors for a diagnosis of attention-deficit hyperactivity disorder. Is this the validation of a syndrome, or does it redefine the term syndrome? If attention-deficit hyperactivity disorder is not a proven syndrome, how can cause be inferred? How can therapies be evaluated?"
In 1995, an article by Zametkin [32], entitled Attention-deficit Disorder: Born to Be Hyperactive was published in the JAMA. In an letter to the editor of JAMA that was rejected, I wrote: Without a statement that there has never been proof that ADHD is a syndrome, a disease, organic or biologic, the review by Zametkin is incomplete and misleading. Under the heading "Pathophysiology" as if there were a "pathophysiology"he writes only, "the cause of ADHD is unknown." The ADHD literature reveals that there was never syndrome validation to begin with. Is this not a fatal flaw? Regarding ADHD, the "informed consent" should include the statement that ADHD has never been proven to be a syndrome/disease; biologic/organic.
Upon rejection of my letter, I wrote to JAMA, Senior Editor, Margaret A. Winker, MD, September 21, 1995, stating:
" I would be especially disappointed if it turns out that you do not plan to publish any correspondence asking for such clarification JAMA would not wish to be seen as failing to disclose the status of what science there is regarding what is commonly referred to as ADHD."
Although I was assured that my letter was passed on to Zametkin, I never received a reply from him. Would JAMA, the AMA, and the AMA Council on Scientific Affairs wish to be seen as failing to disclose the scientific status of ADHD?
I have sought, unsuccessfully, for 5 years to get a straightforward "Yes!" or "No!" answer to the "Is ADHD an actual disease or not?" question, from the leaders of the ADHD research establishment, including, most prominently, Peter S. Jensen, MD, of the NIMH in Rockville, MD, and James M. Swanson, Ph.D., of the University of California, Irvine (both members of the Professional Advisory Board of Children and Adults with Attention Deficit Disorders-CHADD, as well). As unthinkable as it may seem, what we are dealing with here, is nothing, more or less, than a for-profit, invented "disease" and a for-profit invented "epidemic," perhaps the most successful of all time, in monetary terms. At the same time it is among the most diabolical, inhuman, manufactured, "epidemics," of all time, if not, the most diabolical and inhuman!
Psychiatrist, Walter E. Afield,[33], said it best, and, most succinctly. He testified before the Select Committee on Children, Youth, and Families, House of Representative, April 28, 1992, on the psychiatric hospital fraud of the 1980s, as follows:
" Florida is the most inept. Texas is the most corrupt the bad news is that this is a nationwide phenomena. This is right here in Washington, DC. Its at Harvard, McLean Hospital. Its at the Menninger Clinic. Its at Johns Hopkins. there are abuses going on nationwide in our mental health system that are terrible. The DSM-III, were talking about everyone in this room will fit into two or three of the diagnoses In DSM-II, homosexuality was a disease. In III, its not. In IV, therell be some new diseases. Every new disease thats defined gets a new hospital program, new admissions, a new system and a way to bilk it, and this bilking continues "
The answer for one and allthe moment of candor from Swanson, March 7, 1998, at the American Society for Adolescent Psychiatry: "I think we will validate it," translates to is: There is no objective test! There is no disease! The children are normal! They were normal, before psychiatric "help" arrived.
TRAMPLING HUMAN RIGHTS IN THE NAME PSYCHIATRY
Wherever, for a single day, a child, or anyone in the life of a child, is lead to believe that that child is "brain-damaged," "diseased," "subnormal," "abnormal," when they are not--that child has been stigmatized, harmed, and damaged. The "damaging" begins with pencil-paper testsnever a biologic proof . The damaging is compounded when, in addition, they are labeled "dyslexic" "dyscalculic" "learning disabled"not one, a real diseases.
Once Ritalin, or, any one or several psychotropic drugs, courses through their brain (and body) day-in and day-out, they are, for the very first time, physically, neurologically and biologically, abnormal. The disease they have, one that can be proven by objective means, by chemical analysis of any body fluid or tissue, is Ritalin (stimulant) Encephalopathynot ADHD, but Ritalin Encephalopathy (fancy term for brain damage). When the begin to tic and twitch uncontrollably, they do not have idiopathic ticsTourettes syndrome, they have Ritalin-induced tics, a cause-known, iatrogenic diseasea real disease, one which today, in the US, and perhaps in other countries as well, has come to surpass Tourettes syndrome as a cause of chronic, persistent tics.
Today, in the US, millions of parents are being told by teachers, principals, counselors, special educators, psychologists, psychiatrists and physicians of all sorts, that their children cannot learn, and even, that they will not be permitted to come to school, unless they are taking Ritalin. Frequently, it is implied that unless they do so, they are acting contrary to the best interests of their child, and that a court might see fit to limit or terminate their custody of their own childall in the name of a "disease" that doesnt exist! That is a total, one hundred percent, fraud.
Just yesterday, I spoke with a divorced father with an eleven year old son, who believes neither in ADHD or in Ritalin, and who, as a consequence, has had his share of custody sharply curtailed. Further, the judge threatened him with a loss of all custody rights were he to continue to obstruct "treatment" in any way.
To date, I have served as a medical expert or advisor on this issue to approximately 25 such parents, in divorce situations, with ADHD and Ritalin the pivotal, divisive issue. In virtually every instance, family court judges have chosen to believe prevailing psychiatry propaganda, refusing to consider that fact that ADHD does not exist. In so doing, they become accomplices to the heinous, injurious diagnosing and drugging of normal children and to the unprecedented trampling of fundamental, family and human rights, cases of which number in the millions.
After all--the grieving children of divorce, and all of the others too, are not grieving at all; they are not troubled; they have not been failed by the adults in their lives, their schools or communitiesthey have a "chemical imbalance," they have ADHD.
The Hippocratic Oath does not permit such "practice." It does not permit the "treatment" of real childrenof real human beings, for "diseases" that are not real diseases. The Nuremberg Code does not permit the "treatment" of normal, disease-free, children with addictive, dangerous, Schedule II drugs, for profit. It does not permit deception and the abrogation informed consent rights that is occurring today in virtually every case across the United States.
This is criminal. It is child abuse. Nothing about it is the legitimate practice of medicine. It must be exposed. Those responsible for the fraud and deception must be publicly identified, charged, prosecuted and, held accountable.
AFTERWORD: 1998-2001.
This essay was initially submitted to the Journal of the American Medical Association in response to the wholly un-scientific, 1998, report, on ADHD, of the Council of Scientific Affairs of the AMA. However, it was rejected. While they did publish my letter to the editor [34], the authors of the Council Report did not respond, substantively, to my main charge, which was, that they broadly exhort the psychiatric-medical victimization of disease-free, normal children.
Leaving no doubt that US medicine, generally, has added this brand of "mental health" to its portfolio, the (1) American Academy of Pediatrics, in collaboration with the (2) American Psychiatric Association, the (3) American Academy of Child and Adolescent Psychiatry, the (4) American Academy of Neurology, the (5) American Academy of Family Practice and the (6) Child Neurology Society, published its year 2000, "Clinical Practice Guideline--Diagnosis and Evaluation of the Child with Attention-Deficit/Hyperactivity Disorder" [35]. In it, as throughout virtually all industry-published materials, ADHD is referred to as "the most common neurobehavioral disorder of childhood.." In a letter to the editor of the journal Pediatrics [36], I wrote:
"Neurobehavioral" implies an abnormality of the braina disease. An yet, no confirmatory diagnostic abnormality has been found .It is apparent that virtually all professionals of the extended ADHD "industry" convey to parents, and to the public-at-large, that ADHD is a "disease" and that children said to have it are "diseased" and "abnormal." This is a perversion of the scientific record and a violation of the informed consent rights of all patients and of the public-at-large. The wording of the AAP guideline should be changed, forthwith, to reflect the scientific and medical facts of the matter.
Nor did the authors of the "Guidelines" respond, in the least, to my questions, or to the inherent medical/scientific concerns.
And just we thought it couldnt get any worse, Zito, et. al., [37] reported, that 150,000 to 200,000 infants and toddlers between the ages of 2 and 4 years of age, in the United States, are receiving prescriptions for the schedule II, controlled substance, methylphenidate (Ritalin), even though they have no demonstrable/diagnosable disease; even though the drug has been tested and approved only for children ages 6 and up. Steven Hyman, MD, director of the National Institute of Mental Health (NIMH), should have been asking, "How could they?" Instead, with legitimizing illegitimate practice, in mind, he asked: "How can we tolerate a situation in which drugs are prescribed to an increasing number of preschoolers without safety and efficacy data?" Thereby, he set the stage for the NIMH-authored, funded, Preschool ADHD Treatment StudyPATS. They will recruit ADHD subjects 3-6 years of age at 6 academic medical centers for treatment of the sort, which, according to Zito, et. al., is well on its way to becoming standard practice.
Nor was the NIMH bothered by this DSM-IV assertion [page 81];
It is especially difficult to establish this diagnosis (ADHD) in children younger than age 4 or 5 years, because their characteristic behavior is much more variable than that of older children and may include features that are similar to symptoms of Attention-Deficit/Hyperactivity Disorder.
or by my statement in the journal Science [38]:
"In that children who would be the research subjects in the PATS study have no demonstrable disease, there is no justification for giving them Schedule II stimulant medications."
On May 29, 2001 I wrote to the District Attorneys of Orange and Los Angeles Counties, in California, urging that they investigate the PATS research at UCLA and UC Irvine for compliance with the Controlled Substances Act, as follows:
A November 17, 2000, article in the journal SCIENCE announced the NIMH, Preschool ADHD Treatment Study (PATS) to commence at 6 academic centers--UCLA and UC-Irvine, among them--to determine whether or not Ritalin is safe and effective in preschool children (3 to 6 years of age) with attention-deficit hyperactivity disorder (ADHD). Harvard psychiatrist Joseph Coyle worried, "psychoactive drugs might affect the development of visual processing, language, motor skills, and memory of young children." In Los Angeles County, in the year 2000, 3891, 2 year-olds, and 5,311, 3 year-olds were legally prescribed Ritalin and other Schedule II amphetamines. in Orange County, 2,311, 2 year-olds and 2,873, 3 year-olds were legally prescribed drugs of the same category. Drug Laws, 1998--California Edition (including the California Uniform Controlled Substances Act) reads (11190.): "The prescribers record shall show the pathology and purpose for which the prescription is issued, or the controlled substance is administered, prescribed or dispensed." The word "pathology" means disease or abnormality, of which there are none in ADHD, or in any psychiatric disorder.
My article Psychiatric drugs for infants and toddlers: Treatment or crime? has just been published in the International Journal of Risk and Safety in Medicine [Vol. 23 Number 2] .It is time for a thorough, un-biased, analysis of all child-adolescent psychiatric practice where the prescribing of Schedule II, controlled substances is concerned. This analysis should begin with the Preschool ADHD Treatment Study (PATS) just launched in the Departments of Psychiatry at UCLA and UC-Irvine.
Pseudo-scientific research carried out by the Kaiser Wilhelm Society in Germany during WWII turned a club founded in 1911, that once boasted Albert Einstein as a member, into an accomplice in the Holocaust. It started with their twisted ideas of "racial hygiene," which gave the Nazis scientific justification for forced sterilization, forced abortions and "euthanasia"the killing of those deemed a burden on the national gene pool. "I am shocked at how leading scientists of their time gave support to the criminal ideology of a master race," said Max Planck Society president, Hubert Markl [39].
Today, the pseudo-science known as "biological psychiatry" grows hand-in-glove with Big Pharmathe world-wide pharmaceutical industry. Its brazen, across-the-board, claim is that all of lifes emotional pains and mis-behaviors are diseases, needingeven requiring, "treatment". Nor is this pseudo-science pressed upon us by a totalitarian state, rather its impetus comes from Big Pharma, with the full complicity of organized psychiatry and the US Congress.
Persons said to have psychiatric disorders/diseasesnot one of them a disease--undergo court-ordered drugging, electroshock, and incarceration. Millions, in the US are told that their children have ADHD (last count 6 million) and must take "chemical balancers"pills--for their "chemical imbalances." Resist, and you are deemed a negligent parent and lose custody of your child.
Tammy Marie Kubiac of Buffalo, NY, took her 12 year-old son off of his three, stupefying, psychiatric medications, was adjudged "negligent," and was stripped of custody of all three of her children. Diane Booth of Santa Clara County, CA was stripped of custody of her 6 year old son when she refused to keep him on the Ritalin that was caused his tic disorder.
In the US, through the 90s, there have been millions of "custody relinquishments" for the purpose of providing the children "essential" psychiatric care. Imagine, removing children from their natural families to provide them with psychiatric treatment. With 15-20 % of all US school children with school-appended, school-mandated, psychiatric labelson psychiatric drugs--it is, indeed, late in the day.
Parallels to the rise of Hitler are unmistakable. Citizens of the USA, wake up! Your physicians will not be warning you.
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