L*** M***** wrote: Please help my very bright son who is 8. A Neuro Psych. assessed him, found IQ of 120, and most academic strengths well above 90th%
[Fred A. Baughman Jr., MD:
She finds a debilitating problem with speed of processing and filtration of stimuli
[Fred A. Baughman Jr., MD:
. He will see a speech Path. for slow word retrieval
[Fred A. Baughman Jr., MD:
, but has vocabulary in 15-18 yr. old category. Dr. "had" to assign a "code" for public school and chose ADD-Inattentive. I don't believe in ADD or ADHD and I don't want him labeled as such. Can you recommend a Dr. for acacdemic/behavior assesment who does not diagnose ADD or ADHD in the Seattle, WA area? Sincerely, L*** M***** Dr. Baughman's implied argument (in "Making a Killing," Vital Signs, Chronicle Magazine, June, 2003, cowritten by B.K. Eakman) that, if there is no objective means of diagnosing a disease, then there is no need for medical treatment, is akin to throwing the baby out with the bath water. Up until relatively recently, medicine relied on clinical criteria (the combination of the patient's self-report and the physician's subjective observation) in making a diagnosis of disease or health. Many non-psychiatric diagnoses, including acute appendicitis and multiple sclerosis, are still made on largely clinical grounds with scant or conflicting laboratory or imaging evidence. Psychiatry relies on the clinical method exclusively because no one really knows yet what causes psychiatric illness. Despite the abundance of hypotheses and some interesting advanced neuroimaging studies, there is no way yet to diagnose psychiatric disease by means of a blood test or an imaging study. In this way, the modern psychiatrist resembles the general practitioner of the 19th century who could describe and classify various illnesses but who had only vague or incorrect ideas about their cause and treatment. The inability to confirm a diagnosis by technical means should not cause us to doubt the existence of a disorder when one is apparent. There are and always have been unfortunate individuals who hallucinate, experience delusions, or become profoundly disabled as a result of a severe mood disturbance. Sometimes, the cause of these symptoms is physical and measurable. Most of the time, these patients are either physically "normal" or have physical abnormalities that are apparently unrelated to their psychiatric disturbance. The absence of objective diagnostic tools in psychiatry is one of the greatest obstacles facing the field today. Yet the suffering of psychiatric patients is real, and we have to diagnose and treat them to the best of our abilities with the means currently available, no matter how imperfect. Psychiatry is hardly the only medical field that is heavily influenced by the pharmaceutical industry. Criteria for treating elevated cholesterol, blood pressure, and blood sugar are becoming increasingly more stringent, with combination drug therapy being the rule rather than the exception of treatment, even for mild cases that could and should be managed with lifestyle changes alone. It is an oversight to target the psychopharmaceutical industry as "a kind of legal drug cartel" because the same companies that manufacture antidepressant medications also make expensive nonpsychiatric drugs designed to correct "chemical imbalances," albeit of a different kind. The expansion of the illness model to include borderline and possibly normal cases is happening across medical disciplines because most medical research is market-driven. So far as ADHD is concerned, hardly anyone ever wonders about the possible environmental contributions to what is undoubtedly a pattern of increasing distractibility, hyperactivity, and behavioral instability in today's children. The jury is still out as to whether ADHD is a "disease" and whether it is associated with brain abnormalities. The real question is whether this is a condition that is produced in susceptible children by early and excessive exposure to television and other visual media technology that condition the growing brain into developing a short attention span and a drive for constant novelty. In our society, it is much easier just to "treat" this disorder with drugs, since, this way, the market wins, and no one has to make any difficult choices about how to rear children. -Boris Vatel, M.D. Evansville, IN Fred A. Baughman Jr., MD responds to Vatel (this letter to the editor of Chronicles was submitted today 7 31 03. I do not yet know what the final edited form will look like): Dr. Vatel, a psychiatrist, adheres to the belief system-not science-that all psychiatric/emotional/behavioral problems are "diseases"/ "chemical imbalances" of the brain. We are inundated with such claims, mostly in ads for psychiatric drugs-"chemical balancers". Where have these "diseases"/ "chemical imbalances come from? I have been a neurologist since 1964 and I have discovered real brain and genetic diseases. I am not aware that a single psychiatric/emotional/behavioral condition has been proved to be a brain abnormality/disease. In 1948, neurology and psychiatry were formally split by the American Board of Psychiatry and Neurology, neurology to deal with organic disease of the nervous system; psychiatry with emotional and behavioral problems in the neurologically/ physically normal. Nor did psychiatry object. It wasn't until the sixties, with psychiatric drugs being marketed, that Big Pharma and psychiatry merged and, as market strategy-not science-declared that all emotional and behavioral problems were "diseases"/ "chemical imbalances" needing "chemical balancers"- pills. There are no biological tests in psychiatry because there are no biological/physical abnormalities to test for-not one. This is why I wrote Attorney General Janet Reno, April 15, 1998: " the single biggest health care fraud in US history is the misrepresentation of attention deficit hyperactivity disorder.as an actual disease, and the drugging of millions of entirely normal American children." In fact all of psychiatric/emotional/behavioral problems represented to be "diseases"/ "chemical imbalances" of the brain, are a fraud. Every such representation to a patient is an abrogation of their informed consent rights, and medical malpractice. They regularly invoke their "voluminous" literature. Their "disease" research is not "poor" or "misguided" science; it is not science at all. In that not a single psychiatric "disease" has been validated by proof of a confirming abnormality (example: elevated blood sugar in diabetes, malignant cells in cancer), all of their "research" is done on children/subjects who are physically/medically normal, although labeled with one or more of psychiatry's 347 subjective "disease" labels. With our tax dollars and "unrestricted grants" from Big Pharma, they apply state-of-the-art technology to subjects with no abnormality/disease (other than the drugs they are on), generating a deceitful, pseudoscientific literature (replete with press releases) for their every "proof," all of it fraud and deception. A young father testified in Ritalin hearings in Nashville, Tennessee, in December, 1997: : "My ten year old's psychiatrist said the Ritalin was for his "chemical imbalance." I asked him for the lab results. He stuttered, and stammered, then 'lost it,'confessed he had no such records, and banished us from his office." Such is the nature of "biological" psychiatry.
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