The epidemic of psychiatric drugging in the US as nowhere else in the developed world has risen from 150,000 in 1970, to 9-10 million today; 15 to 20% of all US schoolchildren. The ADHD/Ritalin portion now stands at an estimated 6-7 million. Other 'chemical imbalances' treated with other 'chemical balancers'-drugs-make for a total to 9-10 million-all of them normal until the first brain-altering, brain damaging drug courses through their systems.

From 1965 to the present, the number of physicians in the US has grown 5 times faster than the population, from 140 physicians /100,000 population to 280/100,000! [1] Today, each physician has half the number of patients they had 35 years ago. But their incomes have kept pace! To compensate they resort to 'physician-induced need,' or what the Health Care Finance Administration (HCFA) refers to as an increased 'volume' and 'intensity' of prescribing. And, when that no longer compensates, they take to inventing diseases. This, in fact, is the primary cause of the US health care crisis.

 

WHEN DID PSYCHIATRY BEGIN DIAGNOSING 'DISEASES'?

In 1948, the combined specialty of 'neuropsychiatry' was divided into 'neurology,' dealing with organic or physical diseases of the brain, and 'psychiatry' dealing with emotional and behavioral problems in normal human beings. Nor was there any dispute as to the division of labor; psychiatrist

s made no claim that they diagnosed or treated actual brain diseases. Finding no organic disease in patients with non-specific symptoms, non-psychiatric physicians refer patients to psychiatrists. In other words, finding no objective abnormalities (disease) it can safely be concluded that the patient's symptoms are psychological in origin-psychogenic! This is the main pre-condition for referral of a patient to a psychiatrist or to any mental health professional.

As the physician glut worsened, medical costs rose and health maintenance organizations (HMOs) evolved to control costs. HMOs demanded accountability in diagnosis and treatment that cut deeply into psychiatry's open-ended, fictitious diagnosing (and resultant prescribing). Psychiatry had already cast its lot with the pharmaceutical industry [2]. By the late 1960's, psychiatric drugs were 'big' business,' growing 'bigger.'

 

By 1970, it was apparent that psychiatry and the pharmaceutical industry had agreed upon a joint marketplace strategy: they would call psychiatric disorders, that is, all things emotional and behavioral, 'brain diseases' and would claim that each and every one was due to a 'chemical imbalance' o

f the brain [3]. Further, they would launch a propaganda campaign, so intense and persistent that the public would soon believe in nothing but pills--'chemical balancers' for 'chemical imbalances' [4].

 

Just as the National Institute of Mental Health (NIMH) is the primary author of the psychiatric condition/disorder-as-a-disease deception, attention deficit hyperactivity disorder (ADHD) is their prototypical, most successful by far, invented disease. They regularly revise its diagnostic criteria, not for any scientific purpose, but to cast a wider marketplace 'net.' In collusion with Ciba-Geigy (now Novartis), Children and Adults with Attention Deficit Disorders (CHADD), and the US Department of Education they proclaim ADHD a 'disease' so real and terrible that the parent who dares not believe in it, or allow its treatment, is likely to be deemed negligent, and no longer deserving of custody of their child. This is happening in family courts across the country by the hundreds of thousands.

 

Every patient's right of informed consent requires a complete, honest portrayal of both the condition to be treated (including its prognosis or 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 isn't it? (When asking this question of any physician or researcher, ask for reference to the specific article in the scientific literature that documents the confirmatory physical, including chemical, abnormality proving it is a disease).

 

IS IT A DISEASE OR ISN'T IT?All physicians, psychiatrists included, complete a course of study of disease-pathology. They know, full-well, that it is the physician's first duty, patient-by-patient, to determine whether the patient has an actual disease or does not-the "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 Association's Diagnostic and Statistical Manual-III-R (DSM-III-R) [5] and DSM-IV [6]. ADHD has become psychiatry's number one, "biologically-based" "disease."

 

PSYCHOPHARMACOLOGY: INVENTED DISEASES, BIG BUSINESS

 

The American Psychiatric Association's Diagnostic and Statistical Manual has grown from 112 mental disorders in its initial 1952 edition [7]; 163 in the 1968 DSM-II [8]; 224 in the 1980 DSM-III [9]; 253 in the 1987 DSM-III-R [5]; and, 374 in the 1994 DSM-IV [6]. 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.

 

ONE PHYSICIAN'S 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, Baughman [10] discovered the curly hair-anklyoblepharon (fused eyelids)-nail dysplasia syndrome (CHANDS). Its description was published in the Birth Defects: Original Article Series. In 1979, Toriello, et. al. [11] (myself included) established its autosomal recessive mode of transmission and published our findings in the Journal of Medical Genetics . In 1959, Turcot, et al [12], suggested that the combination of polyposis of the colon with gliomas of the brain was an autosomal recessive trait. In 1969, Baughman, et al, [13] described the second, "confirmatory" example of the glioma-polyposis syndrome-Turcot's syndrome. Anyone asking whether or not CHANDS exists, whether or not it has been proven to be "genetic" or, whether or not Turcot's syndrome exists, can look up the references and access the proofs. Such is the way of medical science-with the notable exception

 

On September 23, 1993, I [14] testified in hearings on National Institutes of Health (NIH) Research on Antisocial, Aggressive, and Violence-Related Behaviors and their Consequences:

"If, as I am convinced, these entities are not diseases, it would be unethical to initiate research to evaluate biological interventions-unethical and fatally flawed scientifically. That such unethical, unscientific research has, and is, going on, should be the focus of investigations."

My testimony, and with it, all consideration of the fundamental "disease"/ "no disease" issue, was effectively expunged from their 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 of children who are research subjects.

 

AND ALL THE OTHER BIOPSYCHIATRIC DISEASES, TOO?

Regarding their re-conceptualization of psychiatric "disorders" as "diseases", psychiatrist, Donald Goodwin [15] acknowledged "a narrow definition of disease that requires the presence of a biological abnormality."

Kety and Matthysse [16] 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 [17] 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 expediency-it 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 and every other invented, fraudulent psychiatric 'disease,' those whose only intent is to make 'patients' of every mis-educated, mis-parented, troubled, pained, biologically normal, child.

 

I TRY TO LEARN THE TRUTH 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 is 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 (now Novartis) 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 question-all 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, 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 [18] 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 methylphenidate-Ritalin, 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 [18]: "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 ADHD-the 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 question-or so I thought-from the one person, who, more than any other, speaks of and for ADHD and oversees ADHD research in the U.S.-Peter 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. [19] ) 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 child-one 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 asking that he: 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 [20,21], and Filipek, et al [22], 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 [20,21] studies had been on chronic stimulant therapy, and inquired as to the stimulant status of those in the Filipek [22] study. Swanson acknowledged that Filipek et al [22], also utilized ADHD subjects who had been on chronic stimulant therapy-an acknowledgment nowhere to be found in a review of this research either in the in the Lancet article [19] or in the more recent Report of the Council of Scientific Affairs of the American Medical Association [23].

 

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 ADHD "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 tests-a 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 last-an 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 copies. I am still waiting (7/19/00).

 

On May 13, 1998, F. Xavier Castellanos or the 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 Children's Hospital of Philadelphia, wrote to me:

"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 [24] implies that brain atrophy characterizes and validates ADHD as a disease. He cites MRI studies by Castellanos, et al. [20,21] 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 [20], that 93% of ADHD subjects had been on chronic stimulant therapy and, that the same, treated, cohort was used in the second study. No drug-naïve group (not taking Ritalin, or other stimulants or psychiatric drugs) has been shown to have brain atrophy. It can only be concluded that their brain atrophy is a function of their chronic stimulant therapy-the 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) show 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."

 

In 1986, Ross [25], 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 [26], 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 industry-who speaks for science? To what extent are scientific findings muted? Perverted? Are diseases invented where they don't 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.

 

In the Clinical Psychiatric News of December, 1994, Houston psychiatrist, Theodore Pearlman wrote:

 

"I take issue with Dr. Harold Alan Pincus' (of the Committee of the Diagnostic and Statistical Manual of the American Psychiatric Association) assertion that elimination of the term "organic" in the DSM-IV has served a useful purpose for psychiatry.Far from being of value to psychiatry, the elimination of the term "organic" conveys the impression that psychiatry wishes to conceal the nonorganic character of many behavioral problems that were, in previous DSM publications, clearly differentiated from known central nervous system diseases."

 

Baughman, wrote in the same issue of Clinical Psychiatric News (December, 1994):

 

"The fact that DSM-IV eschews the distinction between organic disease and disorders .that are not organic, does not mean that treating physicians can. To contend that something is a disease when that has not been established is to fail to provide the patient with information sufficient to make an informed decision."

 

In a 1995 review of the neuro-imaging literature on ADHD, Ernst [27] 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 ) combined-none 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?

In all of medicine, other than psychiatry, there is no inventing or conceptualizing of 'diseases' in-committee. Rather, diseases are natural occurrences, recognized as abnormalities-diseases-by physicians who, in turn, find upon review of the literature, that they have not been previously described, who then describe them. Nor are diseases revised in committee, as is regularly done at the American Psychiatric Association for consecutive editions of the DSM. Rather, new features of established diseases are recognized by astute physicians who, in turn, learn that the feature is new, hitherto un-described, and describe it.

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 Report of the Council on Scientific Affairs of the AMA [23] 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 [28].

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" could be found. Nor was it the same or comparable, to any subsequent conceptualization-another chapter of the research record, down the drain.

 

Writing in the Journal of the American Medical Association (JAMA), in 1995, psychiatry spokesmen, Marzuk and Barchas [29] 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 physician's 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 abnormality-pathology, 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 isn't it?" determination. This determination is usually made by physicians other than psychiatrists; usually by those referring patients to the psych

iatrist (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 patient's symptoms are psychogenic.

An ad placed by "America's 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 boardroom did they meet to adopt their "disease"-"chemical imbalance"-"pill" model of all human emotional distress?

Biopsychiatry's researchers are aware that without proven diseases, syndromes (in a medical sense) genotypes 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. (this means that all of their biological research on entities known not to be biological, i.e., known to have an objective abnormality or physical marker, are doomed to prove nothing and are fraudulent).

 

Pam [26] 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 [30] postulates that all intellectual systems-science included-are influenced by special interest and social considerations; a body of information is never unrelated to a political-economic context."

1998: 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, and the AMA, Council on Scientific Affairs [23] has seen fit to conclude: "

.there is little evidence of widespread overdiagnosis or misdiagnosis of ADHD or of widespread overprescription of methylphenidate." Without a confirmatory physical or chemical abnormality to make of it a disease, with which to diagnose it, child-by-child, how could they possibly know whether or not there was ".overdiagnosis or misdiagnosis of ADHD or of widespread overprescription of methylphenidate"?

Ten years earlier, in 1989, the same AMA Council on Scientific Affairs [31], evaluated "dyslexia," a.k.a. "specific reading disability," and duly, and scientifically, concluded there was no satisfactory definition-that 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 isn't it?"

 

What factors have changed which allowed the Council to speak forthrightly-scientifically--on the issue of "dyslexia" in 1989, but not on ADHD, in 1998 [23]?

Is industry (pharmaceutical) control of the practice of medicine more nearly complete today? How often are scientific conclusions not friendly to the "bottom line" published? Quashed?

The AMA and Goldman, et al, 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 question-the "disease"/ "no disease" question.

 

Armed only with the illusion of a disease, no proof that a disease (ADHD) exists, or that the children are other than normal, the RECOMMENDATIONS of the AMA [23] are:

1. "The AMA encourages physicians to use standardized diagnostic criteria in making the diagnosis of ADHD, such as the American Psychiatric Association's 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 substances-constituting, 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 ADHD-the need-still, for a forthright answer to the "disease"/ "no disease" question. In a 1993, letter to the editor of the JAMA [32], I wrote:

Unlike definite syndromes, such as Klinefelter's, Brown-Sequard, and Down's, 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 AJ Zametkin [33], entitled Attention-deficit Disorder: Born to Be Hyperactive was published in the JAMA. In a 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 has been one of the most diabolical and inhuman, of all time, if not, the most diabolical and inhuman.

 

Psychiatrist, Walter E. Afield,[34], 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 1980's, as follows:

" The DSM-III, we're talking about everyone in this room will fit into two or three of the diagnoses.In DSM-II, homosexuality was a disease. In III, it's not. In IV, there'll be some new diseases. Every new disease that's defined gets a new hospital program, new admissions, a new system and a way to bilk it, and this bilking continues.

 

THE SEARCH FOR ADHD 1998 TO THE PRESENT?

 

On April 15, 1998, I wrote to Attorney General Janet Reno charging:

 

"the representation of ADHD as a disease, the children as abnormal, and the psychiatric drugging of the millions of schoolchildren said to have it, was the greatest health care fraud of the century."

 

In May 13, 1998, F. Xavier Castellanos of the NIMH wrote me:

"I agree we have not yet met the burden of demonstrating the specific pathophysiology that we believe underlies this condition." (haven't found it yet)

 

As the main invited speaker at the November 16-18, 1998, NIH, Consensus Conference on ADHD, on the subject: "Is ADHD a Valid Disorder?" Professor William B. Carey [35] concluded:

 

"...common assumptions about ADHD include that it is clearly distinguishable from normal behavior, constitutes a neurodevelopmental disability, is relatively uninfluenced by the environment... All of these assumptions...must be challenged because of the weakness of empirical (research) support and the strength of contrary evidence...What is now most often described as ADHD in the United States appears to be a set of normal behavioral variations... This discrepancy leaves the validity of the construct in doubt..."

 

With no proof with which to counter Carey's assertions, the final statement of Consensus Conference on ADHD (11/18/98) read (p.3, lines 10-13):

 

"...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."

 

Richard Degrandpre, author of Ritalin Nation, and a participant in the Consensus Conference, contributed:

 

". it appears that you define disease as a maladaptive cluster of characteristics in the history of science and medicine, this would not be a valid definition of disease."

 

My own, invited, entirely public, Consensus Conference, testimony, 11/17/98 (un-rebutted), was:

 

Without an iota of proof or credible science, the National Institute of Mental Health has proclaimed the behaviors of ADHD a "disease," and the children "brain-diseased," "abnormal." CHADD (Children and Adults with Attention Deficit Disorders), 35,000-strong, funded by Ciba-Geigy, manufacturer of Ritalin, has spread the "neurobiological" lie. The US Department of Education, absolving itself of controlling the children and rendering them literate, coerces the labeling and drugging.ADHD is a total, 100% fraud."

 

In the press conference that followed (11/18/98), National Public Radio correspondent Joe Palca addressed the Panel:

 

"What you're telling us is that ADHD is like the Supreme Court's definition of pornography, 'You know it when you see it.'"

 

My response to the 1998 Report of the Council on Scientific Affairs of the AMA was published in the Journal of the American Medical Association, 4/28/99:

 

"Once children are labeled with ADHD, they are no longer treated as normal. Once methylphenidate hydrochloride or any psychotropic drug courses through their brain and body, they are, for the first time, physically, neurologically and biologically, abnormal."

 

In the January, 2000 Readers Digest, F.X. Castellanos summarized a quarter of a century of 'biological' research on ADHD:

 

"Incontrovertible evidence is still lacking.In time I'm confident we'll confirm the case for organic causes."

 

Here, Castellanos speaks of "organic causes" when they have yet to confirm ADHD as a disease, a syndrome, or anything at all "organic." Twenty-five years and 6-7 million patients after its 'invention,' and "incontrovertible evidence is still lacking!"

 

More recently still, J.N. Giedd, writing in Attention, the magazine of CHADD [March/April, 2000, p. 19], confessed:

 

".clinical history remains the gold standard of AD/HD diagnosis."

 

This, of course, means that there are no objective abnormalities to be found. This does not deter CHADD President, Matthew Cohen, Esq., from continuing to insist to the public that ADHD is a 'neurobiological disorder' when it is neither neurological or biological; when children said to have it are normal.

 

ENDLESS MARKET: NORMAL HUMANS CRADLE TO GRAVE

 

As if 8-10 million, K-12, on psychiatric drugs were not enough, Zito, et al [36] reported a two- to three-fold rise of psychiatric diagnosing and drugging of normal infants, toddlers and preschoolers between 1990 and 1995. We know these drugs are addictive, dangerous and even deadly. We know that Ritalin and all amphetamines cause growth retardation, brain atrophy, seizures, psychosis, tics, and Tourette's syndrome. We know that Cylert, yet another stimulant, can kill the liver. We know that Canadian officials, but not those in the US, have banned it.

 

RECENT DAMAGES FROM PSYCHIATRIC DRUGS-HEART & BRAIN

 

I have been consulted in 3 cases in which there appear to have been cardiac deaths due to Ritalin/amphetamine treatment for ADHD. Stephanie Hall, 11, of Canton, Ohio, died in her sleep the day she started an increased dose of Ritalin. In March 21, 2000, Matthew Smith, 14, of Clawson, Michigan, fell from his skateboard, moaned, turned blue and died. His myocardium (heart muscle) was diffusely scarred, it's coronary arteries, diffusely narrowed. Ritalin was, indisputably, the cause of death. Randy Steele, 9, of Bexar, County, Texas, became unresponsive and pulseless while being restrained in a psychiatric facility. His heart was found to be 'enlarged.' He had had ADHD and had been on Dexedrine; d-amphetamine. Of the 2,993 adverse reaction to Ritalin, reported to the FDA, from 1990 to 1997, there were 160 deaths and 569 hospitalizations. 126 of these adverse reactions were '

 

 

Further, the brain damaging potential of Ritalin and other of the psychostimulants (most of them amphetamines) has become increasingly clear. And with this new clarity, a particularly heinous crime on the part of ADHD researchers has become clearly apparent-the close-held news that these drugs cause brain atrophy, that is brain shrinkage. Over the past 15 years, psychiatric researchers have maintained that the brains of children with ADHD, as seen on brain scans, were, on average, 10% smaller than those of normal controls. What they have withheld from the public, as well as their readership and professionals that attend their professional meetings, is that virtually all of the ADHD subjects in these many studies over the past 15 years had been on long-term stimulant treatment and that this treatment was the only physical difference between the ADHD subjects and the normal control

 

 

Sensitive now to being held accountable for what they say and write on the issue, Castellanos (NIMH) was quoted in the January, 2000 Reader's Digests as saying some critics claim that such brain differences in ADHD children 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. With 15 years of brain scanning research suggesting that the drugs used in millions of children are shrinking their brains, and they have just, now, decided to look at the brain scans of a cohort of children with ADHD before starting the drugs.

 

 

A study, which will be highlighted at the Society for Neuroscience annual meeting in Miami, Florida from October 23-28,Yale University researchers have found that brief, low-dose, amphetamine use in primates caused possibly permanent cognitive impairment. Researcher Stacy Castner concluded: "It may be the case that even a brief period of low-dose amphetamine abuse in early adolescence or early adulthood can produce profound cognitive deficits that may persist for a couple of years or more after amphetamine use has ended." Yet, the researchers observe, Ritalin (generally identical to amphetamines) is being prescribed to millions of children--including toddlers--who have been loosely "diagnosed" with ADHD.

 

Whether 'loosely' diagnosed or not, the bottom line is that ADHD simply does not exist-the children are normal! At least they were until the amphetamines were started.

 

THE MARKETPLACE STRATEGY OF BIOLOGICAL PSYCHIATRY

 

Present-day biological psychiatrists speak to one another, the public and to their patients as though all emotional and behavioral pains were diseases--chemical imbalances. This nomenclature serves no scientific or Hippocratic-healing purpose. It serves only to gain their acceptance of one-dimensional drug treatment. It makes 'patients' of normal persons and serves only the profit motive. In every single case, as well as in virtually all of their drug, electroshock, and psychosurgical research, they intentionally violate the informed consent rights of the patient. Quite simply, there is no disease on the risk side of the risk/benefit equation in psychiatry. Instead, there are normal, troubled, pained, educable, remediable, adaptable, human beings--human beings who, if treated appropriately, have the potential to improve, to prevail, and to lead happy, normal, productive lives.

Until such time as the diagnosis of a disease has been objectively confirmed, a physician has no right to proceed with any treatment, which is, itself, a source of risk.

 

I would not be justified in starting insulin for diabetes, based only on history, without confirmatory, elevated, blood sugar levels in hand. I would not be justified in surgically removing a breast based upon the naked eye appearance of a tumor, without microscopic confirmation of the presenceof a cancer.

 

Psychiatrists speak to their patients as though their emotional and behavioral problems were 'diseases.' They do so to gain patient acceptance of drug treatment, when this, and this alone, is in the best financial interest of both, psychiatrists, and their pharmaceutical industry partners.

 

A week ago I got a letter from Frank Heutehaus of Don Mills, Ontario, a father-of -divorce, whose son is on Ritalin. He enclosed the Toronto Sun article on the death of Matthew Smith and in his post-script added. "In regards to my case, I am entertaining the prospect of bringing criminal charges of assault and battery against some of the doctors who claimed my son had a disease that doesn't exist."

 

 

Such 'biological' psychiatrists, violate the informed consent rights of their every patient. This is medical malpractice. There is no scientific, medical or moral justification for their pseudo-biological diagnosing or for the drugging that invariably follows.

 

On May, 25,2000, I wrote to the JF Lucey, Editor of the journal Pediatrics, stating:

 

(your) Clinical Practice Guideline opens: "Attention-deficit/hyperactivity disorder is the most common neurobehavioral disorder of childhood." "Neurobehavioral," implies an abnormality of the brain; a disease. And yet, no confirmatory, physical or chemical abnormality of the brain (or anywhere else in the body) has been found.With no evidence that ADHD is a disease, where has the notion come from that it is a disease? .It has become apparent that virtually all professionals who are part 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'-'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.

 

 

We cannot but conclude that medicine, once a healing mission, is now an enterprise.

 

BIOLOGICAL RESEARCH INTO THINGS NON-BIOLOGICAL

 

A closing word about our own National Institute of Mental Health and their dedication to a program of biological research into things emotional and behavioral that are biologically indistinct. Ross [25] and Pam [26] put it most succinctly.

 

Ross [25], 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.

Pursued as medical practice, is this not fraud?

Pam [26] wrote:

.any studies that do not meet standards for proper research procedures (doing biological studies on biologically indistinct entities) 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.

 

Consider the recent mission statement of Stephen E. Hyman, Director of the NIMH, in relation to the above statements of Ross and Pam.

In the December 22/29, 1999 Journal of the American Medical Association [JAMA. 1999;282:2290], we find the musings of heads of the constituent institutes of the National Institutes of Health, as to what the future portends for their disciplines.

 

Targeting the year 2020, Steven E. Hyman, MD, Director of the NIMH states, remarkably enough:

 

By 2020 it will be a truth, obvious to all, that mental illnesses are brain diseases that result from complex gene-environment interactions. We will be reaping the therapeutic benefits that accrue from the discovery of risk genes for autism, schizophrenia, manic depressive illness, and other serious mental disorders.

 

 

We will also routinely analyze real-time movies of brain activity derived from functional magnetic resonance imaging, optical imaging, or their successor technologies, working together with magnetoencephalography or its successor technology. In these movies, we will see the activity of distributed neural circuits during diverse examples of normal cognition and emotion; we will see how things go wrong in mental illness; and we will see normalization with our improved treatments.

 

 

Amazingly, not a single mental, emotional or behavioral disorder has been validated as a disease or a medical syndrome with a confirmatory physical or chemical abnormality or marker within the brain or body. Furthermore, Hyman knows this. And yet the NIMH and all in academic psychiatry and mental health regularly represent all of the "serious mental disorders" as though they were, and would have the public, the legislature, and the judiciary believe that they are.

 

 

Further, with not one psychiatric entity having a confirmatory physical abnormality or marker or any prospect that any technology will validate a one as a disease, Director Hyman pledges the application from decade to decade of every evolving technology to confirm his/biological psychiatry's belief that "mental illnesses are brain diseases". Observe his use of the term "normalization" establishing, etymologically at least, that those with mental illnesses are abnormal.

Because psychiatric disorders are biologically/physically indistinct, biological/physical research, no matter how long pursued, or how sophisticated the technology, is doomed to prove nothing. I suspect that Dr. Hyman and all at the NIMH know this full-well. Might the only purpose of such research be to establish a 'medical'/biological' literature, and, illusions of biology, neurology and disease. After all, without such illusions of disease there would only be normal children.

One final point. This NIH/NIMH research is funded not just with pharmaceutical industry millions but with the hard-earned tax dollars of US citizens. Is there any legitimacy to biological research in psychiatry or is it entirely fraudulent-a deception of the people funded with their very own tax dollars?

F. Baughman