Paul Corona, 'Guru' doctor of mood-stabilizing drugs on probation for second time

From the Orange County Register

A doctor who described himself in an Orange County Register investigation as the “guru” of mood-stabilizing drugs has been put on probation for the second time by state medical regulators.

The Medical Board of California put Laguna Niguel physician Paul Corona on a five-year probation Friday for gross negligence in treating five patients and failing to maintain adequate medical records. He was also put on probation in 2009 after suffering a psychotic breakdown.

Corona, who described himself to the Register as the most prolific prescriber of mood-stabilizing drugs anywhere, is prohibited from supervising physician assistants during his probation.

Jodi Barber, whose son, Jarrod, overdosed in 2010 on a mixture of drugs, some prescribed by Corona, said the state was too lenient. “This is ridiculous. Remove his license permanently. How many slaps on the hand is he going to be given?” said Barber of Laguna Niguel. Her son did not appear to be one of the victims in the state complaint.

Corona was the subject of a 2011 investigation by the Register into how doctors overprescribed to teens, fueling a rise in Orange County overdoses. Coroner records show accidental fatal overdoses have risen steadily from 130 in 2003 to 291 in 2013. Corona preached the use of psychotropic drugs to remove the mental traumas that feed drug addiction.

“I am the top prescriber of psychotropic medications around,” Corona said. “Ninety-five percent of my patients are very happy.”

But drug addiction experts questioned Corona’s tactics, saying it didn’t make sense to use drugs to fight drugs. Dr. Harry Haroutunian, physician director at the famed Betty Ford Center in Rancho Mirage, told the Register in 2011 it is especially dangerous to prescribe drugs with sedative qualities when treating addicts in an outpatient setting, where they might score more drugs on the street.

“If he is telling you he is the highest prescriber,” Haroutunian said, “that would be a dubious distinction by my measuring stick.”

Corona first came under the state’s attention after Orange County sheriff’s deputies were sent to his Laguna Niguel home in 2007 to investigate reports of a man having a psychotic breakdown and threatening suicide, according to a medical board accusation.

“Respondent was acting bizarre and was very aggressive, yelling and screaming incoherently. The officers had to taser respondent several times in order to subdue him,” said the report by the medical board. Corona was hospitalized for nearly a month for psychological observation.

It was the same year that he published a book about treating mood disorders, entitled “Healing the Mind and Body.” In a 2008 interview with the medical board, Corona said he suffered an episode of hypomania three years prior. State documents say that he was prescribed Seroquel by his psychiatrist, but he admitted to self-medicating from his sample drugs after his psychiatrist moved away.

“His disorder has impacted his ability to practice safely and led to his hospitalization for a psychotic breakdown,” the state complaint said. He was put under suspension for five years in June 2009.

Under the latest probation, Corona must take courses in prescribing practices, medical record keeping, medical ethics and clinical education. He must also find another physician to monitor him, according to medical board documents.

Timberlawn mental hospital cut off from federal funding over safety issues

From a much long report in the Dallas News

Federal regulators are taking the rare step of kicking one of North Texas’ largest psychiatric hospitals out of the Medicare and Medicaid programs for leaving patients in “immediate jeopardy” of injury or death.

[...]

Timberlawn flunked a make-or-break inspection, a final chance to prove it could fix an array of problems after promising improvements for months.

The U.S. Centers for Medicare & Medicaid Services found that unlicensed personnel were monitoring patients and some patients were going more than 12 hours without seeing a nurse. Electrical cords and other unsafe objects remained in rooms within reach of suicidal patients.

“These practices posed an immediate jeopardy to the health and safety of patients,” inspectors said in a report.

The state said it is moving quickly to evaluate its enforcement options.

“The issues have been egregious and incredibly disheartening. We are absolutely looking at the full range of penalties, including license revocation,” said Carrie Williams, a spokeswoman for the Texas Department of State Health Services. “Our inspectors have been in and out of the facility since February, citing issues and not seeing progress. It’s turned into a critical situation.”

Much more information at the link, which includes hand wringing over what they will do when a dangerous and unsafe facility is shut down.

California suspends license for Fairfield psychiatrist

From a much larger report in the Daily Republic

The state has temporarily suspended the license for Dr. William Munn after the Medical Board of California said the psychiatrist, in private practice since 1972 at his Travis Boulevard office, put public health at risk by excessively prescribing drugs to five patients.

Munn disputes any risk to public health and says his suspension is detrimental to his 250 patients, who can’t be absorbed by the limited number of psychiatrists in private practice in Solano County.

The Monday suspension follows a hearing in Oakland and the filing by the state Attorney General’s Office about Munn’s prescriptions for the five patients.

Munn referred to providing one patient “telephone psychotherapy,” said the state filing, which describes the therapy as consisting almost entirely of the psychiatrist refilling prescriptions for large quantities of hydrocodone, a semisynthetic narcotic analgesic, as well as amphetamines and alprazolam, often sold under the trade name Xanax.

Another patient was prescribed large doses of alprazolam even though the doctor saw the person only once and continued to prescribe the drug for almost two years, according to the state.

Treatment of the five patients includes numerous extreme departures from the standard of care, added the state, which sought the license suspension until the Medical Board can ensure Mann safely practices psychiatry.

Texas Medical Board temporarily suspends license of Dallas Psychiatrist

Via the Dallas Morning News

The Texas Medical Board temporarily suspended the license of a Dallas physician on Tuesday after determining her continued practice could pose a threat to public welfare.

The board panel received an emergency referral on May 6 from the Texas Physician Health Program based on a self report from Dr. Abbie Ewell. Ewell's self-report claimed she was unsafe to practice because of "a recent relapse of a mental or physical condition," the board said.

Ewell's suspension will last until the board takes further action, the board said.

She graduated in 2008 from University of Texas Southwestern Medical Center and was an assistant professor in the school's psychiatry department.

Bangor psychiatrist ordered to stop treating women

As reported by the Bangor Daily News

A Bangor psychiatrist must stop treating women after allegedly developing an unprofessional relationship with a female patient, according to a state medical licensing board.

Dr. Fred Risser may treat only men and must submit to independent monitoring of his practice to ensure he meets prescribing and recordkeeping standards, his May 12 consent agreement with the Maine Board of Licensure in Medicine states.

While a 30-year-old female was his patient in 2009 and 2010, Risser drove the woman to the pharmacy in his personal vehicle, advocated for her while she was in jail, deposited money into her jail bank account, stored her personal property at his home and allowed her access to his home while he was away, according to the agreement. Risser treated the patient at his private practice in Bangor and at Community Health and Counseling Services in Ellsworth.

In June 2013, Risser met with the licensing board and agreed to take classes in boundaries and professionalism, medical ethics, recordkeeping and the use of medications to treat psychiatric disorders. He also agreed to transfer the patient to another psychiatrist, the agreement states.

In April 2014, Community Health and Counseling warned Risser about prescribing tranquilizers to patients on opioid replacement medications, a combination that raises the risk of overdose and death.

Then in May 2014, a 51-year-old patient he treated in Ellsworth told the board Risser slapped her on the buttocks while escorting her up the stairs to an appointment.

Community Health and Counseling fired Risser in May 2014 for unprofessional conduct, according to the agreement. In signing the consent agreement, Risser neither admitted nor denied the allegations but acknowledged the board had enough evidence to determine the alleged incidents occurred if the issue were to proceed to a formal hearing. He must reimburse the board $4,344 for the cost of the investigation.

In other words, he did it.

Psychotropics Lead List for Youth-Related Drug Poisoning Calls

As Reported by the Psychiatric News section of the American Psychiatric Association Website

The Referenced Report is available here in PDF Format

A new report shows that almost half of the calls made to United States poison control centers on behalf of those aged 19 and under are related to medication—with psychotropic drugs representing 50 percent of the top 10 medications contributing to unintentional poisoning.

Safe Kids Worldwide, in partnership with the American Association of Poison Control Centers (AAPCC), conducted a study to identify the types of medications that contribute to the volume of calls made to poison control centers for drug poisoning in children and teens.

Safe Kids said in statement that the study was designed to “take a deeper look at two specific groups of calls related to medicine: unintentional-general exposures, when kids get into medicine without intending to take it (such as when a young child takes medicine on a nightstand); and unintentional-therapeutic errors (such as when a child is given too much medicine or the wrong medicine).” The study did not include cases in which medications were taken intentionally.

After evaluating data generated from the National Poison Data System of calls made to poison control centers in 2013, analysts from Safe Kids found that 1.34 million calls were associated with poisoning of a child or teen, with 547,042 of those calls related to unintentional-general exposures or unintentional-therapeutic errors. Though 75 percent of the calls made for unintentional drug poisoning involved young children aged 1 to 4 compared with 3 percent for teens, serious health outcomes resulting from unintentional poisoning were six times greater in those aged 15 to 19. The most common mistakes made by teens were forgetting to take a medicine and then doubling up or taking two medicines with the same ingredients, the study found. Atypical antipsychotics and amphetamines intended for the treatment of attention-deficit/hyperactivity disorder were the top two medication classes for serious health outcomes in teens.

Other psychotropic medicines commonly reported for unintentional poisoning throughout all studied age groups included benzodiazepines, clonidine, and methylphenidate. Nonpsychotropic drug classes included antihypertensives such as beta blockers and analgesics such as ibuprofen and acetaminophen.

AAPCC Executive Director Stephen Kaminski, J.D., said the current report points to an urgent need to continue to educate families on using medicines responsibly.

“Our nation’s 55 poison centers play a crucial role in keeping Americans safe by providing poison prevention and free, expert information and advice,” said Kaminski. “In addition to the public, emergency clinicians and pediatricians rely on poison-center professionals to help treat their patients. In fact, about 20 percent of all poison-center exposure calls come from health care providers. It’s good to know that expert help is just a phone call away when the unthinkable happens.”

Science and the Psychiatric Publishing Industry

A paper in the journal Ethical Human Psychology and Psychiatry, Volume 11, Number 1, 2009 , pp. 29-36(8) Publisher: Springer Publishing Company, by McLaren and Niall

Abstract

Objective: An empirical examination of the scientific status of psychiatry.

Method and Results: Analysis of the publications policy of the major English-language psychiatric journals shows that no journal meets the minimum criteria for a scientific publishing policy.

Conclusion: Psychiatry lacks the fundamental elements of any field claiming to be a science. Furthermore, its present policies are likely to inhibit scientific development of models of mental disorder rather than facilitate them. The psychiatric publishing industry is in urgent need of radical reform.

We told you so.

Why people should be concerned with the impending revision of the DSM

An excellent but long post from the fine folks at feministing.com, with only a portion quoted below

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been called the "bible of mental illness" because it lists and defines all of the "official" psychiatric diagnoses according to the American Psychiatric Association. The DSM is in the early stages of undergoing its 5th major revision; each previous revision has seen the total number of mental disorders recognized (some might say invented) by the APA greatly increase. Last year, trans activists were particularly concerned to learn that Ken Zucker and Ray Blanchard had been named to play critical lead roles in determining the language of the DSM sections focusing on gender and sexuality, especially given that these researchers are well known for forwarding theories and therapies that are especially pathologizing and stigmatizing to gender-variant people.

Blanchard has recently presented some of his suggestions to revise the "Paraphilia" section of the DSM. In the past, this section has generally received little attention from feminists, as it has been primarily limited to several sexual crimes (e.g., pedophilia, frotteurism and exhibitionism) and a handful of other generally consensual but unnecessarily stigmatized sexual acts (such as fetishism and BDSM) that are considered "atypical" by sex researchers. However, there are two aspects of the proposed Paraphilia section revision that should be of great concern to feminists, as well as anyone else who is interested in gender and sexual equality.

Expanding "Paraphilia"

First, Blanchard is proposing a significant expansion of the DSM's definition of "paraphilia" to include:

"any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners."

The first concern here is the term "phenotypically normal" (meaning "normal" with regards to observable anatomical or behavioral traits). Thus, according to this definition, attraction to any person deemed by sex researchers to be "abnormal" or "atypical" could conceivably be diagnosed as paraphilic. So, do you happen to be attracted to, or in a relationship with, someone who is differently-abled or differently-sized? Or someone who is gender-variant in some way? Well congratulations, you may now be diagnosed with a paraphilia!

Seriously.

Blanchard and other like-minded sex researchers have coined words like Gynandromorphophilia (attraction to trans women), Andromimetophilia (attraction to trans men), Abasiophilia (attraction to people who are physically disabled), Acrotomophilia (attraction to amputees), Gerontophilia (attraction to elderly people), Fat Fetishism (attraction to fat people), etc., and have forwarded them in the medical literature to denote the presumed "paraphilic" nature of such attractions.

This tendency reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It's bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.

Another frightening aspect of Blanchard's proposal is that any sexual interest other than "genital stimulation or preparatory fondling" is now, by definition, a paraphilia.

In his presentation, he claimed that paraphilias should include all "erotic interests that are not focused on copulatory or precopulatory behaviors, or the equivalent behaviors in same-sex adult partners." Copulatory is defined as related to coitus or sexual intercourse (i.e., penetration sex). So, essentially, all forms of sexual arousal and expression that are not centered around penetration sex may now be considered paraphilias.

So, do you and your partner occasionally role-play or talk dirty to one another over the phone? Or engage in arousing play that is not intended to necessarily lead to "doing the deed"? Do you masturbate? Do you get a sexual charge from wearing a particularly sexy outfit or performing any act that falls outside of "genital stimulation or preparatory fondling"? Well, then congratulations, you can be diagnosed with a paraphilia!

Photos of notorious abandoned "Children's Center" in Maryland

A Photo set on Flickr:

Wikipedia says: "Forest Haven was a children's developmental center in Laurel, Maryland. It is sometimes referred to (inaccurately) as "DC Children's Center", although this was not an official moniker.

It was notorious for its poor conditions and abuse of patients. It was shut down in 1991 by a federal court."

We spent more than 5 hours walking around the campus and probably only saw half of the buildings. Just a huge area of urban decay to explore.

An interesting write-up of Forest Haven can be found here:

http://www.washingtonpost.com/wp-srv/local/daily/march99/grouphome14.htm

If you want to see more photos from Forest Haven, check out the photosets from Jon and Chris.

The Diagnostic and Statistical Manual of Mental Disorders is being revised under a cloak of secrecy

As seen in the LA Times

[...] An update is underway for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, which defines the emotional problems for which doctors prescribe drugs and insurance companies pay the treatment bills. Psychiatrists working on the new edition were required to sign a strict confidentiality agreement.

Critics contend that the American Psychiatric Assn. should allow outside observers to review the scientific debate behind new and revised diagnoses.

Among the most prominent to speak out is the editor of the manual's third edition, Dr. Robert Spitzer, hailed by peers as the most influential psychiatrist of his generation. If the DSM is often called the profession's bible, then the DSM-III is the King James Version. Released in 1980, it set the standard by which others are measured.

Recently, Spitzer broke ranks by publishing an open letter to the profession protesting the confidentiality mandate.

"If you don't know what goes on at someone's meetings, they're suspect of having a conflict of interest," the Columbia University professor said in an interview.

The profession is already confronting that issue through revelations that academics in the field are earning tens of thousands of dollars in consulting fees from drug companies. The financial links between the drug industry and the psychiatric community have sparked a congressional investigation headed by Sen. Charles E. Grassley (R-Iowa).

Officials with the APA counter that the psychiatrists working on the DSM revision are limited to $10,000 annually in fees from drug companies. The association says "transparency" is the byword of those overseeing the process.

Darrel Regier, who heads the APA's research arm, said the critics are failing to recognize progress in the field. "The field of psychiatry has gone from an ideology to a scientific pursuit," he said. The DSM grew out of a guidebook used by the military during World War II. Afterward, it was revised for general use and subsequently enlarged.

When it first appeared in the 1950s, psychiatry was dominated by Freud's model of psychological suffering, one that was resolvable by talking out the conflict with a therapist. Yet even then, drugs were appearing for relief of psychotic symptoms, and leadership in the profession has since passed to psychiatrists with an alternative model: biology and genetics as the source of emotional problems.

As the field has changed, the number of disorders in the DSM has tripled to 300, an increase paralleled by the rise in sales of drugs that pharmaceutical companies and psychiatrists tout as remedies for emotional suffering.

Some critics suspect that a quest for profits has encouraged the field to create mental illnesses out of personality quirks.

In his recent book, "Shyness: How Normal Behavior Became a Sickness," Christopher Lane traces how shyness morphed from a character trait into a pathological condition called "social phobia," which the DSM defines as "fears that he or she may do something or act in a way that will be humiliating or embarrassing." With disorders so broadly drawn, Lane wonders, who among us is sane?

It's an apt criticism, says David Kupfer, who is shepherding the DSM's revision.

"One of the raps against psychiatry is that you and I are the only two people in the U.S. without a psychiatric diagnosis," said Kupfer, head of the psychiatry department at the University of Pittsburgh.

Kupfer said he hopes to reduce the number of diagnostic categories in the forthcoming edition of the DSM, scheduled to appear in 2012.

He argues that scientific progress comes from formulating ideas, then seeing if others can shoot them down. If currently listed maladies fail that test, they'll be dropped, Kupfer said.

Meanwhile, Lane -- who has become something of a thorn in the side of the psychiatric community -- has irked some by obtaining the working papers of psychiatrists who produced the DSM-III and making plans to post them on his website.

Some of his finds read less like scientific discourse than like shtick from a Catskills comedian.

One syndrome under discussion at the time was "chronic complaint disorder."

Its supposed sufferers were largely "of Eastern European ancestry" and revealed their malady when asked how things are going.

"In those cases," the psychiatrists wrote, "the pathognomonic expression becomes, 'Oy vey, don't ask.' "

Whistle-Blowers in Chinese City Sent to Mental Hospital

As Reported in the NY Times

Local officials in Shandong Province have apparently found a cost-effective way to deal with gadflies, whistle-blowers and all manner of muckraking citizens who dare to challenge the authorities: dispatch them to the local psychiatric hospital.

In an investigative report published Monday by a state-owned newspaper, public security officials in the city of Xintai in Shandong Province were said to have been institutionalizing residents who persist in their personal campaigns to expose corruption or the unfair seizure of their property. Some people said they were committed for up to two years, and several of those interviewed said they were forcibly medicated.

The article, in The Beijing News, said most inmates were released after they agreed to give up their causes.

Sun Fawu, 57, a farmer seeking compensation for land spoiled by a coal-mining operation, said he was seized by local authorities on his way to petition the central government in Beijing and taken to the Xintai Mental Health Center in October.

During a 20-day stay, he said, he was lashed to a bed, forced to take pills and given injections that made him numb and woozy. According to the paper, when he told the doctor he was a petitioner, not mentally ill, the doctor said: “I don’t care if you’re sick or not. As long as you are sent by the township government, I’ll treat you as a mental patient.”

In an interview with the newspaper, the hospital’s director, Wu Yuzhu, acknowledged that some of the 18 patients brought there by the police in recent years were not deranged, but he said that he had no choice but to take them in. “The hospital also had its misgivings,” he said.

Xintai officials do not see any shame in the tactic, and they boasted that hospitalizing people they characterized as troublemakers saved money that would have been spent chasing them to Beijing. There is another reason to stop petitioners who seek redress from higher levels of government: they can prove embarrassing to local officials, especially if they make it to Beijing.

The Xintai government Web site noted that provincial authorities had recently referred to Xintai as “an advanced city in building a safe Shandong.” They said that from January to May this year, the number of petitioners who went over the heads of local authorities was 274, a 4 percent drop from the same period in 2007. Although China is not known for the kind of systematic abuse of psychiatry that occurred in the Soviet Union, human rights advocates say forced institutionalizations are not uncommon in smaller cities. Robin Munro, the research director of China Labor Bulletin, a rights organization in Hong Kong, said such “an kang” wards — Chinese for peace and health — were a convenient and effective means of dealing with pesky dissidents.

“Once a detainee has been officially diagnosed as dangerously mentally ill, they’re immediately taken out of the criminal justice system and they lose all legal rights,” said Mr. Munro, who has researched China’s practice of psychiatric detention.

In recent years practitioners of Falun Gong, the banned spiritual movement, have complained of what they call coerced hospitalizations. One of China’s best-known dissidents, Wang Wanxing, spent 13 years in a police-run psychiatric institution under conditions he later described as abusive.

In one recent, well-publicized case, Wang Jingmei, the mother of a man convicted of killing six policemen in Shanghai, was held incommunicado at a mental hospital for five months and released only days before her son was executed in late November.

The article in The Beijing News about the hospitalizations in Xintai was notable for the attention it gained in China’s constrained state-run media. Such Communist Party stalwarts as People’s Daily and the Xinhua news agency republished the article, and it was picked up by scores of Web sites. At Sina.com, the country’s most popular portal, the report ranked as the fifth most-viewed news headline, and readers posted more than 23,000 comments by evening. The indignation expressed was universal, with many clamoring for the dismissal of those involved. “They’re no different from animals,” read one post. “No, they’re worse.”

By Monday evening, the Xintai city government was rejecting the report by The Beijing News as reckless and slanted. In a telephone interview broadcast on Shandong provincial television, an unidentified municipal official suggested that those confined to the mental hospital had gone mad from their single-minded quest for justice. “There are some people who have been petitioning for years and become mentally aggravated,” the official said.

Reached by phone on Monday, a hospital employee said Mr. Wu, the hospital director who voiced his misgivings to The Beijing News, was unavailable. The employee, Hu Peng, said that officials from the local government had taken him away for “a meeting” earlier in the day.

Although he would not provide a reporter with contact information for the former patients, Mr. Hu defended the hospitalizations, saying that all those delivered by the Public Security Bureau were sick. He added that the hospital was not authorized to provide a diagnosis to the patients, only to treat them. “We definitely would not accept those without mental problems,” he said.

Lapses at Psychiatric Solutions Inc., a major hospital chain with high earnings, have put patients at risk, regulators find. Some have even died.

Highlights from a MUCH longer article in the LA Times

Lapses at Psychiatric Solutions Inc., a major hospital chain with high earnings, have put patients at risk, regulators find. Some have even died.

[...]

Since 2005, the 10 hospitals PSI has owned longest have compiled almost twice as many patient-care deficiencies as 10 similar hospitals owned by its closest competitor, Universal Health Services Inc.

The PSI hospitals were cited in three patient deaths and for placing patients in immediate jeopardy four times, the inspection records show. The UHS hospitals received no equivalent citations.

Among private psychiatric hospitals in California, Sierra Vista had the single highest rate of state and federal deficiencies -- about eight times the statewide average.

It has twice been fined $25,000 for endangering patients -- accounting for the only such penalties levied against psychiatric hospitals under a 2006 state law establishing the sanctions. PSI executives declined to be interviewed for this article and, citing privacy law, would not discuss individual patients.

In written responses, they rejected the analysis showing the company's hospitals compared poorly to others, saying: "Your assumptions, calculations and apparent conclusions are invalid."

A spokesman, John Van Mol, said that PSI arguably has improved psychiatric care in the country overall. He cited the comparatively poor performance of state psychiatric facilities around the country in recent years.

PSI officials apologized for incidents resulting in harm to patients, saying they acted immediately to correct any problems. "Any incident involving patient care is one too many in our view, and everyone involved from the hospital level to the corporate level works very hard to prevent them," they wrote.

Recent state and federal inspections show the company's efforts have fallen short:

* Poor patient supervision, understaffing and inadequate worker training have led to instances of chaos and brutality.

A 19-year-old alleged he was raped twice within 24 hours by a fellow patient at an Illinois hospital even after he reported the first assault, federal records show.

Staffers at a Texas facility had to barricade themselves in an office and call in a SWAT team to bring unruly residents under control.

In North Carolina, inspectors found, a 12-year-old boy with a history of sexual aggression was put in a room with a 5-year-old and attempted to force the younger boy to perform oral sex.

* Medical neglect and errors have resulted in grave harm. A nurse at another North Carolina facility gave a 7-year-old boy anti-seizure medication prescribed for an older patient, leaving him so drowsy that a doctor wrote in his chart that "he refuses to wake up."

Workers in Virginia waited almost an hour to call an ambulance for a 17-year-old girl who had suffered a seizure and was bleeding profusely, inspection records show. The girl died later that day.

* In several instances, PSI employees have sought to hide their failings from regulators. A hospital in Texas was cited by state inspectors for concealing key facts about a patient abduction and a suicide. Regulators in Virginia uncovered what they called an organized scheme to cover up violence, suicide attempts and medication errors at a Charlottesville facility for juveniles.

* Some of the PSI hospitals most under fire from authorities are those the chain has owned longest. The Justice Department has opened an investigation into alleged patient-care problems at one of PSI's first acquisitions, Riveredge Hospital near Chicago, issuing subpoenas for records earlier this year.

Nationwide since 2006, health officials have pulled children out of one PSI facility and have moved five times to revoke the state licenses of others. They have withheld or ordered the company to repay more than $2 million in government funding for providing substandard care.

In addition to thousands of pages of inspection reports by individual states and the U.S. Centers for Medicare and Medicaid Services, ProPublica's investigation was based on hospital and court records and interviews with about two dozen former employees.

PSI executives say they are filling a desperate need in a tough business.

"Everyone at Psychiatric Solutions works hard every day to achieve excellence in patient care, often under extremely difficult circumstances to serve a patient population that includes extremely acute and complex diagnoses," Chief Executive Joey Jacobs said in a written statement.

Chad Thompson, who worked in the admissions office at Sierra Vista when PSI took over, has a different view. He felt the chain put intense pressure on him to keep every bed full, with less emphasis on assuring that each patient got high-quality care.

"It's a pattern of behavior driven totally by the almighty dollar," said Thompson, now the director of a nonprofit that provides therapy to the uninsured and chairman of Sacramento County's Mental Health Board, which advises the county Board of Supervisors.

"It's not a client-centered approach. It's a money-centered approach."

Psychiatrist arrested on the probability that he inappropriately touched one of his patients.

From the Sentinel newspaper out of Nouth Brunswick, New Jerseyu

A psychiatrist at a behavioral health center in Edison was arrested on Oct. 17 on the belief that he inappropriately touched one of his patients.

The suspect, Chowdhury M. Azam, a 54-year-old Monmouth Junction resident, was charged with criminal sexual contact, a fourth-degree crime. Criminal sexual contact is described in the state legal code as "intentional touching by the victim or actor, either directly or through clothing, of the victim's or actor's intimate parts for the purpose of degrading or humiliating the victim or sexually arousing or sexually gratifying the actor."

The arrest was made the same day the alleged victim filed a report with the Edison Police Department. Following the filing, the Middlesex County Prosecutor's Office Sex Crime/Child Abuse Unit and the Edison Police Department embarked on a joint investigation, eventually leading to Azam's arrest.

Azam has been a licensed psychiatrist with Compass Behavioral Health, located on Pierson Avenue. According to authorities, it is alleged that the psychiatrist inappropriately touched one of his patients on one occasion. The New Jersey State Board of Medical Examiners, the regulatory agency that licenses medical professionals, was informed of Azam's arrest.

According to police, Azam has been released on $50,000 bail set by Municipal Court Judge Craig Coughlin.

Authorities have not released details regarding the alleged victim's age or gender.

Authorities are currently seeking more information about the matter. Anyone with information regarding this investigation, or incidents similar in nature, is encouraged to contact Investigator Raj Chopra of the Middlesex County Prosecutor's Office Sex Crimes/Child Abuse Unit at 732-745-3600, or Detective Michael Michalski of the Edison Police Department at 732-248-7525 anytime day or night.

Sacramento judge castigates psychiatrist who vouched for killer

A Report from the Sacramento Bee

Napa State Hospital's attempt to release a killer into community treatment in Sacramento was based on the "horrifying" testimony of a psychiatrist who "clearly committed perjury in this court," a judge said Monday.

Sacramento Superior Court Judge Kevin J. McCormick made his comments about the Napa psychiatrist, Dr. Nathan Thuma, when he ruled from the bench that Ronald Benjamin Toppila is not fit for outpatient treatment and must remain in the mental hospital for killing his mother four years ago.

In a decision that will keep Toppila confined indefinitely on a jury's verdict that he was not guilty by reason of insanity, McCormick lashed Thuma for recommending in March that the defendant be released into community treatment even though at that time the psychiatrist had examined the client for barely a half hour.

McCormick said Thuma "could not have had enough information" to make the recommendation and that it was "beyond belief" the doctor could have reviewed Toppila's medical records in the short time he'd been on staff at Napa.

Thuma demonstrated "a total lack of independence and judgment" by concluding that Toppila did not present a danger because, in quoting the psychiatrist, "we all trust Mr. Toppila," McCormick said. The judge said Thuma's "demeanor and manner" in court "could only be described as horrifying."

"He clearly committed perjury in this court," McCormick said of Thuma. "He testified inconsistently at varying times. He showed a complete lack of any insight whatsoever into Mr. Toppila's history."

Thuma did not return a telephone call for comment Monday. A spokeswoman for the state Department of Mental Health said agency director Stephen Mayberg plans to review the judge's comments about Thuma.

"He would take it very seriously and look into it," the spokesman, Nancy Kincaid, said.

"If the judge expressed concern over someone's testimony or professional performance, that would be looked into both by the director of the department and by the executive director at the hospital."

McCormick did not specifically identify areas of Thuma's testimony where he thinks the psychiatrist lied under oath. In Thuma's testimony on Oct. 27, however, he wound up on both sides of a question on whether he thought Toppila had "malingered" to sway the therapists who were evaluating him. There were also inconsistencies in Thuma's testimony over whether he was aware of evaluations done on Toppila before the Oct. 7, 2004, beating death of his 86-year-old mother, Hilma Tone.

Deputy District Attorney Dawn Bladet hailed the judge's ruling, saying in an e-mail: "Toppila's continued confinement in Napa State Hospital is necessary to protect the public safety interest."

Toppila's lawyer, Robert J. Saria, said Toppila and his client's family were disappointed by the ruling. Saria said Toppila "is committed to returning to Napa and pursuing his treatment plan and engaging in all the treatment he is required to."

Toppila, 68, a long-time licensed clinical social worker, stabbed his mother 52 times and also bludgeoned her in the fatal attack in her South Land Park apartment.

Judge McCormick said he was also disturbed by the testimony of Antonio Alocer, an official from the Central Valley Conditional Release Program, which would have coordinated Toppila's community placement if he was released from Napa. McCormick said no treatment plan had been determined for Toppila in the event of his release. The judge said Alocer "could not tell me" where Toppila would be placed.

Alocer could not be reached for comment Monday.

"I cannot state with any degree of certainty based on the evidence that I heard in this courtroom that Mr. Toppila no longer poses a danger to the health and safety of others," McCormick said.

Psychiatrist guilty of misconduct after freeing dangerous patient

From a Report out of Plymouth, England

A Plymouth psychiatrist who released a dangerous schizophrenic from a mental health ward hours before he tried to kill his mother was today found guilty of 'recklessly' putting the public at risk.

Dr Andrea Tocca described the 39-year-old as 'no danger to himself or others' and discharged him from Derriford Hospital in Plymouth, Devon, a day after he assaulted a female patient.

Soon after arriving home, the man, referred to as GA, told his mother: 'I know what I have to do to you' and battered her repeatedly over the head with a spade.

Dr Tocca was found guilty of misconduct after the GMC panel decided that he had 'recklessly put the public at risk' in releasing GA from the ward.

Panel chair Ralph Bergmann said: 'This panel is particularly concerned by your decision to discharge GA on April 25, 2006.

'You had been responsible for the care and treatment of GA for some three months prior to discharging him.'

Mr Bergmann said during this time he had been informed by the patient's previous doctor in Torquay that 'if GA became acutely psychotic, his mother may be at risk.

'He (the doctor) had also informed you that GA had made two very serious suicide attempts.

'The panel accepts the proposition put forward by your counsel that your conduct in discharging GA amounted to a single episode of significant error.

'However, you had access to GA's medical history, you had become very familiar with his condition and you ought to have been very alert to the risks and potential consequences of discharging him.

'Your decision to do so leaves the panel in no doubt that this was serious misconduct on your part.

'As the consultant psychiatrist responsible foe the care and treatment of a vulnerable patient, you behaved irresponsibly and recklessly in allowing GA to be returned to the community.

'You thereby put at risk not only the patient but also his mother and the public.

'Taking all these matters into account, the panel has determined that your fitness to practise is impaired because of your misconduct.'

The GMC panel will now consider whether to kick Dr Tocca out of the medical profession.

The hearing was told that Dr Tocca did not read GA's medical notes and decided to 'make up his own mind' about the patient.

On April 24, GA assaulted a female patient on the unit by holding her in a headlock and punching her.

His medical records show that he had also threatened other patients and believed that the staff on the unit were trying to kill him.

Marios Lambis, for the GMC, said: 'At 9.55am on April 25, Dr Tocca made an entry in GA's notes stating that in his view, that assault on the female patient was not a product of his mental state but rather a result of the high level of stress he was experiencing on the unit.

'He recorded that once the police had completed their investigation into the assault, he would discharge GA, and twenty minutes later he recorded: ''In my clinical opinion, GA is not detainable under the Mental Health Act and he is not really a danger to himself or to others.'''

In a statement read to the panel GA's mother, referred to as Mrs A, told the hearing that Dr Tocca telephoned on April 25 to say her son had assaulted a patient but he was sending him home.

[...]

The GMC heard that GA had developed brain damage after falling from a tree swing at the age of 12 and became 'passive and apathetic.'

In 1991, at the age of 22, he was admitted to hospital in Manchester with paranoid psychotic symptoms, the hearing was told.

Mr Lambis said: 'He would not let anyone into his flat, his furniture was broken and he was talking in an incomprehensible manner.

'He had become suspicious and withdrawn.'

In 1993, he was diagnosed with paranoid schizophrenia and was admitted to acute mental health units nine times over the following three years.

Two years later he made threats to kill his grandmother.

GA took an overdose in 2003 and was later sectioned.

On August 8 2005, he set fire to his mattress five times before lying on it and burning himself in a suicide attempt.

He spent 11 weeks in the burns unit at Frenchay Hospital in Bristol.

Dr Tocca admitted being told by GA's doctor that he became acutely psychotic his mother may be at risk.

He also admitted that he ought to have known that GA had made threats to kill his grandmother and had shown previous incidents of violence, and he discharged GH when he ought to have known he should not have been discharged.

Woman describes alleged abuse by psychiatrist

From a Report in the West Australian

A 62-year-old woman has described freezing with fear as her psychiatrist sexually abused her during a session for post-natal depression in the 1970s.

Former psychiatrist Alan John Stubley, 80, is on trial in Perth Supreme Court accused of forcing sex offences against two of his female patients in the mid-late 1970s.

One of the alleged victims today told the jury the doctor had abused her on her first face-to-face session after being discharged from a psychiatric hospital where Dr Stubley had treated her for post-natal depression.

She said she had been shocked when the doctor told her to sit on his knee.

“It was just a terrible silence and then he repeated it (in a tone that) was very authoritative, quite demanding,” she said.

“He put his hand on my leg and he rubbed his hand up my leg and between my legs.

“I just froze, I was just so afraid. I was afraid of him and what he might do to me.

“I said I didn’t want to do this.”

Prosecutor Alan Troy said Dr Stubley had abused his position by taking advantage of his patient’s vulnerability in the pursuit of his own sexual gratification.

He said the two women submitted to the sexual contact because they had felt intimidated.

Mr Troy said one of the victims, who continued seeing the doctor for decades, had feared that no-one would believe her if she spoke out at the time about the alleged abuse.

“She had recently been in a psychiatric hospital and she didn’t think anyone would believe her,” Mr Troy said.

Mr Troy said she also feared she would be put in an institution if she did not continue to see him.

Defence lawyer Mark Trowell said the sex between his client and the women was consensual and there had been no intimidation.

“This is not a court of morals…he may well have acted unprofessionally as a doctor but that doesn’t make him guilty of criminal charges,” Mr Trowell said.

Psychiatrist arrested

As reported in the Edison/Metuchen Sentinel

Apsychiatrist at a behavioral health center in Edison was arrested on Oct. 17 on the belief that he inappropriately touched one of his patients.

The suspect, Chowdhury M. Azam, a 54-year-old Monmouth Junction resident, was charged with criminal sexual contact, a fourth-degree crime. Criminal sexual contact is described in the state legal code as "intentional touching by the victim or actor, either directly or through clothing, of the victim's or actor's intimate parts for the purpose of degrading or humiliating the victim or sexually arousing or sexually gratifying the actor."

The arrest was made the same day the alleged victim filed a report with the Edison Police Department. Following the filing, the Middlesex County Prosecutor's Office Sex Crime/Child Abuse Unit and the Edison Police Department embarked on a joint investigation, eventually leading to Azam's arrest.

Azam has been a licensed psychiatrist with Compass Behavioral Health, located on Pierson Avenue. According to authorities, it is alleged that the psychiatrist inappropriately touched one of his patients on one occasion. The New Jersey State Board of Medical Examiners, the regulatory agency that licenses medical professionals, was informed of Azam's arrest.

According to police, Azam has been released on $50,000 bail set by Municipal Court Judge Craig Coughlin.

Authorities have not released details regarding the alleged victim's age or gender.

Authorities are currently seeking more information about the matter. Anyone with information regarding this investigation, or incidents similar in nature is encouraged to contact Investigator Raj Chopra of the Middlesex County Prosecutor's Office Sex Crimes/Child Abuse Unit at 732-745- 3600, or Detective Michael Michalski of the Edison Police Department at 732-248- 7525 anytime day or night.

12 Babies die during GlaxoSmithKline vaccine trials in Argentina

GlaxoSmithKline has long gotten into trouble for drugs (including psych drugs) that have had achieved notoriety for a variety of destructive side effects. Thus this most recent report does not come as a surprise, and is sadly revealing of the broader morals of the company

At least 12 babies who were part of a clinical study to test the effectiveness of a vaccine against pneumonia have died over the past year in Argentina, the local press reported Thursday.

The study was sponsored by global drug giant GlaxoSmithKline and uses children from poor families, who are "pressured and forced into signing consent forms," the Argentine Federation of Health Professionals, or Fesprosa, said.

"This occurs without any type of state control" and "does not comply with minimum ethical requirements," Fesprosa said.

The vaccine trial is still ongoing despite the denunciations, and those in charge of the study were cited by the Critica newspaper as saying that the procedures are being carried out in a lawful manner.

Colombian and Panama were also chosen by GSK as staging grounds for trials of the vaccine against the pneumococcal bacteria.

Since 2007, 15,000 children under the age of one from the Argentine provinces of Mendoza, San Juan and Santiago del Estero have been included in the research protocol, a statement of what the study is trying to achieve.

"Only 12 have died throughout the country, which is a very low figure if we compare it with the deaths produced by respiratory illnesses caused by the pneumococcal bacteria," pediatrician Enrique Smith, one of the lead investigators, said.

In Santiago del Estero, one of the country's poorest provinces, the trials were authorized when Enrique's brother, Juan Carlos Smith, was provincial health minister.

According to pediatrician Ana Maria Marchese, who works at the children's hospital in the provincial capital where the studies are being conducted, "because they can't experiment in Europe or the United States, they come to do it in third-world countries."

"A lot of people want to leave the protocol but aren't allowed; they force them to continue under the threat that if they leave they won't receive any other vaccine," said Julieta Ovejero, great aunt of one of the six babies who died in Santiago del Estero.

Fesprosa's Juan Carlos Palomares said that "in most cases these are underprivileged individuals, many of them unable to read or write, who are pressured into including their children" in the trials.

According to Fesprosa, "the laboratory pays $8,000 for each child included in the study, but none (of that money) remains in the province that lends the public facilities and the health personnel for the private research."

Convicted killer working as psychiatrist - Patients don't know he killed his wife

From the Sydney Morning Herald:

The family of a woman killed by her psychiatrist husband in 1987 is disgusted he was later able to be reregistered to practise.

Dr George Sliwinski shot his former wife Alice in 1987 and was sentenced to eight years' jail after pleading guilty to manslaughter on grounds of diminished responsibility.

Dr Sliwinski had been struggling with alcoholism and the use of prescription drugs, which during the 80s had led to a number of breakdowns and admissions to psychiatric hospitals.

After being released on parole in 1990, in 1994 Dr Sliwinski successfully appealed to the Medical Tribunal of NSW to be reregistered.

Since 1996 he has been employed as a psychiatric registrar at Gosford and Wyong hospitals.

The Australian Medical Association opposed his reappointment, Fairfax has reported.

News that Dr Sliwinski was again practising has alarmed his late wife's family, with the victim's sister, Noleen Tasoulis, saying it was "disgusting".

But Dr Sliwinski has been defended by his colleagues and NSW Health.

A spokeswoman for the Northern Sydney Central Coast Area Health Service said there had been no formal complaints about his work.

"All appropriate background checks required at the time of his employment were conducted," she said.

Senior psychiatrist Chris Tennant defended his colleague, saying Dr Sliwinski "met all the conditions imposed on him by the board".

Many of Dr Sliwinski's current patients do not know of his past, as he is under no obligation to tell them, Fairfax says.

Of course, there's been a small uproar over this discovery. We also have this extended report

NINE years after he shot and killed his wife, George Sliwinski was back in his job as a psychiatrist, treating mentally ill patients in public hospitals.

Dr Sliwinski himself had a history of mental illness. This led him to either leave or be dismissed from four medical facilities in the 1980s. In 1987, after a decade of chronic drug and alcohol abuse, he shot his former wife, Alice, four times, a month after their divorce. One of the shots, to her head, killed her.

But Dr Sliwinski was released on parole in 1990. And he was employed as a resident medical officer at the Central Coast Mental Health Service in July 1994, shortly after successfully appealing to the Medical Tribunal of NSW to be re-registered. The Australian Medical Association publicly opposed the re-registration.

Dr Sliwinski was employed as a psychiatric registrar at Gosford and Wyong hospitals in 1996, and continues in this role.

But, to this day, many of his patients are unaware of his past - and there is no obligation for DrSliwinski or authorities to tell them.

The case of Dr Sliwinski raises difficult issues of a patient's right to know the record and background of their doctor and the ability of someone to redeem themselves and begin a new life.

In 1994 the Medical Tribunal said it had "some difficulty" deciding whether he was fit to be a doctor. But it concluded he was suitable because he did not intend to kill his wife, had no history of violence and was supported strongly by three psychiatrists who gave evidence that he had been fully rehabilitated and was very unlikely to relapse.

And yet questions remain unanswered. The Health Department will not reveal how it monitored Dr Sliwinski to ensure he met strict conditions imposed by the tribunal, such as regular urine and/or blood tests, psychiatric treatment and constant supervision. The tribunal also appeared to be unaware that Dr Sliwinski's wifealleged he had a history of violence against her. It found the killing was an "isolated occasion", despite her allegations, set out in an Apprehended Violence Order summons issued in the year before her death.

The Royal Australian and New Zealand College of Psychiatrists - which is responsible for ensuring the suitability of psychiatrists - has refused to comment on what processes it undertook to assess him. And in the 1990s the NSW Medical Board was not required to independently notify employers of a doctor's restrictions. A spokeswoman for the board, Edwina Light, said it was prohibited from revealing why DrSliwinski's strict conditions were lifted in 1999.

Doctors are not legally obliged to tell patients they are working under conditions or have been deregistered in the past, and the Health Department has no policy requiring disclosure.

Dr Sliwinski went on trial in the Supreme Court for the murder of Alice on October 1, 1987, a month after they divorced.

He pleaded guilty to manslaughter on the fourth day of his trial, in 1988, and was sentenced to a maximum of eight years' jail.

He had shot Alice four times but said he could not recall the incident and successfully argued diminished responsibility because of his intoxicated state.

In sentencing him, Justice Ray Loveday said there was no motive for the killing and described it as "quite bizarre".

According to the tribunal's 1994 judgment, he had been abusing alcohol and a cocktail of prescription drugs, mostly tranquillisers, for almost a decade and had sought psychiatric help several times from 1979, including stays at psychiatric hospitals in 1985 and 1987. He feared "dying and going mad".

His drinking dated back to the late 1960s, when he drank on the job as a medical trainee because he found attending cancer wards difficult.

His father died of bone cancer when Dr Sliwinski was 11 and his mother had schizophrenia.

The drug addiction began in 1977 after his first wife, Barbara, left him with their children and a doctor gave him Serepax after he was unable to administer anaesthesia due to a panic attack at Moree Hospital.

However, in its judgment in 1994 the tribunal concluded that Dr Sliwinski was not an intrinsically violent person. "[The shooting] does not indicate a tendency to vice or violence or any lack of probity. It has neither connection with nor significance for any professional function. There is no evidence that the appellant [previously] committed acts of violence towards his ex-wife or any other person …" the tribunal said.

However, a summons was issued to Dr Sliwinski over an allegation that he assaulted her by attempting to choke her in August 1986.

The AVO application, seen by the Herald, alleged that Dr Sliwinski, who had been drinking heavily, said to his wife, "If I hear you have done anything to foul up my career I will kill you", and had assaulted her three or four times during their five-year marriage. The AVO was withdrawn by his wife.

Three years before the killing, he was twice told to take sick leave from his job as a psychiatric registrar at Morriset Hospital due to his depressed mental state and concerns that he was suicidal.

He was also told to take sick leave from the Mater Hospital in Newcastle not long after that.

In 1987 he was sacked from a practice at Kilburn Bay and told to seek psychiatric help. He had come to the North Coast after he left Moree Hospital in 1980 after "difficulties with the Medical Board, [and] with the Hospital Board", and moved to Newcastle, the tribunal said.

He had been investigated by the Medical Board for failing to attend to an unconscious patient at Moree who had had a stroke, and was cautioned over the incident.

A spokeswoman for the Northern Sydney Central Coast Area Health Service, Jenny Dennis, said: "All appropriate background checks required at the time of his employment were conducted." She later confirmed "this included the NSW Medical Board".

"Central Coast Mental Health Service can confirm that Dr Sliwinski complied with the restrictions placed on him by the Medical Board," she said. She said there had been "no formal complaints about his work".

Ms Light, said it was the responsibility of the Royal Australian and New Zealand College of Psychiatrists to determine whether Dr Sliwinski was fit for psychiatry. The college would not comment.

The board's registrar, Andrew Dix, said it regularly monitored conditions. "It's up to the doctor to comply but if they don't comply we know about it very quickly because we've got a data base following this," Dr Dix said.

Alice's sister, Noleen Tasoulis, said the family was devastated that Dr Sliwinski was practising psychiatry. "I think it's disgusting," Mrs Tasoulis said.

She alleged that at the time of his marriage to her sister he was a "violent" alcoholic and her sister supported him with $335,000 she won in a lottery just before they married. "The seven years that he was married to my sister … he was in various [psychiatric] clinics … so it seems rather unbelievable that he could even practise."

Dr Sliwinski had a solicitor, Denis Williams, contact the Herald to arrange an interview yesterday to respond to questions about his past and what monitoring he was subjected to by the area health service.

Dr Sliwinski did not show up but a senior psychiatrist, Chris Tennant, who is a visiting medical officer at Gosford and Wyong hospitals, did, and strongly defended him.

Professor Tennant said "he met all the conditions imposed on him by the board".

He said whether he told the tribunal he was considering a career in psychiatry was irrelevant. "It's not their business," he said.

He declared the Herald "mother f---ers" after the meeting.

Mr Williams said Dr Sliwinski's suitability had been "extensively considered" by the college and the tribunal. "There's been no record anywhere of this bloke not doing the right thing since the day he was readmitted," he said.

Asked whether Dr Sliwinski divulged to the tribunal that there had been other allegations of assaulting his wife, Mr Williams said: "It's too long ago."

Asked about the alleged threat Dr Sliwinski made to his wife that he would kill her, Mr Williams said: "I think we'll end this now. Goodbye."

Are Food Dyes Fueling Kids' Hyperactivity?

ABC News has a report this evening on a request to ban 8 different food colorings from foods sold in the USA. Naturally, the food companies are not pleased. You can see the original press release here:

CSPI Urges FDA to Ban Artificial Food Dyes Linked to Behavior Problems

From the ABC News Report:

The Center for Science in the Public Interest today called on the Food and Drug Administration to ban artificial coloring in all U.S. foods based on a controversial claim that artificial coloring is behind the rise in kids' behavioral problems, like Attention Deficit Hyperactivity Disorder.

"I think it's crystal clear the dyes affect kids' behavior," said Michael Jacobson, executive director of the Center for Science in the Public Interest in Washington, D.C. "The tougher questions are how many kids, and to what extent is their behavior affected? But time is long overdue to get rid of these dyes from the food supply. Let scientists study them in a laboratory."

[...]

Judy Mann of Silver Spring, Md., whose 10-year-old son Jake Kushner suffers from ADHD, said she had tried everything to confront her son's disorder, such as eliminating gluten, eating organic and visiting a psychiatrist and a psychologist.

After looking at the ingredients in buttered movie theater popcorn following one of Jake's outbursts, she became convinced that food dyes played a part in his explosive behavior.

"We started not eating popcorn at the movie theater and he stopped having problems after the movies," Mann said.

"And then a few weeks after, he had five Skittles … and he hit the roof," she added. "And that's when we were sure it was the dyes and not the sugar. And since we've cut them out, it's been an amazing difference."