ADD Hyperactivity Linked to Lax Parenting

Hundreds of thousands of children prescribed the drug Ritalin for hyperactivity might simply be the victims of lax parenting, new evidence suggests. A British scientist has cast doubt on the existence of conditions such as attention deficit disorder (ADD), which will fuel the controversy over the increasing use of Ritalin.

Warwick Dyer, a behavioural expert, claims parents need to accept more blame for their children's "disorders" and move away from the chemical cosh of prescription drugs. He has developed a programme that focuses on the way parents behave towards their children - and claims a 100 per cent success rate over the past five years. Remarkably, he never sees the child involved, and has just one face-to-face consultation with the parents. The rest of his work is limited to a daily telephone briefing with the parents on how to treat their child.

Mr Dyer's theory is based on simple ideas such as a rigid system of rewards and sanctions for good and bad behaviour, with an insistence on politeness towards parents - and a demand that mothers and fathers control their tempers as well.

Mr Dyer said: "I am open-minded about whether ADD exists or not, but what is certainly clear is that a lot of symptoms ascribed to such disorders are in fact easily confused with basic behavioural problems that don't need to be treated with a drug.

Ritalin is an amphetamine with a similar potency to cocaine, and prescribing in Britain has soared one hundredfold in the past 10 years. In 1990, just 3,000 children were on the drug; today, there are 345,000 taking it, costing the NHS more than £3m a year. The drug is being given to children as young as 18 months old.

Now a growing lobby of parents, doctors and other experts is questioning whether ADD or ADHD exists at all.

In this context, this item is of interest:

Letter to the editor Old-fashioned values would benefit classrooms

as well as this one

The number of children taking the controversial drug Ritalin has jumped sharply, official British figures reveal. The BBC reports that the number of prescriptions for the drug increased by 22% last year. and that the number of children taking the drug in England now tops 254,000, double what it was five years ago.

Utah wilderness therapy deaths

The Salt Lake Tribune has an interesting collection of stories on a local widerness therapy program that has resulted in the deaths of children, and which has come under heavy scrutiny.

• A wilderness therapy program heads to court (7/14/2003)
  
• Therapy victim's mom seeks accountability for deaths (7/14/2003)
  
• A Deadly Path (7/13/2003)
  
• Utah wilderness therapy deaths (7/13/2003)
  

A widely circulated list of "wilderness therapy program" deaths includes the names of more than 30 teens who have died in other states. Research by The Salt Lake Tribune shows some teens were in wilderness programs, while others were in boot camps, therapeutic boarding schools or centers and correction facilities.

This type of facility has attracted strong criticism See also this Open Letter to the American Psychological Association opposing corporal punishment (and by implication, programs using corporal punishment) on the basis of the damage such punishment does to young and growing minds.

Highland doctors 'illegally detained mental patients'

As reported in Scotland on Sunday, mental patients were illegally detained by doctors who had no authority to take away their liberty. At least 18 people were wrongly committed by Highland doctors, according to a whistle-blower who claims she has since been forced out of her job as a medical records officer.

Aileen MacDonald said she told Highland Primary Care Trust two years ago that at least one consultant was not on the list of psychiatrists approved as competent to request detention in a mental hospital under the Mental Health Act. MacDonald said at least 18 patients over a period of nine to 12 months were detained, mostly at New Craigs Hospital in Inverness, under invalid orders made as a result of the oversight. The NHS’s own solicitors told her in writing that the problem could lead to any of the detention orders being deemed automatically invalid.

Psychiatric Classifications Not Based on Evidence

The Atlanta Journal Constitution has picked up on that study in the BMJ:

Specifically, the researchers, writing in the July 19 issue of the British Medical Journal, attack the Diagnostic and Statistical Manual of Mental Disorders (DSM) -- the bible for psychiatric diagnoses -- for failing to reflect the biology of different conditions.

[...]

Most people would agree that a fundamental problem in psychiatry concerns categories that are descriptive, arrived at by consensus among experts and not through evidence. The simple reason is that experts don't have the kind of pathophysiological evidence required to create and sustain clear-cut categories.

(emphasis added)

need I say more?

Do psychiatrists even know what they are doing?

Serious flaws in the way doctors classify psychiatric disorders have sent drug development way off track, two scientists assert in a paper in the British Medical Journal

As seen in this news report one of the scientists puts it this way:

"We need to take all of our copies of the DSM and throw them into the sea," cries Edward Shorter, lead author of the article and a professor of the history of medicine at the University of Toronto in Canada. "There are such fundamental flaws that the whole thing needs to be rethought. We need to have indications that correspond to natural, underlying disease processes."

The research paper has this take on who defines the diseases in the first place:

Who defines psychiatric diagnoses?

Officially, diagnostic decisions are made through scientific consensus by the World Health Organization and the American Psychiatric Association. Small committees of experts decide whether, for example, schizophrenia is one disease or several, and the process of decision making should be transparent and based on good scientific evidence. But sometimes the evidence is poor and influenced heavily by the pharmaceutical industry. The industry exerts a major influence through publication of sponsored supplements to journals, which are often poorly peer reviewed and promote unapproved treatments.8 Such supplements are particularly common for drugs for anxiety and depression as these are the most common treated conditions. Worldwide sales of antidepressants dwarf sales of drugs for all other psychiatric disorders.

Industry is said to prefer the disease based approach of DSM-III to any dimensional approach to illness definition. This is because the separate DSM-style diseases represent tidy diagnostic market niches. Every new diagnosis represents a new licensing opportunity. Companies only have to show the effectiveness of an existing drug over placebo for the new diagnosis in large clinical trials. This is expensive but not difficult if the same methods can be used as for previous studies with the old diagnoses.

But the basic symptom for all this is seen as the lack of speedy development of more drugs, instead to acknowledging the more fundamental problem:

Ultimately, the same original problem returns: deficits in the understanding of the basic science of psychiatric disorders. Both the DSM and drug developers are hampered by the same deficiency. In other words, they don't know what they're doing.

Of course, the news article tries to end on an upbeat note for psychiatry. Almost sounds like whistling in the dark.

Adult ADD: Common disorder or marketing ploy?

CNN has a reasonably decent article on the controversial advertising campaign by Eli Lily pushing their medication for treatment of "Adult ADD"., entitled "Adult ADD: Common disorder or marketing ploy?" As one doctor is quoted:

some ethicists said the ad campaigns, paired with education programs for physicians, may result in people receiving drugs who don't really need them.

"I am worried that what you're going to do is generate a disease rather than respond to a problem," said Art Caplan, a bioethicist at the University of Pennsylvania.

Some experts said they find at least parts of the screening tool too broad, with questions such as, "How often do you have difficulty waiting your turn in situations when turn taking is required," asking respondents to choose never, rarely, sometimes, often or very often.

"I've yet to meet the person who says, 'Oh, I really love waiting in line. The longer the line the better,' " said Dr. Edward Hallowell, a psychiatrist and author of the best-seller "Driven to Distraction: Recognizing and Coping With Attention Deficit Disorder From Childhood Through Adulthood."

Caplan said, "Trying to hook a potential user of your drug by this type of questionnaire technique just strikes me as ethically suspicious."

ethically suspicious?

Of course, CNN tries to be fair to both sides, which tends to gloss over this 'minor' detail.

Former psychiatry professor charged with murder and kidnapping

A former Marshall University professor of psychiatry has plead not guilty by reason of insanity to charges of murder and kidnapping in a Scioto County [West Virginia] Courthouse. John M. Adams, 59, of Barboursville, was indicted on charges of aggravated murder, aggravated burglary and three counts of kidnapping earlier this week. Adams is accused of shooting to death Bobby Burns, a community development director, on July 2 in Portsmouth and then kidnapping two women and forcing them to drive him to the Kentucky border, where he had a brief standoff with police. Adams is a former associate professor of psychiatry at Marshall University, according to Dave Wellman, director of communications at Marshall.

Tenet Healthcare Corp indicted on Illegal Kickbacks

A federal grand jury Thursday indicted two subsidiaries of Tenet Healthcare Corp. on charges they paid illegal kickbacks to doctors who referred patients to a San Diego hospital. Between 1992 and 2002, Tenet HealthSystem Hospitals Inc. and Alvarado Hospital Medical Center Inc. paid more than $10 million to a fund that helped recruit doctors to the area, purportedly to fill needs in Alvarado's service area, according to the 17-count indictment returned in San Diego.

Of special note:

In 1994, Tenet -- then known as National Medical Enterprises -- pleaded guilty and paid $325,000 to settle a federal investigation into illegal payments to physicians who referred patients to its psychiatric hospitals.

so it looks like more of the same?

Therapist in jail for ''Fondling Therapy"

And then we came across this item

After treating a young woman for depression a counselor decided that what she really needed was a course of the alternative approach "touching therapy". This led to sex during treatment and now a prison sentence for the therapist.

The woman, single, depressed and psychologically unstable, approached the man's counseling office for help in 1999, when she was aged 22. After several months of alternative treatment, which included conversation, yoga, and meditation, the man decided to embark on 'touching therapy', which basically involved him fondling the patient.

The woman, who had been hospitalized several times for depression, signed up for the 51-year-old man's therapy, which he marketed as "psycho-social anthropological treatment".

Abuse Hell of Tasmanian state ward

As seen in this report

When Tasmanian authorities placed Stephen Barry Randall into state care, they thought they were acting in his best interests. But instead, the five-year-old was subjected to years of sexual and physical abuse at the hands of the very people who were supposed to be protecting him.

Mr Randall launched a civil court action against the State of Tasmania, claiming the people who made him a ward of the state had failed in their duty of care to protect him.

A long sad tale.

Identity Rape: Psych exposed women without their consent

Two transsexual woman featured in Northwestern psychology Prof. J. Michael Bailey's latest book about sexuality have filed complaints with NU, alleging that Bailey did not ask for their consent before using their stories. They have sent a complaint to NU's Vice President for Research C. Bradley Moore asking for a formal investigation of Bailey's research methods. Another woman featured in the book filed a claim July 14 supporting Kieltyka's letter, but an addendum to the claim keeps her name confidential.

Anjelica Kieltyka, who is mentioned in Bailey's "The Man Who Would Be Queen" under the pseudonym "Cher," said she met Bailey while working as a transsexual women's advocate. Between 1994 and 1998, Bailey agreed to interview the women and write letters they needed to qualify for sex reassignment surgery, which Kieltyka had in 1991. Kieltyka said Bailey did not tell the women they would be featured in his book or ask them to sign consent forms. "We didn't even know we were guinea pigs," Kieltyka said.

The issue has received some publicity through the Web site of Lynn Conway, a professor emerita of electrical engineering and computer science at the University of Michigan who transitioned to being female in 1968. In a June 23 letter, Conway advised NU officials to begin investigating Bailey's research methods.

What we seem to have here in these reports is a fundamental disregard by this psychiatrist for the rights and privacy of these human beings, exploiting them for his own profit. In a way it could be considered a form of identity rape.

Psychiatrist pleads guilty to drug conspiracy

As reported in the Kansas City Business Journal

A Leawood psychiatrist has pled guilty to one count of conspiracy to dispense prescription drugs. Bruce Parsa, 40, pled guilty before U.S. District Judge G. Thomas VanBebber to the conspiracy charge on Tuesday. Parsa had pleaded guilty on June 13 to four counts of intentionally using a revoked registration number to get prescription drugs.

According to U.S. Attorney Eric Melgren's court statement: Parsa admitted that between January 2000 and Dec. 17, 2001, while he was employed as a psychiatrist in Leawood and Leavenworth, he conspired with others to dispense a large amount of amphetamines and narcotics. Parsa also admitted that he had issued more than 200 prescriptions during those dates that were outside the scope of his professional practice and not for legitimate medical purposes.

The psychiatrist faces a maximum of 20 years in federal prison without parole. Sentencing is scheduled for October. See also these related stories

It almost sounds like the shrink was selling the drugs inside the prison system, but there is not enough info at hand to verify this speculation at this writing.

Dropping a Doctor like a Hot Potato

As seen in the Health Sciences Institute e-Alert newsletters


Risperdal (the brand name for risperidone) is the most frequently prescribed antipsychotic medication in the U.S. The FDA has approved Risperdal for the treatment of schizophrenia, but it is not approved for children. Of course, that doesn't prohibit doctors from prescribing the drug for a child - even if the young patient has been diagnosed with a condition far less severe than schizophrenia.

Here's Carrie's experience, in her own words: "Doctors are giving Risperdal to children in droves. However, I called the drug company up and they do not recommend it for kids, nor has it been approved by the FDA for children.

"A doctor prescribed it for my son who is 8. I dropped the doctor like a hot potato. They are using Risperdal on children with ADHD to help control them. It can cause incurable disease in children and it is causing strokes and killing the elderly. I talked with a lawyer and was told some parents are giving it to their children who are only 2 and 3 years old."

If you're a longtime HSI member and regular e-Alert reader, then you're probably not wondering how a large group of doctors - independent of one another - would decide to prescribe a potent schizophrenia drug to young children. They do it because salespeople for the drug company encourage them to prescribe "outside the box." Meanwhile, the manufacturer's customer service representatives are telling people on the phone that the drug is not recommended for kids.

Great system: Give the "insider" spin to doctors to pump up sales; give the politically correct spin to consumers; everybody wins. Except the kids..

Interesting Newsletter. Also seems to give decent info for parents, etc.

Shocked! Hall of Shame

As described on the website:

Welcome to the Shocked! Hall of Shame. Here we present the very worst in ECT practitoners and researchers. To be included in the ECT Hall of Shame, candidates must prove dedication to condescension towards patients (there, there, little woman, don't you worry...dr. daddy knows what you need), failure to present the whole truth about the treatment, and general disregard for honesty and respect.

If you have a candidate for the Hall of Shame email awards@ect.org with the information. Write a letter explaining why you think your candidate should win this prestigious award. If you have a photo, include that. Otherwise I have to find a silly cartoon. (Note, if you simply email and say "Dr. So and So should be in the HOS" that won't do. I need to know WHY.)

We eagerly await the 2003 nominees

Dr. Judith Reisman on "Kinsey's kooky shrinks"

Dr. Judith Reisman has an column in the World Net Daily about the psychiatric movement to legalize pedolphia.

She is not happy. In fact, she is plenty irate:

You heard right. The movement to legitimize pedophiles has been gathering steam for some time. In the late 1980s, for example, during the two years I spent as principal investigator for a U.S. Department of Justice study on "Images of Children, Crime and Violence" in mainstream pornography, my research team encountered a stable of paid pornography agents we dubbed "Academic Pedophile Apologists."

Like carnival hawkers, these Academic Pedophile Apologists – college professors, psychiatrists and other mental-health professionals – have served as advisers, writers and "expert" witnesses, telling medical, academic, public school, court and government authorities that the barbaric pedophile crimes of child sexual abuse are harmless and, some said, beneficial.

Now, things have gone so far downhill that this May, the American Psychiatric Association (APA) was walking the Academic Pedophile Apologist tightrope, actually publicly debating a proposal for "Lifting [The] Pedophilia Taboo."

and, as detailed in the column, there are more conferances coming up.

Patients Sue Over Psychiatric Abuse

In New Zealand, around 90 former psychiatric patients are suing the Crown [i.e., the Government], alleging they were abused during their time in hospital. They are claiming damages, saying they were sexually abused, assaulted, locked in solitary confinement and had electro-therapy used on them.

This looks like this will be a big case in New Zealand.

Psych in sex case to get new trial

The Wisconsin state Supreme Court Tuesday has ordered a new trial for a psychiatrist convicted of sexually exploiting a patient, reversing a state appeals court ruling. The court ruled unanimously that James Thiel deserved a new trial because his attorneys then didn't investigate witnesses thoroughly enough or review all the information about the case. A La Crosse County jury convicted Thiel on seven counts of sexual exploitation by a therapist following a trial in 2000.

He was arrested in 1999 after a former patient accused him of having a sexual relationship with her from May 1997 until February 1999. La Crosse County Circuit Judge Dale Pasell sentenced him to four years in prison and 10 years of probation.

There were a number of small errors by defense attorneys that, individually, and by themselves, probably would not have caused the order for a new trial. But taken together....

Newer Antidepressants Can Harm Newborns

Infants whose mothers take certain anti-depressents known as selective serotonin reuptake inhibitors (SSRIs) during the late stages of pregnancy may suffer neurological problems during their first weeks of life. So says a Finnish study in the July issue of The Archives of General Psychiatry. As noted in the report:

Although these effects seem to subside quickly, they may expose the infants to more serious neonatal complications such as convulsions,"

wonderful

Reports detail psychiatrist's mistreatment of patient

Officials in Oregon are investigating allegations of abuse by a senior psychiatrist at the Oregon State Hospital in Salem.

The allegations against Dr. Charles E. Faulk, 53, were outlined in Department of Human Services investigative reports and other records obtained Monday by The Oregonian. They have found that he denied medications to a severely mentally ill patient, causing the man to unduly suffer for months. Apparently Dr faulk cut off the medicine for a severly psychotic inmate, essentially abandoning him and apparently doing nothing significant to help him out. Records show that Faulk, the ward's full-time psychiatrist, visited his ailing patient only once during that period, and ignored repeated staff warnings that Norton was "decompensating."

The patient, Neil Norton, 59, lost nearly 40 pounds, frequently cried through the night and became persuaded that someone had left a dead fetus near a soda machine on the ward. Faulk had cut Norton off his medications in June 2002 after accusing him of being "a pill seeker." When Faulk finally intervened in January, 2003, he did so with six electroshock treatments.

According to the report, Dr. Faulk is paid $9,756 a month.

Additional Note: Four years earlier, Dr. Faulk nearly lost his medical license for what the Oregon Board of Medical Examiners called "habitual or excessive use of intoxicants or drugs."

Additional Note: This comes at a time of increasing scrutiny for the hospital, which receives nearly half of the state's budget to care for the mentally ill yet serves only 1.5 percent of them.

Other Accusations: The patients claimed that Faulk had called one a "homicidal maniac" and told another, "You are the worst patient I have ever had." The alleged abuse also included Faulk telling a Cuban patient to "go back to where you came from." Many of those allegations were never investigated by the Human Services Department because they did not constitute abuse under Oregon law, officials said.

...............

The criticism in the report is for taking the guy off his medications. But obviously, if the guy got better, there would not have been a problem. The response seems to have been to brutalise the patient further instead of doing something effective.

So it seems like he didn't know how to deal with the guy without the patient being in a chemical straight jacket. and instead drove him over the edge further. Not a pretty picture.

update: this story has been picked up by the AP Press wire

Riverside Hospital, Washington DC - Site of Extensive Troubles

Riverside Hospital, the largest psychiatric facility for troubled children in Washington DC, is being revealed in the Washington Post as the site of a number of sex crimes and other forms of child abuse. There have been many allegations of profiteering at the expense of the health and actual care of the kids

Among many disturbing details"

In June 2002, a 12-year-old boy was sexually abused by his 15-year-old roommate after Riverside employees ignored his expressed fears. In December, a 13-year-old girl performed sexual favors for an employee in exchange for snacks, carryout food and help in escaping. In January, an employee threw a 13-year-old boy against a wall and slammed him to the floor.

The same month the 12-year-old was abused, city monitors examining treatment and conditions at Riverside said they were concerned by the frequent use of psychotropic drugs to control behavior, poor upkeep inside the facility, staff turnover and a failure to adequately supervise the children.

Two former employees, including the former associate administrator, said that children were admitted to the locked-down facility even though they didn't appear to have serious psychiatric problems. A parent and a court-appointed mentor said that it was hard to get the hospital to discharge two particular children, even when they appeared to have improved. [...]

One D.C. Superior Court judge who sent children to Riverside in the past has almost entirely stopped. In an April 2002 letter to the city's child protection and mental health agencies, Judge Nan R. Shuker questioned whether it was a financial "conflict of interest" for the hospital to perform court-ordered evaluations of children who could end up receiving expensive long-term care in a Riverside bed.

The Washington Post has an extensive expose at the link. and this is just the tip of that particular iceberg.