Why should this posting be reviewed?
See also Guidelines for Comments and Corrections.
Thank you for taking the time to flag this posting; we review flagged postings on a regular basis.close
Post Your Discussion Comment
Please follow our guidelines for comments and review our competing interests policy. Comments that do not conform to our guidelines will be promptly removed and the user account disabled. The following must be avoided:
- Remarks that could be interpreted as allegations of misconduct
- Unsupported assertions or statements
- Inflammatory or insulting language
Reader Comments (2)
Post a new comment on this article
Re: Phillips CB (2006) Medicine Goes to School: Teachers as Sickness Brokers for ADHD
Posted by plosmedicine on 30 Mar 2009 at 23:54 GMT
Author: Fred Baughman
Position: Retired neurologist/child neurologist
Institution: No affiliation was given
Submitted Date: May 11, 2006
Published Date: May 15, 2006
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.
Re: Phillips CB (2006) Medicine Goes to School: Teachers as Sickness Brokers for ADHD. PLoS Med 3(4): e182
To the Editor,
Phillips writes: "ADHD joins dyslexia and glue ear as disorders that are considered significant primarily because of their effects on educational performance." A "disorder" is "A disturbance of function, structure, or both," and thus, the equivalent of an objective abnormality/disease. 
In neurologically normal children, dyslexia cannot be proved to be a disorder/disease. "Glue ear," however, is otitis media, an objective abnormality/disease.
Phillips continues: "In the case of ADHD, there has been a complex, often heated debate in the public domain about the verity of the illness..." but proceeds, without an answer, to consider "the roles of teachers as brokers for ADHD and its treatment..."
In 1948, 'neuropsychiatry' was divided into 'neurology,' dealing with diseases and 'psychiatry,' dealing with emotions and behaviors .
If there is a macroscopic, microscopic or chemical abnormality, a disease is present. Nowhere in the brains or bodies of children said to have ADHD or any other psychiatric diagnosis has a disorder/disease been confirmed.
Psychiatric drugs appeared in the fifties. Psychiatry and the pharmaceutical industry authored the "chemical imbalance" market strategy: they would call all things psychological "chemical imbalances" needing "chemical balancers" - pills.
At the September 29, 1970, Hearing on Federal Involvement in the Use of Behavior Modification Drugs on Grammar School Children, Lipman of the FDA, argued: "hyperkinesis is a medical syndrome. It should be properly diagnosed by a medical doctor."
In 1986, Nasrallah, et al , reported brain atrophy in adult males treated with amphetamines as children, concluding: "... since all of the HK/MBD patients had been treated with psychostimulants, cortical atrophy may be a long-term adverse effect of this treatment."
On December 22, 1994, Leber of the FDA wrote me: " no distinct pathophysiology... has been delineated."
At the 1998 Consensus Conference, Carey  stated: "The ADHD behaviors are assumed to be largely or entirely due to abnormal brain function. The DSM-IV does not say so but textbooks and journals do." "What is now most often described as ADHD... appears to be a set of normal behavioral variations..."
However Swanson and Castellanos  having reviewed the structural-MRI research testified: "... ADHD subjects have on-average 10% brain atrophy." Baughman  challenged Swanson, asking: " why didn't you mention that virtually all of the ADHD subjects were on stimulant therapy--the likely cause of their brain atrophy?" Swanson confessed this was so--that there had been no such studies of ADHD-untreated cohorts.
The Consensus Conference Panel concluded: " ...we do not have a valid test for ADHD... there are no data to indicate that ADHD is a brain malfunction."
In 2002, Castellanos  published the one-and-only MRI study of an ADHD-untreated group. However, because the ADHD-untreated subjects were 2 years younger than that the controls, the study was invalid, leaving stimulant treatment, not the never-validated disorder, ADHD, the likely cause of the brain atrophy.
In 2002, Weinberger, of the NIMH , claimed "major psychiatric diseases"...are associated with "subtle but objectively characterizable changes" but could reference not a single proof.
In 2002, the Advertisement Commission of Holland  determined that the claim that ADHD is an inborn brain dysfunction was misleading and enjoined Brain Foundation-Holland to cease such representations.
In 2003, Ireland prohibited GlaxoSmithKline from claiming that the antidepressant, Paxil "works by bringing serotonin levels back to normal." Goodman of the FDA , acknowledged that claims that SSRIs correct a serotonin imbalance go "too far," but had the temerity to suggest: "this is reasonable shorthand for expressing a chemically or brain-based problem."
At an FDA hearing, March 23, 2006, I , testified: 'Saying any psychiatric diagnosis "... is a brain-based problem and that the medications are normalizing function," is an anti-scientific, pro-drug, lie. Yet this has become standard practice throughout medicine, as at the APA , AMA , AACAP, AAP, CNS, AAFP , FDA  and virtually all government health care agencies.
Journal articles , press releases, ads  inserts and research, informed consent documents, say, or infer that psychological diagnoses are abnormalities/diseases. All patients and research subjects with psychological problems are led to believe they have an abnormality/disease, biasing them in favor of medical interventions, and against non-medical interventions (love, will-power, talk therapy), which presume, as is the case, that the individual is physically/medically normal and without need or justification for a medical/ pharmaceutical intervention.
The FDA is the agency most responsible for conveying the facts needed by the public to make risk vs. benefit/informed consent decisions. Instead--protecting industry, not the public--the FDA is a purveyor of the psychiatric "disease"/ "chemical imbalance" lie. This must change.
1. Stedman's Medical Dictionary, 25th Edition, Baltimore, MD, 1990
2. American Academy of Neurology: The First 50 Years, 1948-1998. Cohen MM (ed). AAN, St. Paul, MN. 1998:1-8.
3. Nasrallah et al. Cortical atrophy in young adults with a history of hyperactivity in childhood. Psychiatric Research, 1986;17:241-246.
4. Carey, WB. Is Attention Deficit Hyperactivity Disorder A Valid Disorder? NIH Consensus Conference on ADHD, November 16-18, 1998.
5. Swanson J, Castellanos FX. Biological Bases of Attention Deficit Hyperactivity Disorder. NIH Consensus Development Conference on ADHD (p 37-42, program and abstracts), November 16-18, 1998, National Institutes of Health, Bethesda, MD
6. Baughman FA. Challenge from a floor microphone of presenter James M. Swanson at the NIH Consensus Conference on ADHD, November 16-18, 1998.
7. Developmental Trajectories of Brain Volume Abnormalities in Children and Adolescents With Attention- Deficit/Hyperactivity Disorder F. Xavier Castellanos, Patti P. Lee, MD; Wendy Sharp, MSW; Neal O. Jeffries, PhD; Deanna K. Greenstein, PhD; Liv S. Clasen, PhD; Jonathan D. Blumenthal, MA; Regina S. James, MD; Christen L. Ebens, BA; James M. Walter, MA; Alex Zijdenbos, PhD; Alan C. Evans, PhD; Jay N. Giedd, MD; Judith L. Rapoport, MD JAMA. 2002;288:1740-1748 .
8. Weinberger D. Quote in Neuroimaging Advances Offer New Data on Stroke Detection and the Genetics of Mental Illness, in Neurology Today, June, 2002, p 26-28, by Gail McBride.
9. Holland's Advertisement Code Commission on ADHD In the case:Nederland Comite voor de Rechten van de Mens (CCHR), domiciled in Amsterdam, plaintiff. :The Brain Foundation Netherlands, domiciled in the Hague, defendant Decision of the Advertisement Code Commission (Chamber II)4th of July 2002.
10. Wayne K. Goodman, MD Chair of the US Food and Drug Administration (FDA) Psychopharmacologic Drugs Advisory Committee, quoted in Canadian Medical Association Journal, March 14, 2006. SSRI ads questioned. Colin Meek. Wester Ross, Scotland
11. Baughman FA. The "Chemical Imbalance" Lie. (Testimony to the March 23, 2006, hearing of the Psychopharmacologic Drugs Advisory Committee Testimony).
12. American Psychiatric Association. Definition of Mental Disorders; xvi. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, 1994. Washington, DC.
13. Baughman FA. Treatment of Attention-Deficit/Hyperactivity Disorder. JAMA. 1999:281; 1490.
14. Baughman FA. Diagnosis and Evaluation of the Child with Attention-Deficit/Hyperactivity Disorder. PEDIATRICS. 2001, 107: 1239.
15. Lacasse JR, Leo J (2005) Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLoS Med 2(12): e392