The Rise and Fall of ADD/ADHD

The 1950s were the dawn of the ‘age of psychopharmacology’--drugs for emotional/behavioral problems in physically", default", normal persons.

by Fred A. Baughman Jr., MD 9/25/00

In 1948, 'neuropsychiatry' was divided into ‘neurology,’ dealing with organic/physical diseases of the brain, and ‘psychiatry,’ dealing with emotional/behavioral conditions in normal human beings [1]. There was no such thing as a psychiatric ‘disease’ then, and there is no such thing today!

The 1950s were the dawn of the ‘age of psychopharmacology’--drugs for emotional/behavioral problems in physically, normal persons.

Between 1952 and 1994, the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual (DSM) grew from 112 ‘disorders’/ ‘diseases’ in 1952 [2], to163 in 1968 [3], 224 in the 1980 [4], 253 in 1987 [5], and 374 in the 1994 [6].

The ADHD, ‘epidemic’ (by whatever name) has grown from 150,000 in 1970, to a half million in 1985, a million in 1990, and to 6 million today—12-13% of the nation’s schoolchildren.

In the 60’s, psychiatry and pharmaceutical industry launched a psychopharmacology marketing strategy. They would call all emotional/behavioral problems "brain diseases." Thus, the public came to believe in "chemical balancers"—pills--for "chemical imbalances" (of the brain). Moreover, they have ceased to understand what "normal" is.

On October 12, 1970, Congressman, Cornelius Gallagher [7] wrote to Secretary of the Department of Health Education and Welfare, Elliott Richardson, stating, "… a NIMH witness testified that at least one hundred fifty thousand children around the nation were receiving drugs." "I have received letters from people….highly critical of the focus of the medical side of minimal brain dysfunction, which is, incidentally, one of at least thirty-eight names attached to this condition…Such a high incidence in the population- as high as thirty percent in ghetto areas…may not be pathological at all…Amphetamines now rival and perhaps exceed hard drugs as a source of abuse, I recommend studies focusing on other medication to control the behavior of hyperactive children."

In 1980, Attention Deficit Disorder (ADD) was invented, in-committee, for DSM-III [4].

In 1987, ADD was revised, becoming ADHD (Attention Deficit Hyperactivity Disorder) for DSM-III-R [5]. Any 8 behaviors from a list of 14, qualifies a child for the ‘diagnosis.’

In 1994, ADHD is again ‘re-conceptualized’, this time for DSM-IV [6]. Six of the nine behaviors from one of two lists qualifies for the ‘inattentive,’ the ‘hyperactive-impulsive’ or the ‘combined’ type.

On July 15, 1996, Congressman Christopher Shays [7] testified: "In ADHD, we are trying to draw the line between personality and pathology, and we are placing millions of children and adults on either side of the social, medical and legal boundary that divides the healthy from the sick. We should do so only with the greatest care, and with particular reticence to make our children medical patients because as a culture we have lost our patience with them."

At the same hearing, Jensen [8], of the NIMH and CHADD (he is a member of their Professional Advisory Board), assured the Congressman: "…studies have consistently pointed towards disturbances in brain functioning, particularly in brain areas responsible for attention and memory."

Jensen used the wording: "pointed toward disturbances in brain functioning" because there was no proof of brain malfunction at the time. Just as there is none today.

On September 23, 1993, Baughman [9], testified to the Panel on NIH Research on Antisocial, Aggressive, and Violence-Related Behaviors and their Consequences: "If, as I am convinced, these entities are not diseases, it would be unethical to initiate research to evaluate biological interventions—unethical and fatally flawed scientifically.

In December, 1994, Pearlman [10], wrote: "I take issue with Pincus’ (for the APA) assertion that elimination of the term "organic" in the DSM-IV has served a useful purpose for psychiatry… elimination of the term "organic" conveys the impression that psychiatry wishes to conceal the nonorganic character of many behavioral problems that were, in previous DSM publications, clearly differentiated from known central nervous system diseases."

Baughman [11], also responding to Pincus’ APA assertion, wrote: "…to contend that something is a disease when that has not been established is to fail to provide the patient with information sufficient to make an informed decision."

On December 24, 1994, Leber [12] of the FDA wrote me: "…as yet no distinctive pathophysiology for the disorder has been delineated."

On October 25, 1995, Haislip [13] of the DEA wrote me: "We are also unaware that ADHD has been validated as a biologic/organic syndrome or disease."

In 1996, Schiller, of the US Department of Education, Jensen (NIMH, CHADD), and Swanson (UC, Irvine, CHADD) [14], wrote, "Once parents and teachers…recognize that children with ADD are not lazy or "bad", but have a biological disorder, they can stop blaming themselves or their children and take appropriate steps to prevent a pattern of failure.

There can be no doubt here, that they are calling ADD/ADHD a disease; the children abnormal, diseased.

On April 15, 1998, I [15] wrote to Attorney General, Janet Reno, stating: "The single, biggest heath care fraud in US history—the representation of ADHD to be an actual disease, and the drugging of millions of entirely normal American children, as "treatment," is spreading like a plague…That ADHD is wholly devoid of validity as a disease, a medical syndrome or, anything biologic or organic, is the pivotal element of the fraud." No answer!

On October 8, 1998, Diller [16], author of Running on Ritalin wrote to Sue Parry, a concerned mother: "The reason why you have been unable to obtain any articles or studies presenting clear and confirming evidence of a physical or chemical abnormality associated with ADHD is that there are none. Not that medical science, especially in recent years, hasn’t tried. However the search for a biological marker is doomed from the outset because of the contradictions and ambiguities of the diagnostic construct of ADHD as defined by the DSM. I liken efforts to discover a marker to the search for the Holy Grail."

On March 7, 1998, Swanson [17], of the University of California, Irvine and CHADD (a member of their Professional Advisory Board) stated: "I would like to have an objective diagnosis for the disorder (ADHD). Right now psychiatric diagnosis is completely subjective…"

On May, 13, 1998, Castellanos [18] or the NIMH wrote me: "… we have not yet met the burden of demonstrating the specific pathophysiology that we believe underlies this condition."

Opening the November, 1998, NIH, Consensus Conference on ADHD, Hyman [19], Director of the NIMH stated: "ADHD affects from 0-3% in some school districts up to 40% in others. Surely this cannot be right."

Addressing the Consensus Conference, Carey [20] concluded: "What is now most often described as ADHD in the United States appears to be a set of normal behavioral variations..."

Critiquing the report of the Consensus Conference Panel, Degrandpre [21] observed,"… it appears that you define disease as a maladaptive cluster of characteristics…in the history of science and medicine, this would not be a valid definition of disease."

Having failed to validate ADHD as a disease, they seek to change the definition.

Baughman [22] testified at the Consensus Conference: "Without an iota of proof or credible science, the National Institute of Mental Health (NIMH) has proclaimed the … children "brain-diseased," "abnormal." CHADD, funded by Ciba-Geigy, manufacturer of Ritalin, has spread the "neuro-biological" lie. The US Department of Education, absolving itself of controlling the children and rendering them literate, coerces the labeling and drugging…ADHD is a total, 100% fraud."

My appearance was expunged from the government videotape of the conference.

NPR’s Joe Palca [23], chided the Panel: ""What you're telling us is that ADHD is like the Supreme Court's definition of pornography, 'You know it when you see it.'"

The final statement of the Consensus Conference Panel [24], delivered to attendees, and the press, November 18, 1998, read: " ...we do not have an independent, valid test for ADHD, and there are no data to indicate that ADHD is due to a brain malfunction."

An indefinite period following the November 18, "final statement," of the Consensus Conference Panel, the NIH [25], published yet another "final statement" reading: "although an independent diagnostic test for ADHD does not exist, there is evidence supporting the validity of the disorder."

On April 29, 1999, Baughman [26] responded to Report of the Council on Scientific Affairs of the American Medical Association [27]: "Once children are labeled with ADHD, they are no longer treated as normal. Once Ritalin or any psychotropic drug courses through their brain and body, they are, for the first time, physically, neurologically and biologically, abnormal."

On November 28, 1999, I wrote to Matthew D. Cohen, Esq. [28] President of CHADD, stating: "You and I know that whether or not ADHD is an actual disease with a confirmatory, physical or chemical abnormality, (detectable, patient-by-patient) is more fundamental to the debate now raging over the Colorado State Board of Education’s resolution, than whether or not psychotropic drugs cause violence or, are addictive, dangerous and deadly. You at CHADD, including all members of your Professional Advisory Board, are aware that actual, bona fide diseases, are characterized and validated by a confirmatory, physical or chemical abnormality. You are aware of this, even if the general public is not, and is inclined to trust and believe anything physicians tell them. Thus the widespread belief, by the public, in ADHD as a disease, something "neurobiologic", when there is no research-empirical proof. This brings me to ADHD and to your letter to Mr. Clair Orr, Chairman of the Colorado State Board of Education, of 11/2/99. You state: ‘Attention Deficit/Hyperactivity Disorder is a severe neurobiological condition…’ The term "neurobiologic condition" says to the public that there is something wrong or abnormal with the brain or nervous system of the child/person with ADHD. How can CHADD make such a statement to the public, and now, to the Colorado State Board of Education, when there is no objective evidence or proof anywhere in the peer-reviewed literature, that there is any neurological (brain) abnormality in children (persons) said to have ADHD, or that there is anything physically, chemically, or biologically abnormal, at all. How does CHADD justify calling so many normal children diseased, abnormal--for surely you do--for purposes of justifying prescriptions for them, mostly of addictive, controlled, Schedule II, psychostimulant medications?"

I have never heard back from Mr. Cohen. However CHADD repeated its claim, still with no scientific evidence with which to back it up, that ‘Attention Deficit/Hyperactivity Disorder is a severe neurobiological condition…’ in testimony to the Arkansas State House of Representatives, May, 3, 2000.

On December 13, 1999, Surgeon General, David Satcher released his Report on Mental Health. In it he alleged: "Mental illness is no different than diabetes, asthma or other physical ailments…Mental illnesses are physical illnesses…We know the chemical disorders we are treating…"

In a letter of January 25, 2000, I [29] responded: "Having gone to medical school and studied…disease, then, diagnosis, you and I, and all physicians, know that the presence of any bona fide disease, like diabetes, cancer, or epilepsy is confirmed by an objective finding--a physical or chemical abnormality. No demonstrable physical or chemical abnormality: no disease! You also know, I am sure, that there is no physical or chemical abnormality to be found, in life, or at autopsy in "depression, bipolar disorder and other mental illnesses…" Why, then, are you telling the American people that "mental illnesses" are "physical" and that they are due to "chemical disorders"?…Your role in this deception and victimization is clear. Whether you are a physician, so unscientific, that you cannot read their contrived, "neurobiologic" literature and see the fraud, or whether you see it and choose to be an accomplice--you should resign."

In January, 2000 Castellanos [30], summarized the state of ADHD science: "Incontrovertible evidence is still lacking…In time I’m confident we’ll confirm the case for organic causes."

On May 1, 2000, the law firm of Waters and Kraus [31] of Dallas, Texas filed the first class action suit charging that the APA, CHADD and Novartis: " planned, conspired, and colluded to create, develop, promote and confirm the diagnoses of Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder, in a highly successful effort to increase the market for its product Ritalin."

As of September, 2000, five or six or such class action suits had been filed, 2 in California.

It is impossible to escape the conclusion that ADD/ADHD is a total fraud leading to the medical victimization of millions of previously normal, if troubled, mis-educated, children across the United States.

It is also impossible to escape the conclusion that many departments, offices, and officials, of the federal government, are, knowingly and unknowingly, parties to this fraud and victimization.

(PROJECT TRANSPARENCY)

If you, Ladies and Gentlemen, if want to know whether ADHD, or any psychiatric ‘disease’ is truly a disease or not, all you have to do is pose the following question, just as I did, on September 19, to Doctors Hyman and Castellanos (or any reputable psychiatric researcher, or psychiatric organization), of the NIMH:

Is ADHD (or any psychiatric ‘disease’) a bona fide disease with a confirmatory physical or chemical abnormality demonstrable within the patient? Circle ‘yes’ or ‘no.’

(do not write in this space).

If ‘yes,’ cite the article which constitutes proof of the confirmatory physical or chemical abnormality, entering the following:

the author(s)………………………..

title of the article……………….

journal name…………………….

date…………………………….

volume…………………………

page numbers…………………..

(do not write anything else in this section)

Examples:

Baughman FA. CHANDS: the curly hair-ankyloblepharon-nail dysplasia syndrome. Birth Defects: Original Article Series. 1971;7:100-102. (this was the original description of a never-before described disease, validated as such by it’s confirmatory, distinctive, combination of physical abnormalities.

Toriello HV, Lindstrom JA, Waterman, DF, Baughman FA. Re-evaluation of CHANDS. Journal of Medical Genetics. 1979;16:316-317. (this study proved that CHANDS is a genetic disease)

Thank you for this opportunity to portray for you the scientific status, such as it is, of childhood psychopharmacology in the United States, today.

BIBLIOGRAPHY—THE RISE AND FALL OF ADD/ADHD

Fred A. Baughman Jr., MD, 9/22/00

The American Academy of Neurology: The First Fifty Years, 1948-1998. Maynard M. Cohen (ed.). The American Academy of Neurology, St. Paul, MN.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM). Washington, DC. 1952

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 2nd edition (DSM-II). Washington, DC. 1968.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd edition. Washington: American Psychiatric Association, 1980.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-revised (DSM-III-R). Washington, DC. 1987.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Washington, DC. 1994.

Letter from Cornelius E. Gallagher, Chairman of the Right to Privacy Inquiry Special Studies Subcommittee to the Honorable Elliott Richardson, Secretary Department of Health Education and Welfare (HEW) October 12, 1970.

Testimony of Rep. Christopher Shays, R-CN, also of Peter S. Jensen, M.D., at the Hearing of the Committee on Government Reform and Oversight, July 15, 1996.

Baughman FA. Testimony to the Panel on NIH Research on Antisocial, Aggressive, and Violence-Related Behaviors and their Consequences, September 23, 1993.

Pearlman, T. Letter to the editor in Clinical Psychiatric News December, 1994.

Baughman, FA. Letter to the editor in Clinical Psychiatric News December, 1994.

Leber, P. Personal correspondence to F.Baughman of December 24, 1994.

Haislip, G.R. Personal correspondence to F.Baughman of October 25, 1995.

Schiller E, Jensen PS, Swanson J. In magazine of the Parent Teachers Association, from the Office of Special Education, US Department of Education,1996.

Baughman FA Jr. Letter to Attorney General, Janet Reno, April 15, 1998.

Diller, L. personal correspondence, S. Parry, October 8, 1997.

Swanson, J. Quote from presentation at the American Society of Adolescent Psychiatry, San Diego, CA, March 7, 1998.

Castellanos, FX. Personal correspondence to F.Baughman of May, 13, 1998.

Hyman SE. Opening remarks at the November 16-18, 1998, NIH, Consensus Conference on ADHD.

Carey, WB. Invited presentation: "Is ADHD a Valid Disorder" at the November 16-18, 1998, NIH, Consensus Conference on ADHD.

DeGrandpre, R. Quoted at the November 16-18, 1998, NIH, Consensus Conference on ADHD.

Baughman, FA Jr. Testimony at the NIH, Consensus Conference on ADHD, November 17, 1998.

Palca J. Quoted at the press conference of November 18, 1998, following the NIH, Consensus Conference on ADHD.

Final Statement of the Panel of the NIH, Consensus Conference on ADHD, delivered, November 18, 1998,

Final Statement of the Panel of the NIH, Consensus Conference on ADHD. (this was the second final statement authored and put up on the NIH web site, <www.nimh.nih.gov> an indeterminate time after November, 18, 1998)

Baughman, F.A. Jr. Treatment of Attention-Deficit/Hyperactivity Disorder. JAMA. 1999;281:1490.

Goldman LS, Genel M, Bezman RJ, Slanetz PJ, for the Council on Scientific Affairs, American Medical Association. JAMA. 1998; 279:1100-1107.

Baughman, FA Jr., letter to Matthew D. Cohen, Esq., President, CHADD, November 28, 1999.

Baughman FA Jr., letter to Surgeon General, David Satcher, December 13, 1999.

Castellanos, FX. Interview in Making Sense of Ritalin, Readers Digest, January, 2000.

Law firm of Waters and Kraus, Dallas, Texas