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The New York Times on Psychiatric Disorders, “Not Diseases, but Categories of Suffering”

Monday, January 30th, 2012

“We’re like Cinderella’s older stepsisters,” a psychiatrist told me the other day. “We’re trying to stick our fat feet into the delicate slipper so the prince can take us to the ball. But we ain’t going to the ball right now.” Which is why we might feel a little sorry for the beleaguered A.P.A

The New York Time – Jan 30, 2011
By GARY GREENBERG
YOU’VE got to feel sorry for the American Psychiatric Association, at least for a moment. Its members proposed a change to the definition of autism in the fifth edition of their Diagnostic and Statistical Manual of Mental Disorders, one that would eliminate the separate category of Asperger syndrome in 2013. And the next thing they knew, a prominent psychiatrist was quoted in a front-page article in this paper saying the result would be fewer diagnoses, which would mean fewer troubled children eligible for services like special education and disability payments.

Then, just a few days later, another front-pager featured a pair of equally prominent experts explaining their smackdown of the A.P.A.’s proposal to eliminate the “bereavement exclusion” — the two months granted the grieving before their mourning can be classified as “major” depression. This time, the problem was that the move would raise the numbers of people with the diagnosis, increasing health care costs and the use of already pervasive mind-altering drugs, as well as pathologizing a normal life experience.

Fewer patients, more patients: the A.P.A. just can’t win. Someone is always mad at it for its diagnostic manual.

It’s not the current A.P.A.’s fault. The fault lies with its predecessors. The D.S.M. is the offspring of odd bedfellows: the medical industry, with its focus on germs and other biochemical causes of disease, and psychoanalysis, the now-largely-discredited discipline that attributes our psychological suffering to our individual and collective history.

This tension has been high since at least 1917. That’s when Thomas Salmon, a future head of the A.P.A. — which was founded in 1844 — noted that psychiatry’s “classification of mental diseases is chaotic.” He worried that “this condition of affairs discredits the science of psychiatry and reflects unfavorably upon our association” and urged his membership to forge a diagnostic system “that would meet the scientific demands of the present day.”

The American Psychiatric Association has been trying to do just that ever since, mostly by leaving behind ideas about the meaning of our suffering in favor of observation and treatment of its symptoms. In 1980, it hit on the strategy of adopting a medical rhetoric, organizing those symptoms into neat disease categories and checklists of precisely described criteria and publishing them in the hefty — and, according to its chief author, “very scientific-looking” — D.S.M.-III.

That book, with its more than 200 objectively described diagnoses, would have made Dr. Salmon proud. By meeting the scientific demands of the day, it was credited by many with having rescued psychiatry from the brink of extinction, and its subsequent revisions have been the cornerstone of the profession’s survival as a medical specialty.

But as all those Diagnostic and Statistical Manuals have stated clearly in their introductions, while the book seems to name the mental illnesses found in nature, it actually makes “no assumption that each category of mental disorder is a completely discrete entity with absolute boundaries dividing it from other mental disorders or no mental disorder.” And as any psychiatrist involved in the making of the D.S.M. will freely tell you, the disorders listed in the book are not “real diseases,” at least not like measles or hepatitis. Instead, they are useful constructs that capture the ways that people commonly suffer. The manual, they go on, was primarily written to give physicians, schooled in the language of disease, a way to recognize similarities and differences among their patients and to talk to one another about them. And it has been fairly successful at that.

Still, “people take it literally,” one psychiatrist who worked on the manual told me. “That is its strength in a political sense.” And even if the A.P.A. benefits mightily from that misperception, the troubles on the front page are not the organization’s fault. They are what happens when we expect the D.S.M. to be what it is not. “The D.S.M. has been taken too seriously,” another expert told me. “It’s the victim of its success.”

Psychiatrists would like the book to deserve a more serious take, and thus to be less subject to these embarrassing diagnostic squabbles. But this is going to require them to have what the rest of medicine already possesses: the biochemical markers that allow doctors to sort the staph from the strep, the malignant from the benign. And they don’t have these yet. They aren’t even close. The human brain, after all, may be the most complex object in the universe. And the few markers, the genes and the neural networks, that have been implicated in mental disorders do not map well onto the D.S.M.’s categories.

“We’re like Cinderella’s older stepsisters,” a psychiatrist told me the other day. “We’re trying to stick our fat feet into the delicate slipper so the prince can take us to the ball. But we ain’t going to the ball right now.” Which is why we might feel a little sorry for the beleaguered A.P.A.

On the other hand, given that the current edition of the D.S.M. has earned the association — which holds and tightly guards its naming rights to our pain — more than $100 million, we might want to temper our sympathy. It may not be dancing at the ball, but once every mental health worker, psychology student and forensic lawyer in the country buys the new book, it will be laughing all the way to the bank.

Gary Greenberg, a psychotherapist and the author of “Manufacturing Depression,” is writing a book about the making of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Read article here:  http://www.nytimes.com/2012/01/30/opinion/the-dsms-troubled-revision.html

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7 Reasons America’s Mental Health Industry Is a Threat to Our Sanity

Friday, January 6th, 2012

Drug industry corruption, scientifically unreliable diagnoses and pseudoscientific research have compromised the values of the psychiatric profession.

Alternet
By Bruce E. Levine
January 6, 2012

Why do some of us become dissident mental health professionals?

The majority of psychiatrists, psychologists and other mental health professionals “go along to get along” and maintain a status quo that includes drug company corruption, pseudoscientific research and a “standard of care” that is routinely damaging and occasionally kills young children. If that sounds hyperbolic, then you probably have not heard of Rebecca Riley, and how the highest levels of psychiatry described her treatment as “appropriate and within responsible professional standards.”

When Rebecca Riley was 28 months old, based primarily on the complaints of her mother that she was “hyper” and had difficulty sleeping, psychiatrist Kayoko Kifuji, at the Tufts-New England Medical Center in Boston, Massachusetts, diagnosed Rebecca with attention deficit hyperactivity disorder (ADHD). Kifuji prescribed clonidine, a hypertensive drug with significant sedating properties, a drug Kifuji also prescribed to Rebecca’s older sister and brother. The goal of the Riley parents—obvious to many in their community and later to juries—was to attain psychiatric diagnoses for their children that would qualify them for disability payments and to sedate their children making them easy to manage.

By the time Rebecca was three years old, again based mainly on parental complaints, Kifuji had given Rebecca an additional diagnosis of bipolar disorder and prescribed two additional heavily sedating drugs, the antipsychotic Seroquel and the anticonvulsant Depakote.

At the age of four, Rebecca was dead.

At the time of her death, Rebecca had a life-threatening amount of clonidine—enough to kill her—in her body, according to the former director of the Massachusetts toxicology lab and the medical director of a regional poison control center. The medical examiner who performed the autopsy concluded that Rebecca died from intoxication of clonidine, Depakote and two over-the-counter cold and cough medicines that led to heart failure, lungs filled with bloody fluid, coma, and then death. Rebecca’s abusive parents went to prison for the over-drugging that led to their daughter’s death.

Kifuji’s fate? The psychiatric establishment rallied around Kifuji, enabling her to return to Tufts Medical Center practicing child psychiatry without any restrictions, penalties or supervision. After Rebecca’s death, Tufts-New England Medical Center defended Kifuji. A Tufts spokesperson told “60 Minutes” in 2009, “The care we provided was appropriate and within responsible professional standards.”

Apparently, psychiatric care that is considered appropriate and within responsible professional standards includes diagnoses of ADHD for a two-year-old and bipolar disorder for a three-year-old when the symptoms of those disorders are normal behaviors for those ages; prescribing three heavily sedating drugs that have not been approved by the FDA for child psychiatric treatment; ignoring the warnings from a school nurse about over-dosages for Rebecca; and making diagnoses based almost entirely on the reports of Rebecca’s mother, who herself was diagnosed with mental illness and heavily medicated to the point of falling asleep in Kifuji’s office.

Long before the Rebecca Riley tragedy hit the headlines, I was embarrassed by the mental health profession for seven major reasons:

1. Corruption by Big Pharma

How did it become within responsible professional standards for a two-year-old to get an ADHD diagnosis, for a three-year-old to get a bipolar diagnosis, and for toddlers to be prescribed multiple heavily sedating drugs? The short answer is drug company corruption of the mental health profession.

Congressional hearings in 2008 revealed that psychiatry’s “thought leaders” and major institutions are on the take from drug companies.

On June 8, 2008, the New York Times reported about psychiatrist Joseph Biederman: “A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007.”

Due in large part to Biederman’s influence, the number of American children and adolescents treated for bipolar disorder increased 40-fold from 1994 to 2003. Pediatrician and author Lawrence Diller notes about Biederman, “He single-handedly put pediatric bipolar disorder on the map.” In addition to his popularization of bipolar disorder for children, Biederman is one of the most significant forces behind the expanding numbers diagnosed with ADHD; and congressional investigators also discovered that Biederman conducted studies of Eli Lilly’s ADHD drug Strattera that were funded by National Institute of Health at the same time he was receiving money from Lilly.

Not only does the drug industry have influential psychiatrists such as Biederman in their pocket, virtually every major mental health institution is financially interconnected with Big Pharma. Congressional hearings also exposed the American Psychiatric Association psychiatry’s premier professional organization, as being on the take from drug companies. In 2006, the drug industry accounted for about 30 percent of the APA’s $62.5 million in financing. Most relevant here, the APA is the publisher of the psychiatric diagnostic bible, the Diagnostic and Statistical Manual of Mental Disorders (DSM), and thus the APA is the institution responsible for creating mental illnesses and disorders.

2. Invalid Illnesses and Disorders

Psychiatry’s first DSM (1952) and its DSM-II (1968) listed homosexuality as a mental illness. Only because of a fierce political fight waged in the 1970s by gay activists did the APA abolish homosexuality as an illness and eliminate it from its DSM-III (1980). Gay activists’ fight was not only a victory for themselves but a service for everyone else, as it made public the important scientific problem of psychiatric disorder invalidity. Specifically, are psychiatric disorders scientifically valid illnesses, or are they simply behaviors that create discomfort for some authorities at a given moment in time?

While psychiatry lost homosexuality as a mental illness in the 1980 DSM-III, the APA found other groups it could pathologize, groups that could not mobilize and resist, most notably children, who are now routinely given psychiatric diagnoses for behaviors that many of us view as normal for their ages.

Psychiatry sees it as within responsible professional standards to diagnose three-year-olds such as Rebecca Riley with bipolar disorder. The symptoms of bipolar disorder include irritable and rapidly changing moods, severe temper tantrums, defiance of authority, agitation and distractibility, sleeping too little or too much, poor judgment, impulsivity and grandiose beliefs.

Psychiatry also sees it as within responsible professional standards for Rebecca Riley to have been diagnosed at 28 months old with ADHD. The symptoms of ADHD are inattention (easily distracted and bored, difficulty organizing and completing tasks, losing things, not seeming to listen, not following instructions); hyperactivity (fidgeting, talking nonstop, having trouble sitting still, difficulty with quiet tasks), and impulsivity (impatience, blurting out inappropriate comments, interrupting conversations).

Today, children and teens are also diagnosed with oppositional defiant disorder (ODD), the symptoms of which include “often actively defies or refuses to comply with adult requests or rules,” and “often argues with adults.”

The standard for a medical disorder should not be whether or not an individual causes friction.

3. Scientifically Unreliable Diagnoses

Even if you believe that bipolar disorder for three-year-olds, ADHD for two-year-olds, ODD for teenagers, and all the other DSM diagnoses are valid disorders, there is still the scientific issue of diagnostic unreliability—the lack of diagnostic agreement among professionals examining the same person.

A generation ago, psychiatrists admitted that their diagnoses were unreliable and agreed that this was a major scientific problem. So in 1980, in an attempt to eliminate this embarrassment, they created the DSM-III with concrete behavioral checklists and formal decision-making rules, but they failed to correct the problem. Psychiatric diagnoses remain unreliable, but now psychiatry no longer talks about the unreliability problem.

If a measurement is a reliable one, then clinicians trained with it should be in high agreement on the diagnosis. A major 1992 study, conducted at six sites with 600 prospective patients, was done to examine the reliability of psychiatric diagnoses. Experienced mental health professionals were given extensive training in how to make accurate DSM diagnoses. Because of the extensive training, one would expect that diagnostic agreement would be much higher than in typical clinical settings. Herb Kutchins and Stuart Kirk summarize the study in Making Us Crazy (1997):

What this study demonstrated was that even when experienced clinicians with special training and supervision are asked to use DSM and make a diagnosis, they frequently disagree, even though the standards for defining agreement are very generous. . . . [For example,] if one of the two therapists made a diagnosis of Schizoid Personality Disorder and the other therapist selected Avoidant Personality Disorder, the therapists were judged to be in complete agreement of the diagnosis because they both found a personality disorder—even though they disagreed completely on which one! So even with this liberal definition of agreement, reliability using DSM is not very good.

Kutchins and Kirk conclude: “Mental health clinicians independently interviewing the same person in the community are as likely to agree as disagree that the person has a mental disorder and are as likely to agree as disagree on which of the over 300 DSM disorders is present.”

4. Biochemical Imbalance Mumbo Jumbo

Just as nothing was more important in selling the Iraq war in 2003 than the Bush administration’s certainty that Iraq possessed weapons of mass destruction, nothing has been more important in selling psychiatric drugs than psychiatry’s certainty of biochemical brain imbalances as the cause for mental illnesses.

Prior to psychiatry’s proclamation that depression was caused by too little of the neurotransmitter serotonin, few Americans were taking antidepressants. But by declaring that depression was caused by a serotonin imbalance analogous to diabetes and an insulin imbalance, depressed Americans became far more receptive to serotonin-enhancing drugs such as the “selective-serotonin-reuptake inhibitors” (SSRIs) Prozac, Paxil, and Zoloft.

SSRIs can make some depressed people feel better; however, alcohol makes some shy people less shy, but that’s not enough evidence to say that shyness is caused by an alcohol imbalance. The truth is—and scientists have known this for quite some time—that serotonin levels are not associated with depression.

Researchers have used a variety of methods to test the serotonin imbalance theory of depression, including comparing serotonin metabolites in depressed and nondepressed people, and depleting serotonin levels through a variety of means and then observing whether this resulted in depression. Elliot Valenstein, professor emeritus of psychology and neuroscience at the University of Michigan, reviewed the research in his book Blaming the Brain (1998) and reported that it is just as likely for people with normal serotonin levels to feel depressed as it is for people with abnormal serotonin levels, and that it is just as likely for people with abnormally high serotonin levels to feel depressed as it is for people with abnormally low serotonin levels. Valenstein concluded, “Furthermore, there is no convincing evidence that depressed people have a serotonin or norepinephrine deficiency.”

In 2002, the New York Times reported: “Researchers knew that antidepressants seemed to raise the brain’s levels of messenger chemicals called neurotransmitters, so they theorized that depression must result from a deficiency of these chemicals. Yet a multitude of studies failed to prove this precept.”

Yet even now, many psychiatrists and other mental health professionals continue to promulgate the serotonin imbalance theory of depression, and polls show that the majority of Americans continue to believe it.

5. Pseudoscientific Drug Effectiveness Research

There are multiple tricks that psychiatric drug manufacturers and their researcher psychiatrists and psychologists use to make their drugs look more effective than they really are. One of the most common depression measurements used by researchers paid by drug companies is the Hamilton Rating Scale for Depression. In the HRSD, researchers rate subjects, and the higher the point total, the more one is deemed to be suffering from depression. On the HRSD, there are three separate items about insomnia (early, middle and late) and one can receive up to six points for difficulty either falling or remaining asleep; however, there is only one suicide item, in which one is awarded only two points for wishing to be dead. The HRSD is heavily loaded with items that are most affected by drugs, and it is therefore especially damning for antidepressants that even with such measurement dice-loading, these drugs routinely fail to outperform placebos—even dice-loaded placebos.

Proper drug research requires that neither subject nor experimenter knows who is getting the drug and who is getting the placebo (a true double-blind control). Drug company antidepressant researchers use inactive placebos such as sugar pills (which don’t create side effects). Independent research on inactive placebos show that many subjects in antidepressant and other studies can guess if they are getting the actual drug or not, which changes their expectations and subverts the double-blind control. In order to make it more difficult to guess correctly, an active placebo (which creates side effects) should be used. In 2000, a Psychiatric Times article concluded: “In fact, when antidepressants are compared with active placebos, there appear to be no differences in clinical effectiveness.”

Dice-loading depression measurements and placebos are just two of many techniques drug company researchers use to make antidepressants look more effective than they really are. But even with such dice-loading, antidepressants have not fared well, at least when one examines all the studies.

Drug companies try to ensure that those studies showing antidepressants to be no more effective than placebos are not published; however, all studies must be submitted to the FDA. So independent researcher Irving Kirsch and his research team at the University of Connecticut used the Freedom of Information Act to gain access to all data, and analyzed 47 studies that had been sponsored by drug companies on Prozac, Paxil, Zoloft, Effexor, Celexa, and Serzone. Kirsch discovered that in the majority of the trials, the antidepressant failed to outperform a sugar pill placebo (and in the trials where the antidepressant did outperform the placebo, the advantage was slight).

6. Psychotropic Drug Hypocrisy

Chemists consider psychiatric prescription drugs and illegal mood-altering drugs all to be psychotropic or psychoactive drugs. Cocaine and ADHD drugs such as Adderall and other amphetamines affect the neurotransmitters dopamine, serotonin, and norepinephrine; and antidepressants used in combination also affect the same neurotransmitters. Not only are prescription psychotropics and illegal psychotropics chemically similar, they are used by people for similar reasons, including taking the edge off their discomfort so they can function. The hypocrisy surrounding illegal and prescription psychotropic drugs is harmful to society in at least two ways.

At one level, because people are being misinformed about the realities of prescription psychotropic drugs, they are more likely to gulp them down and to give them to their children. This has helped create a tragic phenomenon detailed by investigative reporter Robert Whitaker in his book Anatomy of an Epidemic (2010). Psychiatric drug use turning mild and episodic conditions into severe and chronic ones has helped create a huge increase of Americans with severe mental illness, especially among children.

At a second level, this psychiatric-illegal psychotropic drug hypocrisy allows for unfair criminalizing and incarceration of people using illegal psychotropics.

7. Diversion from Societal, Cultural and Political Sources of Misery

When we hear the words disorder, disease or illness, we think of an individual in need of treatment, not of a troubled society in need of transformation. Mental illness expansionism diverts us from examining a dehumanizing society.

In addition to pathologizing normal behavior, the mental health profession also diverts us from examining a society that creates the ingredients—helplessness, hopelessness, passivity, boredom, fear, and isolation—that cause emotional difficulties. We are diverted from the reality that many emotional problems are natural human reactions to loss in our society of autonomy and community. Thus, the mental health profession not only has financial value for drug companies but it has political value for those at the top of societal hierarchies who want to retain the status quo.

Today, a handful of dissident mental health professionals do challenge and resist their profession’s dehumanizing standard practices. I know several of these dissidents, and they are the only psychiatrists, psychologists and mental health professionals that I have any respect for.

Read article here:  http://www.alternet.org/story/153634/7_reasons_america%27s_mental_health_industry_is_a_threat_to_our_sanity/

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Those in favor of Psychiatry’s Billing Bible? The American Psychiatric Association. Against it? Just About Everyone else

Thursday, November 3rd, 2011

Click image to watch video (explaining in simple terms, what the “problem” with psychiatry is….)

Psychology Today – November 1, 2011

by Allen Frances, MD (Psychiatrist and former Chairman of the DSM task force)

So far, opposition to DSM 5 has been expressed by the following organizations: British Psychological Society; American Counseling Association; Society for Humanistic Psychology (APA Division 32); Society for Community Research and Action: Division of Community Psychology (APA Division 27); Society for Group Psychology & Psychotherapy (APA Division 49); Developmental Psychology (APA Division 7); UK Council for Psychotherapy; Association for Women in Psychology; Constructivist Psychology Network; Society for Descriptive Psychology; and the Society of Indian Psychologists.

An editorial by the Society Of Biological Psychiatrywondered whether DSM 5 was necessary at all. The community of personality disordersresearchers is virtually unanimous in its opposition to the DSM 5 personality disorders section. There has also been widespread opposition to the sections on somatic, autistic, gender, paraphilic, and psychotic disorders.

Last week, a petition was posted quietly be several divisions of the American Psychological Association. It demands reform of the DSM 5 process and the elimination of a number of its most risky and ill conceived proposals. The petition is gaining increasing support and has already been signed by almost 3000 people. It can be accessed at http://www.ipetitions.com/petition/dsm5/ )

Strikingly, there seems to be virtually no support for DSM 5 outside the very narrow circle of the several hundred experts who have created it and the leadership of the American Psychiatric Association (APA) which stands to reap large profits from its publication. There is no group and precious few individuals outside of APA who have anything good to say about DSM 5. And even within the DSM 5 work groups and the APA governance structures, there is widespread discontent with the process and considerable disagreement about the product.

http://www.psychologytoday.com/blog/dsm5-in-distress/201111/dsm-5-against-everyone-else

 

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CCHR exposes list of psycho-pharma front groups

Monday, August 29th, 2011

Natural News
By PF Louis
August 29, 2011

A highly effective public relations technique is the “third party technique” of creating front groups to endorse or promote the need of any service or product. The first party is the original group or client that would benefit more from increased public trust or affinity. The second group is the public or consumers. A third group is created with a contrived name to appear publicly as a disinterested party endorsing the industry of the first party.

Often, the third party, or front group, uses a name that implies authority or concern for the public’s welfare or concerns. You can be sure these bogus front groups are usually only concerned about their clients welfare and themselves.

Edward Bernays Pioneered Front Groups

Edward Bernays, a notorious spin doctor throughout the 20th Century, is considered USA’s original front group creator as well as the father of public relations. The public relations industry is concerned with creating a favorable image more than direct sales advertising, although they can be closely associated at times.

The womens rights movement peaked in 1919 with the passage of the 19th amendment, granting women the right to vote. A very few years later, Edward Bernays created an image to help promote the tobacco industry. He had photographs published in newspapers and magazines of several women marching in a New York City Easter parade brazenly smoking cigarettes, which until then was considered unladylike. The idea was to link a womans struggle for more rights with openly smoking anywhere, just like the guys.

Besides making tobacco appear healthy over several years using fake doctors to promote various cigarette brands, Bernays also used front groups to glorify fluoridating water supplies. He was a very important contributor to our mass poisoning.

Psychiatry, Big Pharma, and Front Groups

The Citizens Commission on Human Rights International (CCHRI) focuses on psychiatry’s irrational and barbaric treatment of mental illness with its propensity for categorizing behavior in order to dispense harmful drugs. It’s a cozy arrangement with the American Psychiatric Association (APA) and Big Pharma.

Ever since the APA was accepted as a regular medical organization a few decades ago, Big Pharma’s sales for psychotropic drugs have gone through the roof. What was once pen and pad for taking notes by a psychiatrist during talk therapy became the pen and prescription pad.

For children, psychiatry’s categorizing behavioral problems enables educational and child care institutional personnel virtual prescription power as well. Children are kidnapped “legally” by social services agencies if parents refuse to medicate them according to psychiatric decree. Big Pharma’s reach into TV advertising enables depressed adults to demand prescriptions for drugs that lead to bad health, actual insanity, and death.

Front groups exposed by CCHRI include the following: The National Alliance on Mental Illness (NAMI), Children and Adults with Attention Deficit Hyperactivity Disorder (CHAAD) and several bipolar, depression or ADHD “support groups” that flourish on the internet.

CCHRI has several more front groups listed on one of their site pages with links to explanations of who they really are and how they function for psychiatry and Big Pharma. (see CCHRI source below)

CCHRI’s depth of investigative reporting offers the premier site for understanding the true nature of psychiatry and its relationship with Big Pharma’s destructive psychotropic drug racket.

Front Groups Everywhere

Front groups can also lobby directly to government officials, elected or appointed. And they are created for almost any controversial issue that needs to be white or green washed.

A former health insurance insider, Wendell Potter, became a whistle blower with his book Deadly Spin. He explained that a front group “Health Care America” was used to attack Michael Moore’s “Sicko” documentary.

APCO Worldwide created Health Care America with Big Pharma money. The insurance industry used APCO in 2007. APCO recruits think tanks and other agencies as allies for their campaigns. The public is unaware of who is really supplying the media’s information.

Earlier in 2011, New York Republican Congresswoman Nan Hayworth submitted a press release photo of her receiving a plaque from a representative of a purported senior citizen support group called 60 Plus Association. The sign above those two declared in large letters “Senor Citizens Thank You for Protecting Medicare and Social Security.”

There are two lies here. Nan Hayworth had voted against Medicare, and 60 Plus has hardly any senior citizen members at all. They remain afloat financially from Big Pharma’s funding, according to AARP.

All this crassly corrupt activity backed by government and corporations continues to escalate through the mainstream media. A lyric from a 1980s jazz tune rings true “We are Caught in a Blizzard of Lies.” The upside is we are forced to distinguish between truth and fiction and become our own informed authority.

Sources for this article include:

List of Front Groups for Psychiatry and Big Pharma http://www.cchrint.org/psycho-pharm…

Main page CCHRI site http://www.cchrint.org/

Insurance whistle blower Wendell Potter http://www.commondreams.org/view/20…

60s Plus Group outed by AARP as Big Pharma front group http://my.firedoglake.com/junkyardd…

Edward Bernays pioneered third party technique of PR and advertising http://www.frontgroups.org/node/418

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Harvard Expert Ties Mental Illness “Epidemic” to Big Pharma’s Agenda

Friday, July 29th, 2011

Minyanville
By Minyanville Staff
July 28, 2011

When the DSM-II was published in 1980, it became “the bible of psychiatry,” writes Angell, who adds, “but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions.”

For any mental illness or passing mood swing that may trouble a person, the Diagnostic and Statistical Manual of Mental Disorders — better known as the DSM — has a label and a code. Recurring bad dreams? That may be a Nightmare Disorder, or 307.47. Narcolepsy uses the same digits in a different order: 347.00. Fancy feather ticklers? That sounds like Fetishism, or 302.81. Then there’s the ultimate catch-all for vague sadness or uneasiness, General Anxiety Disorder, or 300.02. That’s a label almost everyone can lay claim to.

These codes are used by doctors, psychologists, and regulators to maintain a mutual language; it’s a handy shorthand system for bureaucratic purposes. But over the past few decades, the staggering, ever-expanding influence of the ever-expanding DSM, which is published by the American Psychiatric Association, has also played a lead role in building wealth and off-label product uses for the major drug manufacturers. In an insightful essay in this week’s New York Review of Books, Marcia Angell, a senior lecturer in social medicine at Harvard Medical School and former Editor in Chief of The New England Journal of Medicine, explains how.

The medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported."

Angell’s essay is based on a review of three current books examining the psychiatric industry: The Emperor’s New Drugs: Exploding the Antidepressant Myth, by Irving Kirsch; Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America by Robert Whitaker, and Unhinged: The Trouble with Psychiatry–A Doctor’s Revelations About a Profession in Crisis, by Daniel Carlat. She also cites the DSM-IV, the most recent edition of the manual, while her review traces big pharma’s role in our current mental disorder epidemic to the DSM-III, published in 1980.

To begin, Angell describes the psychiatric profession’s backlash against a developing perception in the 1960s and 1970s that the practice was a “soft” almost pseudo science:

In the late 1970s, the psychiatric profession struck back–hard. As Robert Whitaker tells it in Anatomy of an Epidemic, the medical director of the American Psychiatric Association (APA), Melvin Sabshin, declared in 1977 that “a vigorous effort to remedicalize psychiatry should be strongly supported,” and he launched an all-out media and public relations campaign to do exactly that. Psychiatry had a powerful weapon that its competitors lacked. Since psychiatrists must qualify as MDs, they have the legal authority to write prescriptions. By fully embracing the biological model of mental illness and the use of psychoactive drugs to treat it, psychiatry was able to relegate other mental health care providers to ancillary positions and also to identify itself as a scientific discipline along with the rest of the medical profession. Most important, by emphasizing drug treatment, psychiatry became the darling of the pharmaceutical industry, which soon made its gratitude tangible.

Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.

These efforts to enhance the status of psychiatry were undertaken deliberately. The APA was then working on the third edition of the DSM, which provides diagnostic criteria for all mental disorders. The president of the APA had appointed Robert Spitzer, a much-admired professor of psychiatry at Columbia University, to head the task force overseeing the project. The first two editions, published in 1952 and 1968, reflected the Freudian view of mental illness and were little known outside the profession. Spitzer set out to make the DSM-III something quite different. He promised that it would be “a defense of the medical model as applied to psychiatric problems,” and the president of the APA in 1977, Jack Weinberg, said it would “clarify to anyone who may be in doubt that we regard psychiatry as a specialty of medicine.”

When the DSM-II was published in 1980, it became “the bible of psychiatry,” writes Angell, who adds, “but like the real Bible, it depended a lot on something akin to revelation. There are no citations of scientific studies to support its decisions.”

Despite its lack of citations, that DSM named 265 disorders doctors were meant to identify by matching (or mostly matching) a list of symptoms in the book with symptoms described by a patient. The drug companies were quick to see this radical shift in psychiatry as an opportunity. From the 1980s until now, as Angell demonstrates, the drug makers have supported the move away from talk therapy to the drug therapy, which also benefits practitioners, since doling out drugs and tweaking prescriptions earns a psychiatrist more money for less time spent with a patient.

Here Angell explains how companies influence the DSM itself. The bold typeface is ours.

Drug companies are particularly eager to win over faculty psychiatrists at prestigious academic medical centers. Called “key opinion leaders” (KOLs) by the industry, these are the people who through their writing and teaching influence how mental illness will be diagnosed and treated. They also publish much of the clinical research on drugs and, most importantly, largely determine the content of the DSM. In a sense, they are the best sales force the industry could have, and are worth every cent spent on them. Of the 170 contributors to the current version of the DSM (the DSM-IV-TR), almost all of whom would be described as KOLs, ninety-five had financial ties to drug companies, including all of the contributors to the sections on mood disorders and schizophrenia.

The drug industry, of course, supports other specialists and professional societies, too, but Carlat asks, “Why do psychiatrists consistently lead the pack of specialties when it comes to taking money from drug companies?” His answer: “Our diagnoses are subjective and expandable, and we have few rational reasons for choosing one treatment over another.” Unlike the conditions treated in most other branches of medicine, there are no objective signs or tests for mental illness—no lab data or MRI findings—and the boundaries between normal and abnormal are often unclear. That makes it possible to expand diagnostic boundaries or even create new diagnoses, in ways that would be impossible, say, in a field like cardiology. And drug companies have every interest in inducing psychiatrists to do just that.

Eli Lilly gave $551,000 to NAMI

In addition to the money spent on the psychiatric profession directly, drug companies heavily support many related patient advocacy groups and educational organizations. Whitaker writes that in the first quarter of 2009 alone, “Eli Lilly gave $551,000 to NAMI [National Alliance on Mental Illness] and its local chapters, $465,000 to the National Mental Health Association, $130,000 to CHADD (an ADHD [attention deficit/hyperactivity disorder] patient-advocacy group), and $69,250 to the American Foundation for Suicide Prevention.”

And that’s just one company in three months; one can imagine what the yearly total would be from all companies that make psychoactive drugs. These groups ostensibly exist to raise public awareness of psychiatric disorders, but they also have the effect of promoting the use of psychoactive drugs and influencing insurers to cover them. Whitaker summarizes the growth of industry influence after the publication of the DSM-III as follows:

“In short, a powerful quartet of voices came together during the 1980’s eager to inform the public that mental disorders were brain diseases. Pharmaceutical companies provided the financial muscle. The APA and psychiatrists at top medical schools conferred intellectual legitimacy upon the enterprise. The NIMH [National Institute of Mental Health] put the government’s stamp of approval on the story. NAMI provided a moral authority.”

And now here we are in 2011, with almost everyone we know taking two or three different mood disorder drugs. (This trend is not limited to mental disorder, mind you. See Disease Branding.)

Work started on the DSM-V in 1999, which is due out in 2013. It will contain many new disorders, such as “binge eating” and “restless leg disorder.” It will also expand existing categories by tacking on words like “spectrum” to the end of a known disorder, Angell reports. “It looks as though it will be harder and harder to be normal,” she writes.

But the curtain gets pulled back further still.

In her review of Daniel Carlat’s book, Angell calls attention to the “disillusioned insider’s” frank admission that when he prescribes a drug, his decision process is largely guesswork. Carlat’s view is that although any psychiatrist will acknowledge that he or she has had great success with mental disorder drugs for say, depression or anxiety, no doctor can say with certainty whether the drugs are working or if a placebo effect has taken effect.

[Carlat's] work consists of asking patients a series of questions about their symptoms to see whether they match up with any of the disorders in the DSM. This matching exercise, he writes, provides “the illusion that we understand our patients when all we are doing is assigning them labels.” Often patients meet criteria for more than one diagnosis, because there is overlap in symptoms. For example, difficulty concentrating is a criterion for more than one disorder. One of Carlat’s patients ended up with seven separate diagnoses. “We target discrete symptoms with treatments, and other drugs are piled on top to treat side effects.” A typical patient, he says, might be taking Celexa for depression, Ativan for anxiety, Ambien for insomnia, Provigil for fatigue (a side effect of Celexa), and Viagra for impotence (another side effect of Celexa).

As for the medications themselves, Carlat writes that “there are only a handful of umbrella categories of psychotropic drugs,” within which the drugs are not very different from one another. He doesn’t believe there is much basis for choosing among them. “To a remarkable degree, our choice of medications is subjective, even random. Perhaps your psychiatrist is in a Lexapro mood this morning, because he was just visited by an attractive Lexapro drug rep.”

Messy. And, of course, the whole system is now being exported to China and other countries where the middle class is growing and the mental health industry is still in a developing stage.

Angell’s latest book is The Truth About the Drug Companies: How They Deceive Us and What to Do About It.

Read the rest of her essay, which examines the controversial use of brain chemistry drugs to treat children, here.

http://www.minyanville.com/dailyfeed/2011/07/25/harvard-expert-links-our-mental/

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The problem with the DSM

Wednesday, June 29th, 2011

The Commons – June 29, 2011

Do you have a shopping addiction disorder? Perhaps an addiction to food? Maybe one of your kids has Internet addiction disorder, or video-game attachment syndrome.

Well, not quite yet, because these kinds of new mental diagnoses are only proposed, not final, for the new revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of the American Psychiatric Association (APA).

And there is a terrible problem with this.

The DSM was first created in the 1920s. Based on psychoanalytic theory, it enumerated fewer than 100 mental problems that a psychiatrist could diagnose, all of them attributable to environmental conditions, generally the role of parenting.

We know now that this theoretical stance was limited and, in many cases, wrong. In 1980, the second revision of the DSM took place. Freud was discarded, and the revised bible now included several hundred disorders, all delineated by a list of observable symptoms and a framework for limiting and differentiating diagnoses.

Three versions later, the current DSM lists more than 1,000 disorders. No theories are espoused for their origins, though implicit in it is that there is a mix of genetic and environmental causes that shape neurological development.

During this period of about three decades, the incidence of attention disorders in the general population has increased from 2 percent to 10 percent.

In the 1980s, people diagnosed with bipolar disorder represented less than 1 percent of the population; now the number has increased to 5 percent.

New diagnoses, like oppositional defiant disorder and conduct disorder, now cover as many as 5 percent of children.

Autism, which afflicted a tiny percentage of the population in the 1990s, now accounts for 1 out of every 100 children.

What is wrong with this picture? Do we have an epidemic on our hands? Something in the water we drink, or the air we breathe?

The standard APA explanation is that we now recognize and treat disorders that in the past were overlooked, often judged in moral terms, and left untreated.

In this view, a reasonable estimate of the current percentage of adults with undiagnosed attention deficit hyperactivity disorder would be about 1 out of 20, since we were born too early for the new diagnostic scheme. Maybe you. Certainly me.

There is another way to tell the story, however.

In this story, one could argue that each change in the DSM has essentially recruited a new batch of subjects for identification and treatment.

Instead of seeing difference as a natural outcome of personal characteristics, all of which have their place in the wonderful diversity of humankind, we have come to see individuals as made up of symptoms.

In this view, these symptoms are all treatable, usually by medication, within an implicit vision of normality arising from a dominant culture that is mainly driven by economic considerations.

And that’s the problem. The psychiatric and pharmaceutical industries essentially depend on a tautological logic, a kind of nightmarish Field of Dreams approach in which, if you define it, they will come and take their meds.

But it is not the only problem. The reality is that there are real mental disorders that carry a terrible cost, and that many of these can be treated effectively through a combination of medication, psychotherapy, and environmental support.

That our current approach mixes apples and oranges, the relatively small population that is truly in need of medical help with the much larger group that does not, risks discrediting the field in general, in ways that might ultimately mean that individuals who truly require medical intervention might choose not to get it.

It also adds costs to our yearly health-care budget which are largely unnecessary, though I have yet to hear this discussed in the Sturm und Drang that has attended President Obama’s attempt to make sense out of our broken health-care system.

Perhaps the greatest problem is that children who, in another age, were simply different — odd, quirky, restless, bored, sad, angry — are now disordered, and often drugged to make them more “normal.”

Adults, too. Between 2006 and 2010, the number of prescriptions for antidepressants increased by 43 percent. More than 23 million prescriptions were filled last year.

All of this while the world we have shaped seems to be spinning rapidly out of control, whether in the loss of contact with nature caused by urbanization and suburbanization, the terrible dislocations of a post-industrial society in which 1 percent of the population controls almost all the wealth, or in the simple reality that the climate we live in will change over the next decades in ways that will take a horrific human toll.

Who wouldn’t feel sad, or angry?

* * *

The new DSM is coming, probably in 2013 or 2014 — a lot later than its original projected deadline of 2011, in part because debates over what it should include have been so fierce.

One of the main external critiques of the process is that so many of the shrinks working on the bible are affiliated with pharmaceutical companies. It’s an important point, one that the public has barely seen in the popular press.

To my mind, the more important critique is that the fundamental underpinnings of the DSM are flawed, and that the lack of a theoretical basis means that any quirk or problem a person might express can be categorized as illness. Even expert tautological logic is still tautological.

There are reasons why people shop when they are sad, or why children stay up all night playing video games. There are reasons that a lot of preadolescent boys find it hard to sit still in class and cause problems for their teachers. There are reasons why children with overstressed parents, children who spend a lot of time living in an internal world of television, music, Facebook, instant messaging, and texting, have difficulty developing the skill of social interaction. There are reasons why children get sad, or angry, in the world they live in.

You won’t find these in the DSM.

Read the rest of the article here: http://www.commonsnews.org/site/site04/story.php?articleno=3712&page=3

For more information see this video featuring CCHR Co-founder, Dr. Thomas Szasz

http://www.cchrint.org/videos/experts/thomas-szasz/

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At annual convention, psychiatrists collaborate on mental disease mongering to boost profits

Wednesday, June 8th, 2011

Natural News – June 8, 2011

by Monica G. Young

While sipping drinks from coconut shells, psychiatrists from around the world recently met in Honolulu to discuss more ways to capitalize on human behavior and promote drug dependency. The occasion was the annual meeting of the American Psychiatric Association (APA), held in a Hawaiian convention center lined with mental disorder displays and pharmaceutical booths.

“Hot” topics (potential markets for social control and drug pushing) included:

1) Mental health issues during a woman’s reproductive cycle, such as “treating” pregnant women for bipolar – a disorder said to cause unusual shifts in mood and energy levels. In speaking to Medscape News, an APA committee co-chair, Dr. Don Hilty, called this “a really nice-growing area.”

Yet most every woman experiences mood and energy shifts during pregnancy. Despite this, it is not uncommon for pregnant women to be diagnosed as bipolar and prescribed antipsychotics, some of the most powerful drugs on the market. Even the FDA website alerts doctors to “be aware of the effects of antipsychotic medications on newborns when the medications are used during pregnancy.” The site warns of abnormal muscle movements and withdrawal symptoms, and the FDA’s adverse effects reporting program (Medwatch) includes cerebral hemorrhage, heart malformations and death as documented reactions in newborns. Similarly, studies show birth defects and other serious risks for infants whose mothers took antidepressants while pregnant.

2) Childhood disorders were a particularly popular issue at the convention. But they didn’t stop there – prenatal and newborn genetic screening for mental illness has taken on new emphasis in the psychiatric world. “It’s also trying to understand how genetics predict what medications can be used,” stated APA’s Dr. Hilty.

Having already labeled millions of kids “abnormal” and drenched their brains in toxic substances – a multi-billion dollar business – apparently they aren’t satisfied. They aim to brand children as mental patients and destine them for drug-dependency before they’re even born.

The conference even touched upon electroconvulsive shock therapy (ECT) for children – sending electric volts through their heads. That will teach ‘em to shut up and sit still! It will also cause permanent brain damage.

3) ADHD is usually promoted as a childhood disorder but a team of psychiatrists proposed a new definition to make it easier to diagnose (and drug) older teens and adults. They claim people who tend to miss work deadlines and interrupt others deserve this label.

This would surely lead to millions more on daily meds. Who doesn’t know co-workers who miss deadlines or even friends who interrupt you? Not emphasized however is that, per a study published in The Clinical Neuropsychologist, one in four adults seeking an ADHD diagnosis fake it to obtain stimulant drugs.

4) Capitalizing on America’s service men and women was another hot one: diagnosing and drugging the military for post-traumatic distress disorder, depression and anxiety.

Did they mention that 18 U.S. veterans commit suicide daily, largely due to psychiatric drugs? Not likely. As reported by Neev M. Arnell in NaturalNews, “the increasingly high number of deaths among both veterans and active duty soldiers-including suicides, accidental overdose, and lethal drug interactions-have now been linked to the exponential increase in the prescribing of drugs for post traumatic stress disorder, depression and other psychological illnesses.” (http://www.naturalnews.com/032598_v…)

5) Anticipating the “silver tsunami” as the Baby Boomer generation moves into the over-65 bracket, psychiatrists stressed the need for more psychiatric services for the elderly.

Not stressed, if mentioned at all, is the rampant over-use of psychiatric drugs in nursing homes. Elderly patients’ reactions to physical ailments are often squelched with mind-altering drugs. And a recently released government audit shows nearly one in seven elderly nursing home residents are given antipsychotics – nearly all of them dementia patients for whom the drugs can be lethal. Many lawsuits and settlements have revealed that drug companies have falsely promoted these drugs to doctors and nursing homes for years.

6) While not on the “hot” list, another issue that bit was bedbugs. A New York psychiatrist and his colleagues presented a detailed study showing bedbugs can trigger anxiety.

What a remarkable – and potentially profitable – discovery! Gee, with the rise in bedbug infestation in New York City, maybe Bedbug Anxiety should be included in the next edition of the DSM (psychiatry’s diagnostic and billing bible).

Father of psychiatry – the bloodletter

The American Psychiatric Association calls itself “the voice and conscience of modern psychiatry.”

Adorning the convention hall was the APA logo which enshrines Dr. Benjamin Rush (1746-1813) as the father of psychiatry. A very influential doctor, teacher and statesman of his time, Rush propagated his theory that Blacks suffered from an inherited disease called “Negritude.” The only evidence of a cure, he said, was the skin turning white. He warned, “whites should not intermarry with them, for this would tend to infect posterity with the ‘disorder.’” Whites, seeking not to be “infected,” used this fabled disease to justify segregation.

Rush was also a chief proponent of bloodletting as a cure-all for mental and physical illnesses. Widespread in America in those days, he made lots of money at it. One of Rush’s students applied his teachings to a patient who complained of a sore throat: nine pints of blood were removed from the man’s body in twenty-four hours and he died. That patient was George Washington, the first President of the United States.

Sources for this article include:
http://www.medscape.com/viewarticle…

http://www.medscape.com/viewarticle…

http://healthland.time.com/2011/05/…

http://healthland.time.com/2011/04/…

http://www.nytimes.com/2011/05/10/h…

http://www.jstor.org/pss/985399

http://www.websters-online-dictiona…

http://www.cchr.org/cchr-reports/cr…

About the author:
Monica G. Young is a human rights investigator and educational writer with a purpose to expose the truth about the pharmaceutical and psychiatric industries and safeguard human liberty. She encourages non-drug alternative approaches based on healthy lifestyles and human decency. She supports the Citizens Commission on Human Rights and like-minded groups.

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The business of ADHD

Wednesday, May 25th, 2011

SFGate.com City Brights Blog
By Winston Chung, Child Psychiatrist
May 24, 2011

Psychiatrists convened in sunny Honolulu for the 164th Annual Meeting of the American Psychiatric Association (APA) last week, discussing, among other things, moving forward with plans to make the diagnostic criteria for ADHD less stringent: proposed changes include reducing the number of required symptoms from 6 to 4, for adults and teens, and increasing the age-of-onset criteria from 7 to 12.

Russell Barkley, Ph.D., and Joseph Biederman, M.D., have written about abandoning or generously broadening age-of-onset criteria, arguing that the current, precise age-of-onset criteria poses “unwarranted practical problems for the study of older adolescents and adults.” These two men are considered ADHD experts and contributed to the American Academy of Child and Adolescent Psychiatry (AACAP) Practice Parameters for ADHD, which serve as guidelines by which most child psychiatrists practice.

According to a story from the New York Times, Joseph Biederman did not tell university officials about more than a million dollars received from drugmakers from 2000 to 2007, and he promised Johnson & Johnson research results that would benefit the drug company. On the list of AACAP Conflicts of Interests for Practice Parameters not listed in the Practice Parameters, Russell Barkley receives or has received research support, acted as a consultant and/or served on a speaker’s bureau for Eli Lilly and Company and Shire Pharmaceuticals Group.

Shire Pharmaceuticals Group has a substantial focus on ADHD meds, and they have been pulling out all the stops to try and turn a profit in the face of competition from generic drugs.

Earlier this month, Reuter’s Health described how drugmakers, including Shire, have raised prices to make up for lack of new products and loss of patent protection.

“Prices were just shoved up every year to make more money and meet earnings, to be blunt,” Shire (SHP.L) Chief Executive Angus Russell said.

Shire’s CEO also indicated that the FDA is supporting their plan to study the use of their ADHD drug, Vyvanse, for use in depression and schizophrenia, hoping for billions of dollars in extra sales through expansion of potential indications. Amphetamines for schizophrenia? Hmmmm…..

Jim Edwards of BNET wrote about Shire increasing the price of one of their own ADHD drugs, Adderall XR, to encourage users to switch to their branded, cheaper and newer ADHD drug, Vyvanse, leading to increased sales.

Shire somehow sold more ADHD drugs during a recent, national shortage of ADHD medications – their sales of Adderall XR increased 21 percent in the first quarter of 2011 – a time when many of the patients in San Francisco’s public mental health system were unable to receive their regular ADHD medications.

BNET posted excerpts of separate lawsuits filed by Impax and Teva, manufacturers of generic forms of Adderall XR. They claim that Shire did not honor their contracts and hoarded product for themselves during this recent shortage. In the Wall Street Journal, the associate director of FDA’s drug shortages program reported that this national ADHD drug shortage mostly affected generic forms of ADHD meds. Coincidence?

Other ways of getting around stagnant drug development and generic competition include taking an old drug or active ingredient, and changing the delivery system or duration of action and presenting it as a new, patent-protected product. Here are a few examples that have been associated with Shire:

- Vyvanse: Also known as lisdexamfetamine, Vyvanse is a prodrug of dextroamphetamine. Dextroamphetamine has been used since 1937 to treat hyperactivity in children, so it is hardly new. Vyvanse was marketed as having lower abuse potential – specifically, preventing abuse from snorting, since the prodrug requires digestion to release the active form. In my clinical experience, most abuse of stimulants is due to people taking it without a prescription or shaping their symptoms to get a prescription, and a prodrug likely does little to curb college students from seeking stimulants to study for exams.

- Daytrana: The transdermal methylphenidate (methylphenidate is the active ingredient in Ritalin) patch is worn on the skin and was developed as a way of bypassing the digestive tract, and my experience prescribing this drug was met with equivocal reports from patients and families. I guess there is a reason I can’t remember anyone saying it worked – Shire gave up on the ADHD patch after 9 product recalls and a federal probe.

- Intuniv: An extended release form of guanfacine, Intuniv is touted as a new, non-stimulant treatment for ADHD. But child psychiatrists have been using guanfacine in ADHD for years, and this ‘extended-release’ form has a half-life of about 18 hours, while generic guanfacine has a half-life of about 17 hours – not a robust difference, in my opinion.

I liken these approaches to gimmicks utilized in the mass-produced, beer market: color changing labels to let you know if your beer is cold, wide-mouth beer cans, or vortex bottles. Do any of these ‘innovations’ really change the fact that you’re drinking cheap beer?

As the DSM-V looms closer to becoming a reality, I can’t help but think of words from the man who chaired the committee for the DSM-IV. Allen Frances, M.D., wrote in the in the LA Times:

As chairman of the task force that created the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), which came out in 1994, I learned from painful experience how small changes in the definition of mental disorders can create huge, unintended consequences.

Our panel tried hard to be conservative and careful but inadvertently contributed to three false ‘epidemics’ – attention deficit disorder, autism and childhood bipolar disorder. Clearly, our net was cast too wide and captured many ‘patients’ who might have been far better off never entering the mental health system.

The DSM-IV was and the DSM-V will be published by the APA. The same APA that, in 2010, rejected internal recommendations – led by an APA past-president – to regulate or curtail individual psychiatrists’ relationships with the pharmaceutical industry.

Loosening the diagnostic criteria for ADHD, as proposed, will no doubt lead to more people being diagnosed and, inevitably, taking more ADHD drugs. I like to think that the APA and their doctors pushing for the changes are motivated by helping patients and not drug company profits.

After all, if anyone can identify and address unconscious conflicts or psychologically-defended, aggressive drives, it’s a psychiatrist, right?

Read article here:  http://www.sfgate.com/cgi-bin/blogs/wchung/detail?entry_id=89494

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American Psychiatric Association Stunned Again with Ghostwriting Controversy

Wednesday, April 13th, 2011
Project Government Oversight- April 12, 2011
By Paul Thacker

Like an aging, punch drunk fighter struggling through the twelfth round, the American Psychiatric Association (APA) can’t seem to slip the punches coming its direction. Last week, a host of blogs went after them for refusing to print a letter written by three academics that was critical of a medical textbook the APA published with help from the ghostwriting company Scientific Therapeutics Information (STI).

The letter criticized the APA for failing to publish records that explain the provenance of the textbook, including drafts, contracts with STI and/or GlaxoSmithKline, and any communications regarding editing. The text’s purported authors are Dr. Charles Nemeroff of the University of Miami and Dr. Alan Schatzberg of Stanford University.

As The New York Times reported, the textbook was funded by GlaxoSmithKline. Author and blogger Dr. Danny Carlat reviewed the book and wrote that it read like “an advertisement for Paxil.”

Yesterday, a writer over at MIWatch landed a blistering combination on the APA. When she poked them for a response, the APA covered up and peeked back through their gloves. “The APA’s official response has been unconvincing,” she jabbed.

She then landed a solid uppercut.

Before the controversial textbook ended up in the story in The New York Times, she wrote, STI displayed a picture of the book’s cover in their results portfolio. They’ve now yanked the page from their website, but the MIWatch writer found an older version of the page on the Wayback Machine. When you click on the “publications” button and scroll down, you can see a picture of the textbook’s cover.

Wayback shot
The APA caught a few more whallops this morning from HealthCare Renewal and The Carlat Psychiatry Blog. Over at Pharmalot, Ed Silverman scored a brief interview with STI’s CEO John Romankiewicz.  When asked why the book had disappeared from STI’s website, Romankiewicz said,  “Thanks for the inquiry, but we don’t display that kind of stuff on our web site.”

He then hung up the phone.

The APA’s reluctance to engage with critics may be due to the association’s cozy ties to STI. In 2007, STI “medical writer” Sally Laden was deposed during litigation regarding Paxil. POGO has acquired a copy of the deposition. There are quite a few editing errors, so bear with us. Some interesting tidbits from pages 237-238:

Question: Okay So we talked about the workbooks And now I think we are down to the next topic

Sally Laden: Which is an APA symposia

Question: Okay Did STI help well you tell me What go ahead Keep taking me through this

Sally Laden: We worked on a number of APA the American Psychiatric Association has an annual meeting some time in the spring every year And for many years we helped them with programs symposia at the APA

Question: Okay And so what is the next topic here?

Sally Laden: It says who chose topics and speakers

Question: Okay And what was the answer to that?

Sally Laden: The general topics say depression  in the elderly would be chosen by GSK  Saying can you help us with the symposium  on that And we have already spoken to a  Chairperson Now will you work with the Chairperson to come up with the agenda and the speakers for this program

Question: Okay Do you recall setting up speakers to talk on the topic of adolescent depression?

Sally Laden: Sometimes we did I don t remember if we did one at APA or not

Question: I m sorry?

Sally Laden: I don t remember if there was an APA symposia on adolescent depression

Seems like the American Psychiatric Association and Scientific Therapeutics Information have been friendly for some time, no?

Paul Thacker is a POGO Investigator.

http://pogoblog.typepad.com/pogo/2011/04/american-psychiatric-association-stunned-again-with-ghostwriting-controversy.html

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American Psychiatric Association Slammed by Disease Mongering Parody Featuring Instant Disease Generation Engine

Wednesday, March 23rd, 2011

Saleonl.com, March 23, 2011
By Steve Diaz

click image for Disease Mongering Engine

The American Psychiatric Association is under fire today by an independent health news site’s launch of the “Disease Mongering Engine” – an online tool that allows users to instantly generate disorders, dysfunctions and syndromes that sound real, but aren’t.

Available at www.NewsTarget.com, the Disease Mongering Engine was created by Mike Adams, a vocal critic of modern psychiatric medicine and its practice of labeling healthy people with fictitious diseases, then over-medicating them with patented pharmaceuticals.

“Modern psychiatry has lost its way and has now become a marketing branch of Big Pharma,” Adams said. “Convincing healthy people that they’re diseased, then harming them with unsafe chemical medications, is not a legitimate approach to health and healing.” Diseases ranging from ADHD to Social Anxiety Disorder were “invented” by drug companies and psychiatrists, Adams says, as a way to generate billions of dollars in profits by selling treatment drugs and services to people who don’t need them.

The Disease Mongering Engine is capable of generating more than 73,000 unique disease names. Disease definitions are also generated using advanced linguistic modeling that results in real-sounding disease explanations using words and phrases found in the American Psychiatric Association’s DSM-IV, the “bible” of psychiatric disorders.

In initial testing, the engine randomly generated more than 25 disorders that are actually listed in the DSM-IV and used by psychiatrists to diagnose children and adults.

Humorous disease names generated by the Disease Mongering Engine include Repetitive Erectile Sleepwalking Dysfunction (RESD), Repetitive Manic Identity Syndrome With Anxiety (RMISWA) and Intermittent Dysmorphic Eating Dysfunction With Indigestion (IDEDWI). Users can generate more fictitious diseases at: http://www.newstarget.com/disease-mongering-engine.asp

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