Does your child really have a behaviour disorder? A shocking book by a leadingtherapist reveals how millions of us - including children - are wrongly labelledwith psychiatric problemsPUBLISHED: 00:31, 7 May 2013 | UPDATED: 00:32, 7 May 2013Comments (194)ShareoooFrom depression to anxiety and ADHD, more of us now suffer from mental health problems and need pills totreat them — or so we’re told. But in this shocking indictment of modern psychiatry, JAMES DAVIESsuggests that this rise in mental illness is down to the greed of drug companies and the pursuit of medicalstatus. The author is a psychological therapist who has worked for the NHS and the mental health charityMind.When I meet Sarah Jones, a mother of two and a care worker in West London, her love for her family and workclearly shine through. But when we talk about her seven-year-old son Dominic, she seems overcome with anxiety.„Dominic is a lovely boy, but last year he started getting agitated and aggressive. He was doing badly at school andthen he got into a fight,‟ she says.The school psychologist wanted Dominic to have a doctor‟s assessment. After seeing the boy for 25 minutes, thedoctor said he was suffering from attention deficit hyperactivity disorder, or ADHD.(Stock image) James Davies believes that doctors are too quick to diagnose children with disorders such as ADHD„Dominic is on pills,‟ says Sarah. „He seems less distracted sometimes, but he also doesn‟t seem himself either. Itfeels as if a part of his spirit has gone.‟ Sarah‟s distress is palpable.Year on year, increasing numbers of children like Dominic are having mental disorders such as ADHD diagnosed. Inthe past ten years, ADHD diagnoses have risen so sharply that around 5 per cent of children in Europe are thought tohave it.More...A VERY unusual reason why men can struggle to become fathers (And it can all date back to childhood)The Botox for hair that could save women from going bald: Fish protein found in diet of Greenlands Inuits reduces thinning hair
This vaulting rise in ADHD is consistent with a growth in childhood psychiatric disorders. It‟s estimated up to 15 percent of children fall under the criteria of a diagnosable mental disorder in any year.These figures pale in comparison with those for the adult population. On the subject of „psychiatric morbidity‟, the UKOffice for National Statistics reckons that in any given year a quarter of all adults qualify as suffering from at least onedisorder.James Davies has written on the subject of the medicalisation of psychological issuesThis is as defined in manuals such as the psychiatrists‟ „bible‟, the Diagnostic and Statistical Manual of MentalDisorders (DSM) or its close equivalent, the International Classification of Diseases (ICD), which they use as thebasis of making diagnoses.In the Fifties, the figure was more like one in 100. So why in just a few decades have we apparently all become sopsychiatrically unwell?The explanation lies in an unhappy truth at the heart of mainstream psychiatric practice: much of the profession‟sclaimed knowledge about diagnosing mental illness is scientifically baseless.Unlike in other areas of medicine, where a doctor can conduct a blood or urine test to determine whether they havereached the correct diagnosis, in psychiatry no such methods exist.Such scientifically objective tests don‟t exist because psychiatry has yet to identify any clear biological causes formost disorders listed in the DSM, which has grown bigger and bigger with each edition.When we look into the manual‟s origins, we uncover some disturbing evidence.I interviewed Dr Robert Spitzer, the Columbia University psychiatrist, who was in charge of compiling the third editionof the DSM, which set the trend for modern psychiatric practice. When it was published in 1980, it became asensation and sold out immediately.In the manual, his team had defined 80 new mental disorders. These became household terms. For example, post-traumatic stress disorder and major depression became as real in the popular imagination as the common cold.In Britain, the manual had such impact that by the end of the Eighties most British psychiatrists were being trained touse it.Yet, as its influence spread, the truth about its construction remained obscure. Most professionals using it didn‟t knowthe extent to which biological evidence or solid research failed to guide the choices its authors made.SCIENCE? NO, IT’S A SHAMBLES
When I spoke to Dr Spitzer, he told me matter of factly: „There are only a handful of mental disorders in the DSMknown to have a clear biological cause. These are known as the organic disorders [such as epilepsy andAlzheimer‟s]. These are few and far between.‟„So, let me get this clear,‟ I pressed. „There are no discovered biological causes for many of the remaining mentaldisorders in the DSM.‟There are only a handfull of disorders that are actually biological, but these are few and far betweenHe replied: „It‟s not for many, it‟s for any! No biological markers have been identified.‟In other words, the definitions were based purely on what the committee who drew up the DSM-III decided should goin. And these discussions were far from rigorous.Renee Garfinkel, a psychologist who participated in two committees that helped to compile the DSM-III, told me:„What I saw happening on these committees wasn‟t scientific — it more resembled a group of friends trying to decidewhere they want to go for dinner.„One person says “I feel like Chinese food,” and another one says “No, no, I‟m really more in the mood for Indian.”Finally, after some discussion and collaborative give and take, they all decide to have Italian.„On one occasion there was a discussion about whether a particular behaviour should be classed as a symptom of aparticular disorder.„To my astonishment, one committee member piped up: “Oh no, no, we can‟t include that behaviour as a symptom,because I do that.”„So it was decided that behaviour would not be included because, presumably, if someone on the committee does it,it must be normal.‟
Allen Frances, who led the compiling of the next edition, DSM-IV, has seen how this process of adding newdiagnoses can run out of control.The fourth manual added Asperger‟s syndrome (covering people who don‟t have full-blown autism), ADHD andbipolar II — broadly speaking, a milder form of bipolar disorder, or manic depression as it used to be known, in whichthe „up‟ swings never reach full-blown mania.„These decisions helped promote three false epidemics in psychiatry,‟ he told me.„We now have a rate of autism that is 20 times what it was 15 years ago. By adding bipolar II, that has resulted inlots more use of anti-psychotic and mood- stabiliser drugs.„We also have rates of ADHD that have tripled, partly because new drug treatments were released that wereaggressively marketed.‟TURNING GRIEF INTO AN ILLNESSThis month we are due to see the publication of a new edition, called DSM-5. „The situation is only going to getworse,‟ Frances told me.„DSM-5 is suggesting changes that will dramatically expand the realm of psychiatry and narrow the realm of normality— converting millions more people from being without mental disorders to being psychiatrically sick.„It will have many unintended consequences, which will be very harmful. I am particularly concerned about those thatwill lead to the excessive use of medication.‟DSM-5 proposes to make ordinary grief a mental disorder. Feelings of deep sadness, loss, sleeplessness, crying,inability to concentrate, tiredness and low appetite, if they continue for more than two weeks after the death of a lovedone, could warrant a diagnosis of depression.Frances is also worried by the new „generalised anxiety disorder‟, which threatens to turn the pains anddisappointments of everyday life into mental illness.Then there is „disruptive mood dysregulation disorder‟, which will see children‟s tantrums become symptoms ofdisorder.Wherever this manual is used we can expect vaulting numbers of people to become yet more statistical droplets inthe ever expanding pool of the mentally unwell.They will very often then be prescribed drugs. With conditions such as depression, those drugs are purported toremedy so-called „chemical imbalances‟ in the brain.Putting labels on people is that it ends up medicalising problems that are notmedical in nature.Dr Sami Timimi, psychiatristBut despite nearly 50 years of investigation into the theory that chemical imbalances are the cause of psychiatricproblems, studies in respected journals have concluded that there is not one piece of convincing evidence the theoryis actually correct.And if the evidence for the biological causes of this growing number of mental health conditions is almost non-existent, the evidence for the drugs being used to treat them is also most often unconvincing.This is particularly true of anti-depressants. The pharmaceutical industry makes more than £13 billion worldwide eachyear from anti-depressants. Doctors are convinced of their effectiveness. But solid scientific research showsotherwise.To find out why, I visited Professor Irving Kirsch, an associate director at Harvard Medical School and perhaps themost talked-about figure in antidepressant research.Kirsch‟s reputation stems from an analysis he performed that gathered all the clinical studies he could find thatcompared the effects of anti-depressants to sugar-pill placebos on depressed patients. He pooled all the results toget an overall figure, which led to a startling conclusion.
„What we expected to find was that people who took the antidepressant would do far better than those taking theplacebo. We couldn‟t have been more wrong,‟ said Kirsch.In fact, the difference in improvement between placebo and anti-depressant groups was clinically insignificant. Sowhy are so many psychiatric drugs prescribed when the evidence underpinning them is so scant, and when theillnesses diagnosed have no biological basis?GlaxoSmithKline settled out of courand paid $2.5million for charges of consumer fraud after the Seroxat scandalNearly all research into psychiatric drugs is sponsored by the pharmaceutical industry. This has led to thecompromise of scientific standards, and the manipulation of research with the aim of maintaining or increasing profits.In one notorious example, the British company GlaxoSmithKline conducted three studies of its anti-depressant,Seroxat. These investigated whether this drug could reduce major depression in adolescents.One trial showed mixed results, another that Seroxat was no more effective than a placebo, while the third suggestedthe placebo may be more effective with certain children.A COVER-UP BY THE DRUG GIANTSDespite these results, the company published only the most positive study. An internal company document, leaked tothe Canadian Medical Association, showed that company officials had suppressed negative results from one studybecause, as they said: „It would be commercially unacceptable‟.A U.S. lawsuit was filed against GlaxoSmithKline in 2004 for intentionally hiding negative findings.This was settled out of court two months later when the company paid $2.5 million for charges of consumer fraud; ameagre sum considering it made $4.97 billion in worldwide sales from the drug in 2003.
GlaxoSmithKline claimed that Seroxat had positive results when in fact it had failed several testsIt‟s hardly an isolated case. An article published by the New England Journal of Medicine in 2008 reviewed more than70 major studies of antidepressants‟ efficacy and found 33 that showed negative results had been buried ormanipulated to convey a positive outcome.But pharmaceutical companies‟ influence runs deep. In the past 20 years the industry has become a major financialsponsor of psychiatry, with unprecedented influence over psychiatric practice and research.Nearly all research into psychiatric drugs is pharmaceutically financed. Nearly 90 per cent of all clinical trials in theUK are conducted or commissioned by the industry.The influence of drug companies also reaches into the latest editions of the psychiatrists‟ bible. A study by theUniversity of Massachusetts showed that of the 170 panelmembers of DSM-IV, 95 (or 56 per cent) had one financial association or more with the pharmaceutical industry.This trend has continued with the writers of the forthcoming DSM-5. Of the 29 members of the task force thatoversees it, 21 — including the chairman and vice-chairman — have received consultancy fees or funding frompharmaceutical firms.