Two front page articles in today’s New York Times are of particular significance addressing both quality of care and expenditure.
1. “Revising Book on Disorders of the Mind” by Benedict Carey, reveals that the bipolar diagnosis for children and the prescribing of toxic antipsychotics for children will be delegitimized in the revised diagnostic manual in psychiatry, the DSM-5.
http://www.nytimes. com/2010/ 02/10/health/ 10psych.html
The foremost revision to psychiatry’s diagnostic manual (in the forthcoming DSM-V) overturns current American psychiatric practice of loosely “diagnosing” children with bipolar and then mis-prescribing toxic antipsychotics for children. These practices have been aggressively promoted by leading child psychiatrists, most notably by Dr. Joseph Biederman of Harvard / Massachusetts General Hospital .
Under the revised DSM-V diagnostic criteria, “Far fewer children would get a diagnosis of bipolar disorder.”
This revision is clearly the result of documented evidence brought to public attention. The evidence shows that children have become casualties of psychiatry’s commercially driven, drug-centered, clinical practices. Adding fuel were the revelations about those psychiatrists’ financial ties to psychotropic drug manufacturers.
”‘The treatment of bipolar disorder is meds first, meds second and meds third,” said Dr. Jack McClellan, a psychiatrist at the University of Washington who is not working on the manual. ‘Whereas if these kids have a behavior disorder, then behavioral treatment should be considered the primary treatment’.”
Children have been misdiagnosed, then targeted for abusive prescribing of toxic drugs, endorsed by American child psychiatrists at leading academic institutions and the American Psychiatric Association. “The misdiagnosis led many children to be given powerful antipsychotic drugs, which have serious side effects, including metabolic changes.”
Leading psychiatrists now admit that most of unruly children were misdiagnosed as bipolar: “One significant change would be adding a childhood disorder called temper dysregulation disorder with dysphoria, a recommendation that grew out of recent findings that many wildly aggressive, irritable children who have been given a diagnosis of bipolar disorder do not have it.”
“Some diagnoses of bipolar disorder have been in children as young as 2, and there have been widespread reports that doctors promoting the diagnosis received consulting and speaking fees from the makers of the drugs.”
Of note, psychiatry’s leadership – those who are largely responsible for the meteoric rise in the labeling of normal children as “bipolar” – who led the way by lending the appearance of legitimacy to the illegitimate prescribing antipsychotics for young children – which rank among industry’s most damage-producing drugs – are retreating from their stance.
Even Dr. David Shaffer, a child psychiatrist at Columbia, a strong proponent of using psychoactive drugs for children; the psychiatrist responsible for the design and promotion of TeenScreen – a mental screening dragnet designed to increase the number of school children labeled with mental disorders requiring immediate intervention; has now conceded that the current practice of labeling misbehaving children as bipolar has been wrong.
A second important revision would retreat from the practice of presuming that children’s misbehavior signaled “risk syndromes” for severe incapacitating mental illness which justified interventions with toxic pharmaceuticals:
“I completely understand the idea of trying to catch something early, but imagine the human tragedies that follow the mislabeling of 70% of children as severely mentally ill, who are then exposed to extremely toxic drugs that induce diabetes, cardiovascular disease, and a host of other severe adverse effects. Adding insult to injury, US taxpayers have been saddled with the cost of drugs that undermine the health of children who then require life-long care for drug-induced (iatrogenic) chronic diseases.
http://www.nytimes. com/2010/ 02/10/health/ policy/10care. html?ref= todayspaper
see also www.ahrp.org
Tags: behavioral treatment, bipolar