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There Is No Such Thing as a Psychiatric Disorder/Disease/Chemical Imbalance

Fred Baughman, MD

In her recent PLoS Medicine article, Christine Phillips writes: “ADHD [attention deficit hyperactivity disorder] joins dyslexia and glue ear as disorders that are considered significant primarily because of their effects on educational performance” [1]. A “disorder” is “a disturbance of function, structure, or both,” and thus, the equivalent of an objective abnormality/disease [2]. In neurologically normal children, dyslexia cannot be proved to be a disorder/disease. “Glue ear,” however, is otitis media, an objective abnormality/ disease. Phillips continues: “In the case of ADHD, there has been a complex, often heated debate in the public domain about the verity of the illness,” but proceeds, without an answer, to consider “the roles of teachers as brokers for ADHD and its treatment.”

In 1948, “neuropsychiatry” was divided into “neurology,” dealing with diseases, and “psychiatry,” dealing with emotions and behaviors [3]. If there is a macroscopic, microscopic, or chemical abnormality, a disease is present. Nowhere in the brains or bodies of children said to have ADHD or any other psychiatric diagnosis has a disorder/disease been confirmed. Psychiatric drugs appeared in the fifties. Psychiatry and the pharmaceutical industry authored the “chemical imbalance” market strategy: they would call all things psychological “chemical imbalances” needing “chemical balancers”—pills.

At the September 29, 1970, hearing on Federal Involvement in the Use of Behavior Modification Drugs on Grammar School Children, Ronald Lipman of the United States Food and Drug Administration (FDA), argued: “hyperkinesis is a medical syndrome. It should be properly diagnosed by a medical doctor” [4].

In 1986, Nasrallah et al. [5] reported brain atrophy in adult males treated with amphetamines as children, concluding: “since all of the HK/MBD [hyperkinetic/minimal brain dysfunction] patients had been treated with psychostimulants, cortical atrophy may be a long-term adverse effect of this treatment.”

At the 1998 National Institutes of Health (NIH) Consensus Development Conference on ADHD, Carey [6] stated: “The ADHD behaviors are assumed to be largely or entirely due to abnormal brain function. The DSM-IV does not say so but textbooks and journals do.... What is now most often described as ADHD...appears to be a set of normal behavioral variations.”

However Swanson and Castellanos [7], having reviewed the structural magnetic resonance imaging (MRI) research, testified: “Recent investigations provide converging evidence that a refined phenotype of ADHD/HKD (hyperkinetic disorder) is characterized by reduced size in specific neuroanatomical regions of the frontal lobes and basal ganglia.” I challenged Swanson, asking: “Why didn't you mention that virtually all of the ADHD subjects were on stimulant therapy—the likely cause of their brain atrophy?” [8] Swanson confessed this was so—that there had been no such studies of ADHD-untreated cohorts.

The Consensus Conference Panel concluded: “We do not have a valid test for ADHD... there are no data to indicate that ADHD is a brain malfunction” [9]. (This wording appeared in the version of the final statement of the Consensus Conference Panel distributed at the press conference in the final part of the Consensus Conference, November 18, 1998. This wording, which appeared for an indeterminate time on the NIH Web site, was subsequently removed and replaced with wording claiming “validity” for ADHD.)

In 2002, Castellanos et al. [10] published the one and only MRI study of an ADHD-untreated group. However, because the ADHD-untreated patients were two years younger than the controls, the study was invalid, leaving stimulant treatment, not the never-validated disorder, ADHD, the likely cause of the brain atrophy.

In 2002, Daniel Weinberger, of the National Institute of Mental Health, claimed “major psychiatric diseases” are associated with “subtle but objectively characterizable changes” but could reference not a single proof (quoted in [11]).

In 2002, the Advertisement Commission of Holland [12] determined that the claim that ADHD is an inborn brain dysfunction was misleading and enjoined the Brain Foundation of the Netherlands to cease such representations.

In 2003, Ireland prohibited GlaxoSmithKline from claiming that the antidepressant Paxil “works by bringing serotonin levels back to normal.” Wayne Goodman of the FDA acknowledged that claims that selective serotonin reuptake inhibitors correct a serotonin imbalance go “too far,” but had the temerity to suggest that “this is reasonable shorthand for expressing a chemically or brain-based problem” (quoted in [13]).

At an FDA hearing on March 23, 2006, I testified: “Saying any psychiatric diagnosis ‘is a brain-based problem and that the medications are normalizing function’ is an anti-scientific, pro-drug lie” [14]. Yet this has become standard practice throughout medicine, for example, at the American Psychiatric Association [15], American Medical Association [16], American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, Child Neurology Society, American Academy of Family Physicians [17], FDA [13], and virtually all US government health-care agencies.

Journal articles [6], press releases, ads [18], drug inserts, and research informed consent documents say, or infer, that psychological diagnoses are abnormalities/diseases. All patients and research participants with psychological problems are led to believe they have an abnormality/disease, biasing them in favor of medical interventions, and against nonmedical interventions (e.g., love, will power, or talk therapy), which presume, as is the case, that the individual is physically and medically normal and without need of a medical/pharmaceutical intervention.

The FDA is the agency most responsible for conveying the facts needed by the public to make risk versus benefit and informed consent decisions. Instead—by protecting industry, not the public—the FDA is a purveyor of the psychiatric “disease” and “chemical imbalance” lie. This must change.

Fred Baughman
El Cajon, California, United States of America
E-mail: fredbaughmanmd@cox.net

References

1. Phillips CB (2006) Medicine goes to school: Teachers as sickness brokers for ADHD. PLoS Med 3: e182 DOI: 10.1371/journal.pmed.0030182. Find this article online
2. Stedman TL (1990) Stedman's medical dictionary, 25th ed. Baltimore: Williams and Wilkins. 1784 p.
3. Cohen MM, editor (1998) American Academy of Neurology: The first 50 years, 1948–1998. St. Paul (Minnesota): American Academy of Neurology. 338 p.
4. Lipman R (1970 September 29) Federal involvement in the use of behavior modification drugs on grammar school children of the right to privacy inquiry. Hearing before a Subcommittee of the Committee on Government Operations House of Representatives, Ninety-First Congress, Second Session.
5. Nasrallah HA, Loney J, Olson SC, McCalley-Whitters M, Kramer J, et al. (1986) Cortical atrophy in young adults with a history of hyperactivity in childhood. Psychiatry Res 17: 241–246. Find this article online
6. Carey WB (1998) Is attention deficit hyperactivity disorder a valid disorder? In: Program and Abstracts, NIH Consensus Development Conference on Attention Deficit Hyperactivity Disorder; 16–18 November 1998; Bethesda, Maryland. pp 33–36.
7. Swanson J, Castellanos FX (1998) Biological bases of attention deficit hyperactivity disorder. Program and Abstracts, NIH Consensus Development Conference on Attention Deficit Hyperactivity Disorder; 16–18 November 1998; Bethesda, Maryland. pp 37–42.
8. Baughman FA (1999) ADHD—Total, 100% fraud [video]. Produced from the official video of the NIH Consensus Development Conference on Attention Deficit Hyperactivity Disorder; 16–18 November 1998; Bethesda, Maryland.
9. (1998 November 18) National Institutes of Health Consensus Development Conference Statement.
10. Castellanos FX, Lee PP, Sharp W, Jeffries NO, Greenstein DK, et al. (2002) Developmental trajectories of brain volume abnormalities in children and adolescents with attention- deficit/hyperactivity disorder. JAMA 288: 1740–1748. Find this article online
11. McBride G (2002 June) Neuroimaging advances offer new data on stroke detection and the genetics of mental illness. Neurol Today: 26–28.
12. Holland's Advertisement Code Commission on ADHD In the case: Nederland Comite voor de Rechten van de Mens (CCHR), domiciled in Amsterdam, plaintiff; The Brain Foundation Netherlands, domiciled in the Hague, defendant. Decision of the Advertisement Code Commission (Chamber II) 4 July 2002.
13. Meek C (2006) SSRI ads questioned. CMAJ 174: 754. Find this article online
14. Baughman FA (2006 March 23) Fred Baughman's testimony to the Psychopharmacologic Drugs Advisory Committee. Washington (D. C.): Department of Health and Human Services. Available: http://www.fda.gov/ohrms/dockets/ac/06/transcripts/2006-4212T1-Part1.htm. Accessed 13 June 2006.
15. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders DSM-IV, 4th ed. Washington (D. C.): American Psychiatric Association. 886 p.
16. Baughman FA (1999) Treatment of attention-deficit/hyperactivity disorder. JAMA 281: 1490. Find this article online
17. Baughman FA (2001) Diagnosis and evaluation of the child with attention-deficit/hyperactivity disorder. Pediatrics 107: 1239. Find this article online
18. Lacasse JR, Leo J (2005) Serotonin and depression: A disconnect between the advertisements and the scientific literature. PLoS Med 2: e392 DOI: 10.1371/journal.pmed.0020392. Find this article online

Funding: The author received no specific funding for this article.

Competing Interests: FB is a retired neurologist/child neurologist, board certified, with no financial conflicts of interest, and with no affiliations with organizations or institutions having such conflicts. Formerly FB was a March of Dimes/National Foundation scholar and published considerably from a private practice base. FB is author of the book The ADHD Fraud—How Psychiatry Makes “Patients” of Normal Children. FB has testified widely about the absence of proof that any psychiatric disorders have been validated as objective abnormalities/diseases. Most recently FB testified at hearings at the US Food and Drug Administration (March 2006) and before the Congress of Mexico (March 2006).

Published: July 25, 2006

DOI: 10.1371/journal.pmed.0030318

Copyright: © 2006 Fred Baughman. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Citation: Baughman F (2006) There Is No Such Thing as a Psychiatric Disorder/Disease/Chemical Imbalance. PLoS Med 3(7): e318

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