Richard Friedman’s “call for caution” on the use of anti-psychotic drugs in the American population comes a bit late in the day. Professors like Joseph Biederman remain at places like Harvard.

… Biederman is a leading proponent of the off-label use of antipsychotic drugs to treat bipolar illness in children. His work is widely seen as contributing to an explosive growth in such prescriptions, and much of his support came from companies that benefited from his research.

Friedman doesn’t even talk about the grotesque over-prescription of these drugs for children.

The professors putting together the upcoming edition of the DSM are also doing their bit, pathologizing moods like “mild emotional discomfort” so that everyone will feel comfortable medicating them with powerful anti-psychotics.

The author of a new book about growing is interviewed.

[G]etting a mental-health diagnosis can intersect with the adolescent search for self. Being diagnosed and using medication confers an identity, that of someone with a mental disorder. To an adolescent who is preoccupied with constructing an identity anyway, and looking for clues to who she is, that can be a big deal. Some adolescents feel that having a diagnostic label is clarifying and that it helps them. But others wrestle with it. They ruminate about what it means to be sick. They take that identity deep inside, and sometimes magnify it way out of proportion. A diagnosis event can have lasting, rippling consequences, and I think adults should be very cautious and careful before they impose a diagnostic label, or let a young person self-impose such a label, on what may be ordinary developmental struggles.

But hey. That’s nothing. Because of the work of Joseph Biederman and others, it’s now routine for American toddlers to be given powerful psychotropics.

… hit close to home for UD last year, with one of her colleagues in the econ dept (here’s the post about him) (and here’s the original article about the conflict of interest) failing to note that a paper of his offering “a strong argument for shrinking the role of the Federal Housing Administration in insuring mortgages… was at least partially underwritten by the private mortgage insurance giant Genworth Financial Inc., which stands to benefit from a pull back in the market by FHA.”

Turns out this sort of thing is all in a day’s work for a lot of economists, who, like some scientific researchers at universities (led in the enterprise, until recently, by Charles Nemeroff and Joseph Biederman), don’t see why it’s anyone’s effing business which corporation or interest group pays for (and maybe ghostwrites) their research.

The American Economic Association has now adopted a few COI rules.

One of the daffier experimental ideas in the Australian mental health community – trying out anti-psychotic drugs on children as young as fifteen who have never had a psychotic episode but might, by some mysterious standard, be at risk for one in the future – has been shot down due to international outrage.

Whether it’s Joseph Biederman here or Patrick McGorry there, note the common thread: dosing young and vulnerable brains and bodies with immensely powerful drugs, based on the thinnest of diagnostic justifications. It’s a sickening, destructive, and frightening trend. Universities need to be aware that they are housing – and often celebrating – the dosers.

… Hauser immediately after the sanctioning of Harvard’s Joseph Biederman, it’s time to pause and think about the striking number of very high-powered faculty there who over the last few years have been under a cloud, or disgraced or, like Hauser, forced out. What’s it mean?

Keep in mind, first, that simply by virtue of happening at Harvard, faculty news gets a lot of attention. For all we know, multiple high-ranking faculty at Clemson have been punished or forced out for research misconduct, conflict of interest and failure to report massive income, conspiracy to defraud, failure to register as a lobbyist, plagiarism, etc. But we don’t pay attention to Clemson; we pay attention to Harvard.

Still, whatever the numbers, it’s pretty amazing that during the course of this blog I’ve followed endless stories of the most high-powered professors in the world — high-powered Harvard professors — doing bad things.

Most of these stories involve what I’d call crimes of grandiosity. Not opportunity; grandiosity. You work your way to the top legitimately; then, at the top, the same cleverness and ego and competitiveness and sense of invulnerability and restless insistence on more that got you to the top tips you in the direction of recklessness.

To be sure, some of these cases are boringly about personal greed (Biederman and Shleifer in particular); but all of them involve as well a significant element of empire-building, power-mongering, and arrogance. Many involve people who, bizarrely, don’t need to break rules in order to maintain their position of prominence in the culture. They break them anyway. So say also that there’s some operation of pleasure at work here; that these particular personalities have been drawn to the rarified, high-energy setting of Harvard because there’s visceral gratification to be had by scoring repeatedly and scoring big.

UD‘s colleagues Anthony Yezer and Robert Van Order appear to be small players in the very large, competitive game of corporate funded and controlled research results (even corporate controlled faculty) in the contemporary American and European university.

**********************************************

Lately, some of the bigger players seem to be jostling each other out of the way for the right to pleasure the financial sector. BABY, TELL ME WHAT YOU WANT ME TO SAY AND HOW TO SAY IT. WRITE IT YOURSELF IF YOU WANT AND I’LL SIGN IT. LIE BACK AND NIBBLE MY INTELLECTUAL NEUTRALITY.

Harvard’s bipolar babe, Joseph Biederman, pitched his research center to Johnson and Johnson by writing to them that it would “move forward the commercial goals of J.& J.”

Most of these chicks deny. Biederman burbles happily away and Harvard can’t get enough of it…

Sure, when he gets really out there they sanction him … But he’s still a big girl on campus… And always will be!

So here you’ve got this latest article in the New York Times about how a German bank gave a couple of universities there a lot of money and

the bank was allowed a say in the hiring of … two professors. It was also given the right to have bank employees designated as adjunct professors, allowed to grade student work. Appropriate topics for research and research strategy would be decided by a steering committee made up of two academics and two bank employees, with the managing director, a bank employee, casting the deciding vote in the event of a tie.

Deutsche Bank was given the right to review any research produced by members of the Quantitative Products Laboratory 60 days before it was published and could withhold permission for publication for as long as two years. The agreement even specified that the laboratory would be located “in close proximity to the Deutsche Bank” headquarters in Berlin.

Finally, the whole agreement was to be secret…

At last my heart’s an open door; and my secret love’s no secret anymore!

… this book. It shows a child’s hand grabbing a massive number of pills. [Scroll down to read some of the book.]

Your Child Does Not Have Bipolar Disorder is a richly deserved attack on one of Harvard University’s most prominent professors, Joseph Biederman, a man whose financially self-interested insistence on this serious diagnosis continues to damage and stigmatize millions of young children.

The book’s author, Stuart Kaplan, a professor at Penn State, also has a blog on which he worries, in a day-to-day way, about the psychiatric profession maintaining Buy-Bipolar Biederman’s regime. He notes that although the diagnosis is gradually (thanks to books like Kaplan’s, and to Biederman’s having been sanctioned for taking and not disclosing drug money) being discredited, the editors of the latest, in-progress DSMV are still saying things like this:

… ‘[C]lassic’ adult [bipolar disorder] clearly does present in pre-pubertal children as well as in adolescents, although it may be rare in the younger age group. Unambiguous agreement about this fact weighed heavily in the Work Group’s deliberations.

Kaplan goes to town on this:

The use of the wording “unambiguous agreement about this fact” is a coercive rhetorical device that has held sway for more than 15 years in the pediatric bipolar scientific literature. Instead of providing evidence, the Work Group attempts to persuade the reader that everyone who is smart and important knows this to be true. In truth the assertion is unfounded and has no place in sophisticated scientific discussions of bipolar disorder in children. The clause “although it may be rare in the younger age group” suggests some hesitation on the part of the Work Group in endorsing the existence of Bipolar Disorder in pre-pubertal children.

That the committee accepted as fact that bipolar disorder exists in children raises the issue of the use of the word fact in psychiatry as contrasted with its use in other sciences and in everyday conversation. The use of word “fact” in scientific papers in psychiatry is highly unusual. The use of the word in this context by the DSM-V Work Group is jarring to regular readers of the scholarly literature in psychiatry. In this scientific literature, papers end with conclusions preceded by discussions that are expected to point out the limitations of the scientific work. Conclusions are usually modest, tentative and limited. The word fact is almost never used.

Are there “facts” in psychiatry comparable to the physical constant of the speed of light in physics, the periodic table in chemistry, the function of the adrenal gland in biology, or the boiling point of water on the earth at sea level in everyday life? There may be some (e.g., need for an adequate environment for infants and children for psychological growth and development) but most so called facts in psychiatry are brief stand-ins or proxies for many inferences and theories that shift and change abruptly. For example, the diagnosis of bipolar disorder in adults is based to some degree on the diagnosis of Manic Depressive Insanity first developed by Kraepelin. The veracity of his observations and theories about psychosis are part of the brew of the current diagnosis of Bipolar Disorder. The diagnosis is based to limited degree on Kraepelin’s theories and a large number of other hypotheses many of which are disputable. Fact as the acceptance of some immutable truth does not enter into the discussion.

When the DSM-V Work Group refers to the unambiguous fact that the disorder exists in prepubertal children, does the Work Group have any specific age range in mind? Preschoolers? Children ages 10 years to 12 years? Children ages 6 years to 12 years? Each of these age groups has been the subject of controversy related to bipolar disorder in children, but they are lumped together without any discrimination between them. Similarly, the use of the word “rare” by the DSM-V Work Group remains inexplicably undefined. The expression “rare” has a specific meaning in medicine, referring to a prevalence of 1 or less cases per 1500. Is this what the DSM-V Work Group means? There is a startling lack of precision in the discussion of the existence of pediatric bipolar disorder in childhood by the DSM- V Work Group. Many people, myself included, believe it is closer to the truth to assume, until proven otherwise, that this prepubertal “disorder” does not exist at all.

The misdiagnosis monster lives: the stake must still be driven in to the heart of the beast.

Beast? Why the strong language?

Because the diagnosis is doing terrible things to children; and because the only people benefiting seem to be the people who sell all those pills under the child’s hand on the book’s cover.

The bipolar monster was loosed because American university professors, in cooperation with drug companies, created it. Indeed the problem that confronts us now, as Kaplan says, is how to kill it.

We’re talking Australia here (the stats for the States are probably worse); and the Australian media is beginning to wonder

1. why the country hasn’t been able to come up with prescription guidelines for this runaway train; and

2. why the committee of experts charged with this task has got in-hock-to-pharma folk on it.

Of course the underlying problem is that Australia is … a little slow. How long does it take for news to get there? We’ve known for years that Joseph Biederman’s research is compromised by his own pharma affiliations, but here comes the committee to announce that they’ve been unable to decide on the Australian guidelines because

US psychiatrist Joseph Biederman, whose work is cited over 80 times in the draft guidelines, and two colleagues were sanctioned by Harvard University after allegedly failing to report more than $1.6m they received from drug firms.

Uh… ye-e-e-s-s… Biederman’s conflicts of interest and non-disclosures and, er, “strong pro-drug views” have now gotten him into formal trouble. But Harvard took its sweet time. Everybody’s been scandalized by Biederman for ages. Where were you guys?

Meanwhile, millions of children down under get diagnosed with ADHD and have to take really strong drugs… I guess… Ho hum.

Kajoko Kifuji, a professor at Tufts, prescribed homicidal amounts of anti-psychotics to a child.

I mean, of course, she handed the prescriptions to the child’s parents – the child was only four at the time.

Kifuji had been giving her powerful drugs since she was two.

Rebecca Riley’s parents killed her (the mother has been convicted of second degree murder; the father’s trial begins soon) via doses of the multiple non-FDA-approved (for use in children) drugs Kifuji gave them.

Kifuji – who prescribed the same drugs to the parents’ other two children – based these prescriptions on what the mother told her about her children.

Kifuji testified that her diagnosis was primarily based on Carolyn Riley’s description of her daughter as aggressive and disruptive. She in 2004 prescribed Clonidine to Rebecca for ADHD; the next year, she prescribed Depakote to treat bipolar disorder.

Kifuji went on to approve a double dosage of the medication after Carolyn Riley told her that she was giving Rebecca twice the daily recommended amount.

That’s from the Tufts newspaper. Here’s Lawrence Diller with more detail:

Dr. Kifuji determined that Rebecca at age two had hyperactivity and began prescribing drugs to her at that time. Kifuji changed her diagnosis to bipolar disorder at age three. She also made the same diagnosis for Rebecca’s brother and sister who were nine and seven. All three were receiving variations of these sedating psychiatric medications. Kifuji, who was granted immunity against prosecution to gain her cooperation, testified during the trial that she relied almost exclusively on reports from Rebecca’s mother on the children’s aggressive behavior, sleep problems and history of mental illness in the family to make the diagnosis for the three children.

… [A] three year old was prescribed three psychiatric drugs for bipolar disorder…

… Joseph Biederman, head of Harvard’s Pediatric Psychopharmacology Clinic, has long espoused the bipolar diagnosis in children. He and his group have claimed the diagnosis can be made in children as young as two and should be followed by aggressive psychiatric drug interventions…

Once Kifuji’s finished with her busy court appearance schedule, she will be hiring lawyers to defend her against a malpractice suit from the estate of Rebecca Riley.

Tufts thinks she’s great. Happy to have on her board.

This memorable quotation from Springtime for Hitler serves nicely to introduce Harvard’s latest attempt to shut up its critics. UD‘s friend Bill sends her this link to a New York Times article. Excerpts:

Harvard Medical School is backing off a new student policy that would have restricted interaction with the news media after students complained it would chill their ability to talk about current issues in medicine, school officials said Tuesday.

… Nate Favini, a Harvard medical student and chairman of the Student Council Advisory Board, said in an e-mail message Tuesday: “Instead of limiting students, we should encourage bold thinking and allow them to advocate for the reforms that our health care system so badly needs.”

[The dean of students] did not deny that the policy was prompted in part by student remarks earlier this year about the influence of pharmaceutical companies on medical education.

… David Tian and Kirsten Austad, activist medical students at Harvard, said in an e-mail message Tuesday, “It is hard to imagine that this new policy is not somehow related to the past advocacy efforts of students. The reason we spoke out against conflicts of interest was to promote patient welfare as the primary concern of medicine, in the face of institutional practices that can harm patient care.”…

Half empty, half full kind of thing… Empty people protecting Joseph Biederman’s privileges… But, on the other hand, young people full of moral ferocity…

Usually the empty people win. Maybe this time they won’t.

In a move Harvard University should consider in connection with Joseph Biederman, Washington University has rid itself of a professor so deeply compromised in his research ethics as to do terrible damage to the school’s reputation as long as he remains on the faculty.

… [F]our former colleagues [accuse Kuklo of] falsifying research on a bone-growth product made by Medtronic that was used on severely injured soldiers. He was also accused of forging the other doctors’ signatures when he submitted a research report to a medical journal last year.

The Army, which investigated the matter, issued a report rebuking him. It took no further disciplinary action, Army officials said, because Dr. Kuklo is now retired from the military. But Walter Reed notified Washington University of its findings five months ago.

The Journal of Bone and Joint Surgery, a British publication, retracted Dr. Kuklo’s article in March after receiving a report of the investigation from the Army. But the episode largely escaped public notice until last week.

This week, a Republican senator, Charles E. Grassley of Iowa, sent letters seeking more information about Dr. Kuklo from Walter Reed, Washington University, two medical journals and Medtronic.

Dr. Kuklo has been a consultant to Medtronic…

Kuklo’s silence in the face of all of this has been as total as the silence of the pretend soldiers he enlisted in his study. He won’t talk to anyone. UD guesses he refused to talk to Washington University too, and that this persuaded the university of his guilt – or at least so pissed it off that it booted him out.

… of God.

Everyone’s picking up on Joseph Biederman’s statement in a recent deposition that the rank after full professor is God.

Everyone’s dumping on him because he’s so arrogant as to have said that.

But while there’s every reason to abhor Biederman for his perversion of science, I’m not sure this lame attempt at humor merits the attention it’s gotten. Like a lot of people who end up in courtrooms and Grassley Letters, Biederman’s a twisted character for sure. The fact that he can be sophomoric under pressure, though, seems to UD neither here nor there.

Unfortunately for him, it’s an easy sound bite to sink your teeth into.

Brings back memories of Mr Risperdal himself, Harvard University’s Joseph Biederman.

The Australian commenter posing this question can look over here, at the States, to see what a national sedation policy might look like.

Not that every one of us has been zoned by Zeneca… mummified by Merck… Lalalanded by Lilly… but, you know, tens of millions of Americans have gotten there, and – out-of-it-wise – we’re way more advanced than the Aussies. Our best poets sing of it:

Let us go then, you and I,
Where America is spread out against the sky
Like a nation etherized upon a table…

In one particular way, Australia looked for awhile as though it might overtake us – i.e., in government-sponsored anti-psychotic dosing of children without psychotic symptoms.

To be sure, we’ve got Joseph Biederman (type his name into this blog’s search engine and enjoy).

But Australia’s got Patrick McGorry who, until he (under pressure from scientists around the world) abandoned the idea, thought it might be clever to experiment with giving fifteen-year-olds he determined to be “pre-psychotic” powerful antipsychotic drugs. Some people thought it wasn’t too cool to give “children who had not yet been diagnosed with a psychotic illness…. drugs with potentially dangerous side effects.” So last summer McGorry dropped the idea.

And now – under equally strong pressure from an outraged scientific community, McGorry has gone one step further.

Concerns about the overmedication of young people and rigid models of diagnosis have led the architect of early intervention in Australian psychiatry, Patrick McGorry, to abandon the idea pre-psychosis should be listed as a new psychiatric disorder.

The former Australian of the Year had previously accepted the inclusion of pre-psychosis – a concept he and colleagues developed – in the international diagnostic manual of mental disorders, or DSM, which is being updated this year.

Drug companies must be mildly dismayed. (Only mildly, because they’ll find a way around this.) Popular American news shows are pointing out that for most people anti-depressants are placebos with serious side effects. Critics are attacking the idea of a grief pill. And now the packed-with-potential idea of pre-psychosis (who ain’t pre-? and when will they figure out that an even niftier idea is clinically pre-neurotic?) is being savaged simply because some people think giving symptom-free people immensely powerful drugs is unethical!

Zoom in on the bigger picture here, if you will. Through incessant advertising, and through incentivized research professors at our universities, the drug industry is slowly rebuilding our basic human self-appraisals. We simply cannot get through life without pills.

… and now they’re coming for the Ritalin!

These American staples, the backbone of our thriving pharma-economy, are under assault by scientists who claim they don’t work for most people and that they can do terrible harm.

What’s next? Our babies’ antipsychotics??