News from the AD(H)D front

By Henning Köhler, September 2015

Shortly before his death, the US psychiatrist Leon Eisen­berg, one of the “inventors” of attention deficit hyperactivity disorder, confessed that this was a prime example of a fabricated illness. He deeply regretted his error because the actual (mostly psychosocial) causes for the symptoms were ignored if an inherited neurochemical imbalance is assumed and methylphenidate prescribed.

Despite rumours to the contrary, Eisenberg did not exclude that a minimal proportion of the affected children might indeed be suffering from a primary metabolic disorder of the brain.

His colleague Richard Saul also considers this a possibility but claims that even these few children did not suffer from ADHD but by definition from another disorder which he calls NDI (neurochemical distractability/impulsivity). In all other respects there are always other primary neurological causes, according to Saul, when the ADHD stamp is brandished.

His 2014 book, ADHD Does Not Exist: The Truth About Attention Deficit and Hyperactivity Disorder, which has just been published in a German version by Klett-Cotta, is likely to cause a furore.

He lists a total of 26 conditions which are wrongly and unnecessarily classed as ADHD and are accordingly given the wrong treatment. I miss a number of important aspects in Saul (psychosocial factors, school stress, stress as such, nature deficit disorder, and others), but have also learnt from him. His book should be read in parallel with the also newly published (PattlochVerlag) polemic Burnout Kids / Wie das Prinzip Leistung unsere Kinder überfordert (Burnout Kids / How the performance principle overworks our children) by the Hamburg child and adolescent psychiatrist Michael Schulte-Markwort. Although it does not deal explicitly with ADHD, it does do so implicitly. The author also raises the subject of school pressure and demands an urgent rethink.

For my taste he takes the treatment with psychotropic drugs, for example for stress-related depression, too lightly. Is it not absurd in most cases to know that stress is the cause and then prescribe pills nevertheless?

I would like to discuss that with him. Finally, let me refer to an excellent book whose somewhat sensational title could raise false expectations. But it is thoroughly serious, is praised by respected experts in the foreword and received the Annual Book Award of the British Medical Association in the category Basis of Medicine: Peter C. Gotzsche, Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare  (Radcliffe Publishing 2013). We learn a lot about the machinations of the pharmaceutical corporations and the scientists assisting them as well as about falsified and suppressed studies.

Naturally there is also a detailed discussion of ADHD: an object lesson in procedures which range from the dubious to the illegal.

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