Conflicted researchers and psychiatrists write letter to Editor of New England Journal of Medicine
Pediatric Mental Health Care Dysfunction Disorder?
The CABF gang is at it again, defending the pediatric childhood bipolar paradigm directly influenced by Joseph Biederman, and his side kick Wozniak.
LETTER
To the Editor:
The Perspective article by Parens et al. (May 20 issue)1 misleads, misinforms, and is missing relevant facts. The authors imply that the increase in the diagnosis of pediatric bipolar disorder was due to a cabal of child psychiatrists rather than the increase in published, peer-reviewed research.
They argue that “no existing DSM [Diagnostic and Statistical Manual of Mental Disorders] diagnosis conveys the appropriate severity” of the moods and behaviors of children “who can be explosively angry, irritable, frantically active, suicidal, or even homicidal.” An adult with these symptoms would very likely be diagnosed with bipolar disorder, and 65% of adults with bipolar disorder report an early onset of the condition.2 Research from multiple sites supports the validity of pediatric bipolar disorder.3
The authors cite “sparse” evidence supporting the efficacy of medications. Large-scale pediatric trials documenting safety and efficacy have led to Food and Drug Administration approval of two agents.4 They describe nonmedical treatments as “first-line,” even though few studies document the usefulness of these resource-consuming therapies; those that do consider them adjuncts to medication, not replacements.5
Joseph Biederman, M.D.
Janet Wozniak, M.D.
Massachusetts General Hospital, Boston, MA
Stephen V. Faraone, Ph.D.
State University of New York (SUNY) Upstate Medical University, Syracuse, NY
FINANCIAL DISCLOSURES
Dr. Biederman reports receiving grant support from Alza, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Janssen, McNeil, Merck, Organon, Otsuka, and Shire, lecture fees from Fundación Ramón Areces, Medice Pharmaceuticals, the Spanish Child Psychiatry Association, Janssen, McNeil, Novartis, Shire, and UCB Pharma, and consulting fees from Janssen, McNeil, Novartis, and Shire;
Dr. Faraone, receiving consulting fees from and serving on the advisory boards of Eli Lilly, Ortho-McNeil, and Shire and receiving grant support from Pfizer and Shire; and
Dr. Wozniak, receiving lecture fees from Primedia, McNeil, Shire, and Janssen.
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Other disclosures not reported in the Letter to the Editor
Joseph Biederman
-Boston Globe-Grassley investigates
"Senator Chuck Grassley of Iowa has widened his investigation into well-known Harvard child psychiatrist Dr. Joseph Biederman, questioning whether Biederman promised pharmaceutical giant Johnson & Johnson that his research into the company's drugs would yield positive results before beginning the studies."
Researchers Fail to Reveal Full Drug Pay
"A world-renowned Harvard child psychiatrist whose work has helped fuel an explosion in the use of powerful antipsychotic medicines in children earned at least $1.6 million in consulting fees from drug makers from 2000 to 2007 but for years did not report much of this income to university officials, according to information given Congressional investigators.
Like Dr. Biederman, Dr. Wilens belatedly reported earning at least $1.6 million from 2000 to 2007, and another Harvard colleague, Dr. Thomas Spencer, reported earning at least $1 million after being pressed by Mr. Grassley’s investigators. But even these amended disclosures may understate the researchers’ outside income because some entries contradict payment information from drug makers, Mr. Grassley found.
In one example, Dr. Biederman reported no income from Johnson & Johnson for 2001 in a disclosure report filed with the university. When asked to check again, he said he received $3,500. But Johnson & Johnson told Mr. Grassley that it paid him $58,169 in 2001, Mr. Grassley found."
CABF
Child Adolescent Bipolar Foundation
Advisory Council
CABF:
Janet Wozniak, M.D.
Director, Pediatric Bipolar Disorder Research Program; Assistant Professor of Psychiatry, Harvard Medical School and Massachusetts General Hospital
Joseph Biederman, M.D.
Professor of Psychiatry at Harvard Medical School. Chief, Clinical and Research in Pediatric Psychopharmacology Massachusetts General Hospital and McLean Hospital.
Age-Dependent Decline of Symptoms of Attention Deficit Hyperactivity Disorder: Impact of Remission Definition and Symptom Type
Joseph Biederman, M.D., Eric Mick, Sc.D., and Stephen V. Faraone, Ph.D.
Bipolar Disorders in Children and Adolescents: Coexisting Conditions
"In one study of children referred to a psychopharmacology clinic in Boston, 41% of children with mania met criteria for conduct disorder, and 40% of children with conduct disorder had symptoms of mania (Biederman, Faraone, Chu, & Wozniak, 1999)."
--
May 2010 New England Journal of Medicine
The article Biederman et al are referencing is this one in the May 2010 NEJM.
Note the authors of the article.
All of these doctors have received pharmaceutical funding for speaking on behalf of drug companies that market drugs for the treatment of bipolar and depression, and Carlson and Biederman are heavily influencing the pediatric market that is exploding with the use of psychiatric medication use in children.
Pediatric Mental Health Care Dysfunction Disorder?
Erik Parens, Ph.D., Josephine Johnston, L.L.B., M.B.H.L., and Gabrielle A. Carlson, M.D.
N Engl J Med 2010; 362:1853-1855May 20, 2010
Excerpt:
"In February, the American Psychiatric Association released draft revisions for the next iteration of its diagnostic manual (the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders [DSM-V]). One of the draft's most talked-about features is a new diagnostic category for children: temper dysregulation disorder with dysphoria (TDD). The addition has been praised by some as a verdict on one of the hottest questions in child psychiatry: Is the dramatic increase in the number of children with a diagnosis of bipolar disorder appropriate? The answer appears to be no. But the creation of this new category raises another . . ."
Gabrielle Carlson (also on Childhood Bipolar Foundation -CABF-Advisory)
Dr. Gabrielle Carlson, Pharma, CABF, and the Medicaid-ed Child
The AACAP 2009 January Psychopharmacology Update Institute faculty includes:
Gabrielle A. Carlson, M.D.
Financial Disclosures
Advisor/Consultant: Bristol-Myers Squibb Company, Eli Lilly and Company, Otsuka America Pharmaceutical, Inc., Validus
Honorarium and Travel Expenses: American Academy of Child & Adolescent Psychiatry, Ortho-McNeil-Janssen Pharmaceuticals, Inc., Shire Pharmaceuticals, Inc.
Research Funding: Bristol-Myers Squibb Company, Eli Lilly and Company, GlaxoSmithKline, Otsuka America Pharmaceutical, Inc.
Spouse Advisor/Consultant: Eli Lilly and Company, H. Lundbeck A/S
New York Times December 2009
Poor Children Likelier to get antipsychotics: Medicaid kids given antipsychotics 4X's higher
"New federally financed drug research reveals a stark disparity: children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance. And the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts, the data shows."
Gabrielle Carlson in the article:
"“Maybe Medicaid kids are getting better treatment,” said Dr. Gabrielle Carlson, a child psychiatrist and professor at the Stony Brook School of Medicine. “If it helps keep them in school, maybe it’s not so bad."
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The bottom line is that children are a hot market for the pharmaceutical industry, and the industry has willing takers of their funding, for being paid for speaking for their drugs and these people are the leading KOL's of the pediatric bipolar depression medical modality--the drugging of America's children younger and younger, with drugs not shown efficacious in long term use in children or studied in long term use in children for safety and outcome on growing child's body and brain. The examples of income and funding for Biederman vs. Carlson are basically drug company vs. drug company, or for example Seroquel vs. Abilify (AstraZeneca/BMS). One must consider the drug company money influence in these researcher/doctors and what drugs and diagnosis they represent.
Parents must know, in my opinion that the pharmaceutical industry has a profit target to sell their product, and whether the drugs are sold to adults or children has no boundary. The risk of children taking these drugs can end in preventable tragedy, such as Rebecca Riley, age 4 and Destiny age 3. My own daughter, age 22 now disabled after 1/2 her lifetime on antipsychotics. Still alive, but at what cost?
Science becomes muddy water when pharma and conflicted researchers are the ones writing journal abstracts for evidence on validity of psychiatric diagnoses.
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