In my prior columns I have focused on issues such as fraud, malpractice, pharmaceutical industry abuse and improper diagnoses and treatment of conditions like chronic fatigue and back pain.
In this next series of columns, I will discuss the rarely discussed areas of the burgeoning psychiatric industry, including the treatment and diagnoses of children.
Considering that more than 8 million children, including pre-school toddlers, are being diagnosed and treated with risky drugs, this is an area that needs to be discussed.
A sad case that occurred four years ago in Massachusetts is an example of this problem as well as the problem with government entitlement programs.
Rebecca Riley was a 4 year old whose family survived almost entirely on Social Security disability. The parents were both receiving disability for vague physical complaints while their two older children were on disability for mental illness diagnoses.
They decided when Rebecca was 2½ to get her on disability.
They were denied until they concocted a scheme to exaggerate behavior systems to get her declared disabled to a mental disorder.
They complained of her behavior to a doctor who referred her to a child psychiatrist.
Based almost entirely on the parents’ reports of her behavior, she was given the diagnosis of bipolar disorder, a condition qualifying for disability.
Then, of course, came the drug treatment. Remember, this was a 4 year old. Before her death, she was taking Depakote, Seroquel and Clonidine, all powerful drugs with major side effects and risks.
Her health started to decline, including bouts of disorientation and vomiting.
Instead of worrying about physical symptoms, her parents were only concerned about her psychiatric diagnosis and never reported her physical condition to her doctors.
The family was receiving more than $33,000 in yearly disability benefits and didn’t want to disturb the status quo. They allowed her condition to deteriorate until she died. The pathology report noted excessive amounts of psychiatric drugs in her system.
Unfortunately, in some cases the psychiatric treatment of young children is for the benefit of the parent or doctors.
The dramatic growth in psychiatric diagnoses in children coincided with the development of new drugs and the expansion of indication of older medications.
These drugs are extremely profitable for the drug companies. How profitable?
In 2009, Pfizer was fined more than $2.3 billion for fraudulent marketing of several drugs. The biggest of these is a powerful anti-psychotic drug Geodon.
Their marketing of this (and other mental illness drugs) for unapproved indications (including the treatment of children) resulted in far more profits than they lost from the fines.
The number of children on disability due to mental illness (not retardation or behavioral problems) rose from 250,000 to 595,000 in a short period. The percentage of children receiving disability for these illnesses rose from 32 percent to 52 percent.
Quietly, this has become a huge industry and represents the biggest area of drug use growth.
Rise if bipolarism
Bipolar disorder has become the “popular” diagnosis of the 21st century. It’s almost fashionable to proclaim that one has bipolar disorder.
What is this disease?
In the past, it was called manic-depression. Now it’s called bipolar disorder.
The primary feature of this disorder is periods of mania-racing thoughts, irritability, ignoring risks. The term derives from a Greek work that described frenzy.
There are now five forms of bipolar disorder, depending on the pattern and nature of symptoms, such as how profound they are and how often they occurs.
The growth in diagnosis and treatment began when the diagnosis expanded to include less-pronounced symptoms. This is called bipolar type 2.
The biggest problem with this disease is overdiagnosis. A large study reported in the Journal of Clinical Psychiatry found almost one-third of patients diagnosed with this didn’t meet the criteria, especially of mania.
The danger is that the drugs have significant side-effects. A worse problem is that the diagnosis is often made by physicians, family practitioners and internists, who may not have the in-depth expertise of this disorder. This leads to both wrong diagnosis or incorrect treatment.
Since most bipolar is associated with periods of depression, treating these patients for their depression with antidepressants is known to worsen the illness.
Everyone should remember that all psychiatric drugs are approved only for those patients who meet the accepted diagnosis, as found in the current Diagnosis and Statistical Manual of Mental Disorders, the bible of psychiatry.
Always make sure that a doctor prescribing for a mental disorder can back up his diagnosis.
And always think twice times before accepting drugs for the treatment of any psychiatric disorder in children. See a child psychiatrist.
Charles Barta retired to Green Valley after 10 years as a medical director for several health care insurers. Before that, he was physician-in-charge of Kaiser Permanente of Colorado and a private internist in Las Cruces, N.M. He had previously held a management position in the Medical Systems Division of Pfizer. His column is published Sundays. He can be reached at Cbar52@aol.com.