SAN FRANCISCO, March 10 (UPI) -- More than two decades after its formal recognition as a mental illness in the official manual of psychiatric disorders, attention deficit/hyperactivity disorder continues to have an identity crisis.
As psychiatrists press for greater efforts to identify and treat what they deem a disorder that, undetected and unattended, can cause children unnecessary suffering, the critical minority pushes in the opposite direction, contending it is overzealous attention focused on inattention that is causing youngsters needless pain.
"Instead of a culture where we say we have the wealth and resources to identify people with mental illness and offer them treatment, we say instead mental illness is bad, but treatment is worse, so we'll stigmatize both treatment and mental illness and incorporate the dysfunction associated with that into our definition of normal," said Dr. John Walkup, director of child and adolescent psychiatry at Johns Hopkins University.
"That's very sad for a progressive country," he added. "You live with lots of dysfunctional people and say bad things happen to people, and we can't do much about it."
Off the mainstream-beaten path, one of the most dogged of the critics, Dr. Fred Baughman, a California neurologist who retired after 35 years in the field, has been tirelessly crusading against the diagnosis and treatment of ADHD.
"They made a list of the most common symptoms of emotional discomfiture of children; those which bother teachers and parents most, and -- in a stroke that could not be more devoid of science or Hippocratic motive -- termed them a 'disease,'" he said.
"Twenty-five years of research ... has failed to validate ADD/ADHD as a disease, and yet, the 'epidemic' has grown from half-million in 1985 to between 6 million to 7 million today!"
It is a charge he carries through his books, articles, television, radio and newspaper interviews, Internet postings, public lectures and protests and appeals to public health and government officials in the United States and abroad.
Baughman, who often testifies as an expert witness for plaintiffs claiming harm from psychiatric practices, has served as a medical adviser to The Citizens Commission on Human Rights, a self-described watchdog group founded in 1969 by the Church of Scientology.
Scientology's anti-psychiatry absolutism and efforts to limit psychotropic drug use through legislation received a worldwide airing when one of its most visible adherents, actor Tom Cruise, railed against the "pseudo-science" in general and ADHD drug treatments Adderall and Ritalin in particular during a movie-promoting interview June 24, 2005, on NBC's "Today" show.
The ensuing firestorm brought out the top guns of the psychiatric mainstream and its bevy of supporters to denounce the remarks as deceptive and damaging.
Much of the outcry mirrored complaints lodged in a consensus statement issued in 2002 by an international group of scientists attesting to the legitimacy of ADHD as a mental disorder.
Among other displeasures, the statement bristled at "the periodic inaccurate portrayal of attention-deficit/hyperactivity disorder ... in media reports." It also expressed fear that "inaccurate stories rendering ADHD as myth, fraud or benign condition may cause thousands of sufferers not to seek treatment for their disorder."
The profession's blanket censure of Cruise was not unanimous. In a "Today" follow-up, Harvard University psychiatrist Dr. Joseph Glenmullen conceded a few points to the Hollywood heartthrob, namely, that psychiatric drugs can mask the real problem, be overprescribed and aim to fix an unproven chemical imbalance in the brain.
These ideas were soundly rebuffed by fellow guest on the program Dr. Steven Sharfstein, president of the 35,000-member American Psychiatric Association.
In a replay of earlier media criticism, pundits used the television parade of unlike-minded talking heads that followed Cruise's lambaste as grounds for reprimanding reporters who give equal representation to views out of step with predominant thinking.
"Medical reporting needs to be based, obviously, on solid critical thinking and great reporting," Dr. Ivan Oransky, deputy editor of The Scientist and a board member of the Association of Health Care Journalists, told Psychiatric Times, which touts itself as "the most widely read publication in the field of psychiatry."
"You will see the fringes of science and medicine because, for whatever reason, journalists are not able to distinguish between an either mainstream or prevailing opinion and not."
Cruise's was but one of a series of dust storms of dissent kicked up over the nature of ADHD, which has been linked to everything from the Digital Revolution to biological evolution.
Author and social theorist Douglass Rushkoff, for one, has portrayed the condition as a defense mechanism of multimedia-steeped children cutting off their attention to avert the onslaught of omnipresent and exploitative advertising.
Writer and radio talk-show host Thom Hartmann, in turn, has described it as an expression of biodiversity emanating from the natural course of human events.
The prevailing view among the medical mainstream shrugs off the naysayers. It maintains cutting-edge tools have pried loose some of the mind's innermost secrets, leading to a consensus on ADHD as an unquestionably common condition rooted in inherited biological and chemical brain abnormalities.
Definitive answers are at a premium, however, and the complex mechanisms underlying ADHD remain under investigation.
Next: Looking for evidence of genes at work.
(Editors' Note: This series on ADHD is based on a review of hundreds of reports and a survey of more than 200 specialists.)
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