08/13/14

The Dumbest “Diagnosis” Ever

Is your child drowsy/sleepy at times? Do you see signs of daydreaming, mental confusion, slowed thinking or behavior, lethargy or apathy? Don’t worry; it may just be the early signs of Sluggish Cognitive Tempo (SCT)! By some estimates, SCT is present in two million children. While still not acknowledged as an official psychiatric disorder, the January 2014 issue of The Journal of Abnormal Child Psychology devoted the entire issue to SCT. Be patient, it will eventually become an official childhood psychiatric disorder, if its advocates have their way. And then you will have a brand new reason to give your son or daughter stimulant medications.

If you think this satire is too off-the-wall, read the April 11, 2014 article in the NYT by Alan Schwartz, “Idea of New Attention Disorder Spurs Research, and Debate.” Schwartz said that “Experts pushing for more research into sluggish cognitive tempo say it is gaining momentum toward recognition as a legitimate disorder—and as such, a candidate for pharmacological treatment.” He added that some of the identified symptoms so far in the research “have helped Eli Lily investigate how its flagship A.D.H.D. drug might treat it.” The psychiatric drug industry has excelled at expanding the market for its drugs, generating tremendous wealth for many.

Becker, Marshall and McBurnett did a search of journal articles (for their own article in January 2014 issue of The Journal of Abnormal Child Psychology) and found that “very few papers explicitly examined or even mentioned SCT between 1985 and 1999.” Since then there has been a steady increase in the articles that either focused on SCT or mentioned it in the body of the paper. They observed that while symptoms of under-arousal and low levels of mental energy were noticed to be part of attention deficit as early as 1798, it wasn’t until the 1970s that inattention was seen as causing even more impairment than hyperactivity. By the mid-1980s, “empirical support for the SCT dimension separate from inattention emerged.”

Russell Barkley, one of the most influential advocates for ADHD, noted in his article for the special issue of The Journal of Abnormal Child Psychology that there was a dearth of studies on SCT. Students now entering the profession could make a successful research career specializing in the research of SCT. He felt there would surely be an increased demand for such empirically-based research in view of the clinical referrals already occurring; and the anticipated increase in the near future as the general public becomes aware of SCT. “The fact that SCT is not is not recognized as yet in any official taxonomy of psychiatric disorders will not alter this circumstance given the growing presence of information on SCT at various widely visited internet sites such as YouTube and Wikipedia, among others.”

Alan Schwartz reported in his NYT article that Barkley has said that SCT “has become the new attention disorder.” Barkley also has financial ties to Eli Lily, receiving $118,000 from 2009 to 2012 for consulting and speaking engagements. He has also published a symptom checklist to identify adults with the condition. The forms are available for $131.75 apiece from Guilford Press. Oh, and Barkley also edits sluggish cognitive tempo’s Wikipedia page. The SCT Wikipedia page carried the following note at the top of the page on June 20th, 2014: “A major contributor to this article appears to have a close connection with its subject. It may require cleanup to comply with Wikipedia’s content policies.”

One of the SCT researchers, David McBurnett, said a scientific consensus on SCT could be many years in the future. “We haven’t even agreed on the symptom list—that’s how early on we are in the process.” And yet, Dr. McBurnett recently conducted a clinical trial funded and overseen by Eli Lilly to see if the proposed SCT diagnosis could be treated with Straterra, the company’s primary ADHD drug. Published in The Journal of Child and Adolescent Psychopharmacology in November of 2013,his study concluded: “This is the first study to report significant effects of any medication on SCT.”

This process with SCT reminded me of what Robert Whitaker depicted in Anatomy of an Epidemic. He showed that in order to sell our society on the benefits of psychiatric drugs, “Psychiatry has had to grossly exaggerate the value of its new drugs, silence its critics, and keep the story of poor long-term outcomes hidden.” This has meant telling a false story to the American public, and then actively hiding research results that reveal the poor long-term outcomes with a drug-centered paradigm of care. Whitaker said it was a conscious, willful process that exacts a horrible toll on our society.

The number of people disabled by mental illness during the past twenty years has soared, and now this epidemic is spreading to our children. Millions of children and adolescents are being groomed to be lifelong users of these drugs. This grooming happens by twisting childhood behaviors like daydreaming, slowed thinking or behavior, and lethargy into symptoms of a new so-called childhood psychiatric disorder.

Allen Frances, chair of the fourth edition of the DSM, said that “’Sluggish Cognitive Tempo’ may possibly be the very dumbest and most dangerous diagnostic idea I have ever encountered . . . .The risk that it could do great harm is real . . . .The last thing our kids need is to be misdiagnosed with ‘Sluggish Cognitive Tempo’ and bathe in even more stimulants.”

Still not convinced? Listen to this pod cast by Peter Breggin where he interviews psychologist Fred Ernst about Sluggish Cognitive Tempo and the “psychiatric assault” on children through psychiatric medication.