Mental Health Blogs

A child psychiatrist at Alta Bates Medical Center in Berkeley, California named Edmund Levin has thrown before his colleagues a major gauntlet, aimed in particular at the bio-psychiatry, bipolar child proponents at Harvard. In a paper in the Journal of The American Academy of Psychoanalysis and Dynamic Psychiatry (something the Biederman crowd likely doesn’t read), he asserts that child psychiatrists are over-medicating their young patients, diagnosing them with pediatric bipolar disorder when a diagnosis of developmental trauma disorder is more appropriate, and that dramatically reducing medications actually improved children he’s observed.

His conclusions come from four decades of working with children in residential treatment programs. From the paper’s conclusion:

“Residential treatment programs can serve children well by reconsidering their diagnoses and by re-evaluating medication use. This study argues from an individual clinician’s experience that the overwhelming majority of children do no worse and most do considerably better entirely off or at doses of psychotropic medication significantly lower than that prescribed in the mainstream of contemporary child psychiatric care. It seems reasonable to attribute the clinical improvement of these children to diminished efforts to control thinking, affect, and behavior by pharmacologic interventions, while simultaneously increasing the amount and quality of analytically informed treatment. Success in
effecting dramatic reductions in prescribed medications suggests that in mainstream child psychiatric care there is excessive overdiagnosing and overmedicating of affectively labile and rageful, aggressive children. Very likely, these children are responding to trauma and warrant the diagnosis of DTD rather BD/PBD/SMD and comorbid ADHD.”

DTD is not in the DSM currently and I don’t know enough about it to offer any wisdom. That said, Levin’s assertion that many children with pediatric bipolar disorder diagnoses are in fact responding to a trauma of some kind is bound to be controversial among the bio-psych crowd because it would tend to point the finger for a childhood mental disorder squarely at a child’s environment, to put it gingerly.

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Related posts:

1. Doctor Diagnosed 2-Year-Old With Bipolar For Seeing Monsters, Ghosts
2. Questioning Antipsychotics In Kids, SF Chron Supports Their Use
3. Study: Medicaid Kids Get Antipsychotics At Four Times The Rate Of Privately-Insured Kids
4. The "Problem Child", Scapegoating and the Family System
5. Kids Non-Profit Head Slams Overmedicating Of Kids