Opinion of professionals

In this website area we show an important set of opinions and declarations of  doctors, specialists (psychiatrists, children neuro-psychiatrists, clinical psychologists, educators, etc) and representatives of institutions, all agreeing on being critical towards the growing trend to medicalize children’s discomfort and to administrate psychiatric drugs to children. In order to see the copy of other opinions by Institutions, you can also see this section (in italian).

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“My opinion is well known, both about informed consent and about the use of psychiatric drugs, as an integration to psychotherapy and/or other interventions. In the register for children with ADHD, in Italy, we have a consent model among the best and most complete. I believe that every oncologist asks the written consent for chemotherapy or any other therapy, therefore I think that one cannot say – as recently told by a pharmacy doctor in an interview to the Corriere della Sera – that in Italy ‘the problem is the lower consumption of psychiatric drugs towards other countries’, using a marketing criterion as the one used per car sales that have to be always increased (however causing some environmental problems!). I believe useful and timely the presentation of a bill to discipline this matter, and I hope that it will be approved in short and acceptable times”.

(Pietro Panei, Responsible for the Adhd Project of  the High Healthcare Institution)

***

“The declared exponential increase of depression cases is a stereotype: it is necessary to understand if it is a real phenomenon or if it is artificially increased data. I can affirm with safety and without fearing confutation – as widely shown in my last book – that it is artificially increased by collusion between the interests of pharmaceutical companies and those of psychiatrists ready, in most cases, to follow the indications of the companies. Depression in the last 50 years has been a country of conquest by pharmacy companies that, by using the “disease mongering” (i.e. strategies for the creation of pathologies) created “ad hoc” new pathologies and above all new needs to create a wider category of customers… not surely of patients. It is disconcerting to see how some psychiatrists and researchers have colluded – often in an conscious way – with these market dynamics that have nothing to do with science”. Then, given the difficulty of knowing the true epidemiology of depression, the used criterion, anyway very incorrect, is to calculate the quantity of depressed patients on the basis of the quantity of consumed antidepressive drugs. Through the easiness and superficiality  of those prescribing these drugs, especially after the market immission of SSRI (Selective serotonin reuptake inhibitors), whose success is principally due to lower presence  of collateral effects, the epidemiological data,  calculated this way, is falsed in surplus. Moreover, this way one considers as already foreseen 2 problems that have to be taken seriously. The first is to decide in which way and in which cases the antidepressive drugs really function. The second is if equivalency between antidepressive consumption (caused by a more aggressive advertising by pharmacy companies) and quantity of depressed patients is an acceptable equation”.

(Nicola Lalli, Psychiatrist and  Psychotherapist at the Rome University “La Sapienza”)

***

“The work you, of the team of  ‘Giù le Mani dai Bambini’, are doing on ADHD in Italy is important and very deserving. Your consent document on ADHD is a guide book also for us abroad, for its value and its clearness of explanation”.

(Leon Benesayag, Professor of Neurology and Neuropediatrics of Medicine Faculty Of Buenos Aires University, Argentina)

***

“The creation of this Register  to schedule children suspected of ADHD, without the adequate guaranties that one must have, is a trap: one risks to treat with Ritalin children who must not begin a therapy. The great problem being ignored is that of therapeutical protocol, presently lacking and oriented to pharmacological solution, with the result that diagnoses risk to be done roughly and that the alternatives to drug are not correctly evaluated. Therefore the good idea of the Register checking the givings, can become a skylarks mirror, if one does not evaluate with greater seriousness the criteria of children management”.

(Federico Bianchi di Castelbianco, Psychotherapist  of evolution age)

***

”The questionnaires used to diagnose these children problems  are highly subjective and impressionist. Differences of experience, tolerance and emotional state of interviewer and interviewed child  are not considered,  and in spite of this vagueness, and in spite of the fact that used evaluation  scales do not answer to basis psychometrical criterions, the supporters of this approach pretend that these questionnaires give an accurate diagnosis, but it is not so”.

(prof. William Carey, head physician and professor of Clinical Pediatrics by Pennsylvania University, head physician of Behaviour Pediatrics at the Philadelphia Hospital, member of national Academy of USA Sciences)

***

“With reference to behavioral disorders, and in particular to “attention deficit hyperactivity disorders (ADHD”), I would like to say that we are more coping with “fashion” rather than with an inconsistent and vague diagnosis. We surely cannot, but more, we must not do these diagnoses, as they are too easily refined.  It is my opinion that the Register will be not very useful, without a full protocols revision: what will change when children, who should not have been treated with Ritalin,  are included in the Registry?”.

(Emilia Costa, head of  1^ Psychiatry Chair of the University of Rome La Sapienza)

***

 “Doctors are to be fully responsible and must protect patients’ right to health, especially when they are minor. We will surely not solve any issue, by opening a Registry that will allow us to go on prescribing psychiatric drugs that are questioned and at risk of abuse.  Press columns widely demonstrate such attitude is under accuse every other week”.

(prof. Claudio Ajmone, psycotherapist, member of  European Psychoanalysis Association)

***

 “Health Ministry wants to create a ‘monitoring network’ on children, that will be filed and classified  according  to their supposed behavioral disorders. They will be then treated with energizing psychotropic drugs. Finally, we will fill a death list, like in US. I really want to state it clearly: Health Ministry knows neither what they do, nor what the consequences of their actions will be”.

(prof. Giorgio Antonucci, psychoanalyst, already contributor of Franco Basaglia)

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“Look at the reality where we let our children live: too often there are oppressive expectations and reasons related to uneasiness that are transferred on the weakest, and that we adult give as granted. Why are the problems not faced in families? Don’t be astonished then if children have problems, also serious”.

(Prof. Franco Blezza, Full Professor of General Pedagogy at the Chieti University)

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“I have the clear sensation that we are not totally conscious about to what the feeding of stimulating psychiatric drugs to children of 5 or 10 years old leads, of the impact on their metabolism, on the hormonal system, on the development of their  nervous system”.

(Luigi Cancrini, psychiatrist, Parliamentary Commission on Childhood)

***

“Considering that it does not exist only one kind of depression, that every story is unique and we cannot generalize, the success of psychotherapies  is known in scientific literature, but too often ignored in therapy. Often one uses with superficiality psychiatric drugs, and one thinks that pharmacological therapies do not work: but the problem is that  they have been “snubbed” for a long time in favor of solutions with more immediate effects. It is time that professional therapists accept what literature gives as certain: that even if the drug has its own dignity in its use, in the proper cases when it is requested, psychotherapy really changes the cerebral structure and influences concretely and positively the behaviours, and one can touch and measure these improvements. I do not understand how one can continue to ignore these facts, always preferring the biological, organical and pharmaceutical approach, and superficially degrading psychotherapy to “some words” between therapist and patient”.

(prof. Emilia Costa, owner of 1° Chair of Psychiatry by Rome University La Sapienza)

***

“Dozens of thousand of Italian children are depressed: this consideration has no scientific value. Children are bright, sometimes unquiet, they are not attentive at school. But there is a misunderstanding, as violence in children for example is tried to be classified as pathological data: this is an ethical, social problem, but it is surely not a clinical problem!”.

(Prof. Giorgio Antonucci, Dean of Italian psychoanalysis, already contributor of Dr Basaglia)

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“Let’s check the practical reality: accidentally I quote one of the ‘big five’ in scientific journalism, the ‘New England Journal’, financed for the  74% by pharmaceutical industry. Then, here is the true problem: the ethics of the researches. Why don’t we begin to publish also the researches that gave negative answers, that are the great majority?”.

(Dr Paolo Roberti di Sarsina, Psychiatrist, Coordinator of the Committee for unconventional medicines)

***

“Depression is not a sickness, depression is a symptom! Here one tries to “diagnosticate” a depression without asking to oneself and to the child what has caused the problem: it is similar to the situation when one cries the death of  a relative trying to heal the grief with a collyrium, blocking the activity of  the tear ducts! An acritical diffusion of antidepressants on children is a great risk for mental illness of new generations: they will make  this kind of problems chronic”.

(Luigi Cancrini, psychiatrist, Parliament Commission on Childhood)

***

“These psychiatric drugs have surely some effects, improve the attention of children, but both of the healthy ones and of the ill, and at which price in the long run? The fact that pharmacy, in these cases, is a scientific serious  approach, has to be demonstrated: we, specialists, must stop making fun about it, we must become humble, we must come down on earth, and begin from here.  Let’s leave a remark on the opportunity to use these psychiatric drugs”.

(Enrico Nonnis, child neuropsychiatrist, Democratic Psychiatry)

***

“Unfortunately, a pill cannot lift kids and teen’s uneasiness, it is a pure illusion, a heavy and guilty idea, an inexcusable oversimplification when we pretend that psychiatric drugs can be a solution. We are walking the wrong way if we believe an antidepressant might put us back to a good mood, for example. A chemical element, by its own, can just mitigate an issue, but cannot resolve it at all”.

(Cardinal Ersilio Tonini)

***

“Unfortunately, the drug suffers from being considered a commodity like any other: now sold using refined marketing techniques like a phone or a car”.

(Prof. Agostino Pirella, Professor of History of Psychiatry, University of Turin)

***

“The Food and Drug Administrations (health monitoring agency in the USA, ed.) is making changes to the classification of different classes of psychiatric drugs used so far to treat ADHD (Attention Deficit Hyperactivity Disorder), drugs used to date without proper consideration of the adverse effects associated with their use. Descriptions of side effects such as visual hallucinations, suicidal intent, psychotic behavior, as well as aggressive and violent behavior will be included”.

(Jennifer Corbett Dooren, Dow Jones Newswires Agency, Washington)

***

“These diagnosis are worked out, without considering the environment where children live;  as a consequence we stick a “pain” to kids eradicated from their social roots, and this is a huge mistake. Moreover, the diagnosis puts us in a real danger, as the psychiatric drug therapy provokes serious collateral effects. Nevertheless we must take into account consequences deriving from stating to a 7-8 year old kid, “you are insane”.

(prof. Agostino Pirella, full professor of Psychiatry History at the Turin University)

***

“Suicide-related behaviours (suicide attempt and suicidal thoughts), and hostility (predominantly aggression, oppositional behaviour and anger) were more frequently observed in clinical trials among children and adolescents treated with antidepressants”.

(European Medicines Agency EMA).

***

“My impression is that prescribing Ritalin to children is a completely busted hypothesis. My puzzles concern primarily the diagnosis and especially its “hyperextension”: it even includes categories of children who have only temporary peculiarities of behavior. And we know what is the pressure that can come from major pharmaceutical companies: many of their actions have a scientific pseudo-justification manufactured in their allied universities”.

(Prof. Sergio Piro, Psychiatrist, doyen of Neapolitan psychiatry)

***

“Unfortunately we do not dispose of many documents or diagnosis protocols on the effect of psychiatric drugs on minors, that  can help and lead to a serious prescription guide. I deem it important to be rigorously careful when prescribing those drugs to teens and kids”.

 (Sen. Anna Maria Serafini, President of the Childhood Bicameral Commission)

***

 “I cannot leave out that “uneasiness medical treating” represents an extreme measure. I consider “Giù le Mani dai Bambini” (Hands off our children) a valuable initiative, especially today when the issue has come out of the dark and in consideration of the latest statistics. I am in favor of all such initiatives, aimed to outline the phenomena and its borders”.

(Hon. Dorina Bianchi, Vice President of Social Affairs of Deputies Chamber)

***

“This type of pharmacological interventions on children, based on psychiatric drugs, should be reduced to a minimum and, whenever you can, carefully avoided”.

(Senator Paola BinettiSocial Affairs Commission of the Senate)

***

“The lack of services and family cares often facilitates the use of chemical shorthands, that certainly do not help, because that is not the solution. The drug often goes to fill the lack of certain services: where there are no services, no family, not even a functioning school, behavior can be treated with medication. This exclusive use of the drug has limited action, only symptomatic in nature, because it often does eliminate the child’s disorder, but simply reduces some negative side effects, decreasing the discomfort of adults who are near. A child must be treated on an educational and psychotherapeutic plan, not with the exclusive use of drugs”.

(Ernesto Caffo, Psychiatrist, President of the European Society of Child and Adolescent Psychiatry)

***

“To authorize the administration of a drug that the FDA considers harmful, giving it to children, is a choice that must be revised immediately. Addressing at the health level what is a problem of social and educational nature, is a convoluted and wrong way of doing things. There are advanced techniques that channel the energies of hyperactive children in the right way, in case of kids who often have extraordinary gifts and abilities above average. Before making such a choice, made with excessive haste, a broader debate would be needed: it didn’t take into account many authoritative scientific and academic voices with opposing views.

(Giulio Riccio, Councillor for Social Policies of the Municipality of Naples)

***

“It’s easy to say ADHD. And yet, it is true that all children are affected by ADHD? And I add: does the syndrome of ADHD exist as it is described? And how are these diagnoses made, by what criteria, with which paths? Until a convergence in the answer to these questions is not found, more and more psychiatric drugs will be given to children, hiding behind the excuse of a diagnosis. A child treated with psychiatric drugs will probably be a medicalized, disturbed, upset adult. I am also a father, and I would never want all this to happen to my daughters.”

(Prof. Massimo Di Giannantonio, Professor of Psychiatry at the University of Chieti)

***

“Certainly regarding this problem, the abuse of the administration of psychiatric drugs to children, there are strong pressures from medication lobbies -  I really have little doubt about it. Maybe in Italy the situation is a little different, but even at home [Italy, ed.note],  I fear these interests, which can still talk and whisper to the ears of our dedicated structures.”

(Hon. Luana Zanella, the Parliamentary Committee for Children)

***

“The data we collected clearly show that there is something
wrong. The tendency is to to administer drugs to children too easily,
especially in the age group between 14 and 17, perhaps trying to heal other forms of discomfort that instead would require different approaches. It has been shown that some products of this kind – especially those  for the treatment of depressive states- increase suicidal tendencies in minors”.

(Dr. Maurizio Bonati, Institute Mario Negri, Milan)

***

“In the case of depressed children the diagnosis should be very careful because it is easy to confuse the symptoms, and the only efficient cure is of educational, certainly not pharmacological nature.”

(Prof. Gabriel Levi, Professor of Developmental Neuropsychiatry, University of Rome “La Sapienza”)

***

“Italy should stop imitating the United States, especially when the interests of big pharmaceutical companies come into play. I do not think that in a civil society standardized children, who always say “yes sir”, can exist in schools. Many of our administrators and doctors think: “if the drug is used internationally to treat a certain disease, and I do not use it, I could be sued.” We’re taking a road that is less psycho-relational and more chemical, trying to quell the effects of deficiencies that are, rather, above. Honestly, I do not think children should be treated with Ritalin.”

(Fausto Rossano, Psychiatrist, Director of the Department of Mental Health of Naples)

***

“No  psychiatric drug is safe: the industry would need years and years of  testing of each molecule, to acquire certainties, and no one can afford it. Today we are lovers of the ‘brand’: I can personally testify that  a whole range of useful drugs was eliminated from the market, just to make room for new ‘fashionable’ products , with  more risk and much less tested.”

(Loris Jacopo Bononi, former spearhead of international research for the pharmaceutical company Pfizer)

***

“Psychiatric drugs lack a clear testing, careful and transparent about their effectiveness. It is in fact medical products for adults, who may have completely different effects on children.”

(Ernesto Caffo, Psychiatrist, president of  “Telefono Azzurro”)

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“Ritalin is considered by the WHO as one of the 300 medications most dangerous the world. The fact that it is approved for administration is very serious.”
(Antonella CammardellaVice President of the Healthcare Commission of the Campania Region)

***

“In these years we are observing a strong medicalization of Italian people: for every minimal symptom, the citizen  takes medicine.”

(Roberto Raschetti, National centre of Surveillance and Promotion of Health of the Health High Institute – Health Ministry)

***

“We are very concerned, and we are against such medicalization of distress: as requested by ‘Giù le Mani dai Bambini’ (Hands off our children), a debate must be open immediately. Do not repeat the mistakes of the United States, who have fallen victim to the reckless pressure of pharmaceutical companies, which, in Italy, obviously know, which are the right ears to whisper to. The drug can not and should not be a short cut: it is certain that some psychiatric drugs can get immediate positive effects, but at what cost? It acts only on the symptoms, ignoring completely the root causes of these inconveniences.”

(Luana Zanella, Member of the Italian Parliament, House Committee on Childhood)

***

“In this way a generation is transformed into little ‘zombies’. In the absence of scientifically discovered pathologies, children must be helped and accompanied in their growth. Stuffing them with psychiatric drugs only makes them feel ill when they are not. In the Parliament we will speak loud and will do all the necessary to stop this foolishness “.
(Laura Bianconi, Member of the Italian Parliament, Parliamentary Commission on Childhood)

***

“If we consider that in the 82 centers where Ritalin will be distributed to children, as far as I am aware of, no additional resources compared to existing ones will be made available, the families will be placed in front of a forced choice: either administering the drug to their children, although in a controlled way, or fixing it by themselves, paying for therapies alternative to psychiatric drugs, which may well get good results without exposing children to risks. These pills have the same risk profile of heroin and cocaine and the British government recently ranked among the 20 most dangerous drugs in the world.”

(Francesco Caruso, Member of the Italian Parliament, Social Affairs Committee of the Chamber of Deputies)

***

“… the use of stimulants such as methylphenidate/Ritalin to treat
of Attention Deficit/Hyperactivity Disorders (ADHD) is increased by an
astonishing 100% in more than 50 countries. In many countries - Australia, Belgium, Canada, Germany, Iceland, Ireland, Netherlands, New Zealand, Norway, Spain and the UK - the use of drugs could reach levels as high as those in the United States. The Council therefore calls on countries to assess the possible overestimation of ADHD and curb the excessive use of methylphenidate/Ritalin …”

(International Narcotic Control Board – ONU)

***

“ADHD and attention deficit disorder (ADD) are being misdiagnosed and therefore psychostimulant drugs overprescribed, despite the growing evidence of the harmful effects of these drugs… [the committee] recommends that further research be undertaken on the diagnosis and treatment of ADHD and ADD, including the possible negative effects of psychostimulants on the physical and psychological well-being of children, and that other forms of management and treatment be used as much as possible to address these behavioural disorders.”

(Concluding Observations Committee on the Rights of the Child dell’ONU, in relation to the prescription of psychostimulants)

 ***

“Longer-term negative effects are often disregarded, underestimated, or subordinated to short-term cost savings. There is a wide range of complementary or alternative treatment approaches for many of the mental disorders and painful conditions treated today with pharmaceuticals (psychotherapy, counseling, traditional medicine), and such alternatives may often be culturally more relevant and more effective. (…) Health authorities should promote the use of culturally relevant and proven complementary or alternative treatment modalities, keeping in mind that, by relying on such therapeutic options rather than on pharmacotherapy per se, cost savings can be substantial”.

(International Narcotic Control Board on report 2000- ONU)

***

“50% of drugs in circulation are unnecessary and could be safely deleted. Ours is a society increasingly drug-centric, because it sees the solution to all problems in the medicine. In addition, the enormous economic interests that revolve around drugs and the trend in health care consumerism, is the framework within which the not always better use of pills, ampoules and syrups takes place. The National Health Service could save a lot, with more decisive action on life habits”.

(Silvio Garattini – Mario Negri Institute)

***

“There is a worrying increase in the tendency – even in psychology and psychiatry – to medicalize everything and everyone, to make a diagnosis in order to identify which syndrome may be at the root of a problem. Every conceivable behavior (with the term “disturb”) can find a place in the DSM (Diagnostic and Statistical Manual) and diagnosed as a symptom of an alleged mental illness. Based on this criterion today in the United States amphetamines and psychiatric drugs are daily administered to more than 11 million children. In Italian school programs for mass screening have started to identify youngsters who suffer from psychological problems. Is it sufficient that a child is restless and undisciplined to diagnose a syndrome of attention deficit and hyperactivity disorder? How can this approach be considered scientific, if the syndromes are not evaluated according to scientific criteria? And how is the rejection of such a diagnosis interpreted? As the cause of a lack of attention due to refusal by a crowd? ADHD is a possibility, but there are others: for example, incompetent teachers or inattentive parents…”

(Sabrina Parsi, journalist and researcher)

***

“Giving psychiatric drugs to children, and in general to growing beings, is something scientifically abominable, and ethically horrible”

(Bob Johnson, Psychiatrist, member of Royal College of Psychiatrists and Director of the James Nayler Foundation)

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