On Thursday, October 18, 2012 the following article appeared on the front page of the Wall Street Journal: The Long Battle to Rethink Mental Illness in Children. The following letter has been sent by JBRF to the Editor of the Wall Street Journal:
To evaluate the classification Disruptive Mood Disorder with Dysphoria (DMDD), proposed as an alternative to pediatric bipolar disorder and slated for inclusion in the next Diagnostic and Statistical Manual (DSM-5), one need look no further than the research base from which it sprung. The investigative group used existing DSM classifications and assumptions as the anchor points by which all data were measured. However, 30 years of DSM-based research has not led to any breakthroughs or predictable diagnosis and treatment.
A seminal research initiative launched in 2010 by the NIMH divorces itself from DSM. Dr. Tom Insel, Director, wrote, “Reliability [of a classification] is not the same as validity. As research increasingly reveals the brain circuitry for various forms of behaviors, we can look forward to a classification system validated by a knowledge of both the genetic risks and neural basis of mental illness.” The new paradigm, “makes no assumptions about current categories.”
Yet DMDD tenaciously reshuffles those old assumptions. Of grave concern is that the new iteration calls for a treatment plan which we believe is contraindicated for the population.
For over a decade our foundation has supported a line of research consistent with the newly defined NIMH priorities. We have identified a unique clinical profile which unifies symptoms currently flung across the DSM spectrum. The profile incorporates the chronically explosive behaviors of “DMDD” as well as previously unconsidered symptoms. Significantly, the profile associates with a clear physiological deficit. A 4+ year pilot study has used a novel treatment regimen for more than 50 severely ill children who fit the profile. The treatment corrects the deficit and simultaneously relieves the problem behaviors and symptoms. (http://www.youtube.com/watch?v=YIe7idNqXZI&feature=youtu.be). An FDA/IRB approved clinical study is now underway.
We submitted this information to the DSM-5 Task Force however they indicated no interest in further discussion.
Inger Sjogren, Executive Director Juvenile Bipolar Research Foundation Maplewood, NJ www.jbrf.org Dr. Demitri Papolos, Director of Research Juvenile Bipolar Research Foundation Alissa Bronsteen, Research Manager Juvenile Bipolar Research Foundation