Joseph Biederman

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By Dr Martin Whitely

The central characteristics of ‘Disruptive Mood Disregulation Disorder’ proposed for inclusion in DSM5 are childhood “irritability” and “temper outbursts” occurring, ”on average, three or more times per week”.[1] Disruptive Mood Disregulation Disorder represents a disturbing evolution of the absurd and dangerous practice of diagnosing children, even very young children, with ‘Juvenile Bipolar Disorder’.  Although not an official psychiatric disorder Juvenile Bipolar Disorder was enthusiastically and successfully promoted by disgraced Harvard University Professor of Psychiatry, Joseph Biederman.

Biederman, who was also Director of the Johnson & Johnson Centre for Paediatric Psych-Pathology research at Massachusetts Hospital and according to the New York Times is the “the world’s most prominent advocate of diagnosing bipolar disorder in even the youngest children and of using antipsychotic medicines to treat the disease”.[2] He is largely responsible for the enormous growth in US antipsychotic prescribing rates to children including Johnson & Johnson’s very profitable antipsychotic Risperidone (brand name Risperidal).  In April Johnson & Johnson were fined US$1.2Billion by an Arkansas court for making misleading claims about the safety of Risperidal. This followed similar outcomes in other US states.[3]

In 2011, US congressional investigations led by Iowan Senator Charles E. Grassley exposed that Biederman received at least US$1.6m in undisclosed fees from drug-makers from 2000 to 2007 and only revealed a tiny fraction of this income to Harvard University.[4] The New York Times reports “court documents dating over several years that Dr. Biederman wants sealed showed that he told the drug-giant Johnson & Johnson that planned studies of its medicines in children would yield results benefiting the company”.[5]

Taking and not disclosing drug company money and planning beneficial research results is reprehensible behaviour. Harvard University’s decision to effectively give Biederman little more than a rap on the knuckles brings discredit to one of the world’s most prestigious universities.[6] Perhaps Harvard was motivated more by the funding that Biederman and his cronies attract to the university than by the damage they bring to the university’s reputation. Harvard’s failure to take strong ethical action against Biederman has meant that his influence, although waning, is still considerable.

Thankfully Juvenile Bipolar Disorder is not officially recognised as a diagnosable condition in the current DSM (DSMIV). Supporters lobbied to have it included in the DSMIV, however the DSMIV development committee “found scientific support unconvincing and refused to do so”.[7] Regardless, hundreds of thousands, possibly millions, of children have been diagnosed with the unofficial disorder and treated with anti-psychotics like Johnson & Johnson’s Risperidal.[8] These medications “can cause serious complications – major weight gain, obesity, diabetes, cardio vascular disease and possibly shortened life expectancy.  Sudden death has occurred in a few cases where excessive doses and/or multiple drugs were given to very young children.”[9]

The proposal to include Disruptive Mood Disregulation Disorder is in part a reaction to criticisms of the use of anti-psychotics for Juvenile Bipolar Disorder.  The authors of DSM5 are proposing Disruptive Mood Disregulation Disorder as an alternative to the diagnosis of Juvenile Bipolar Disorder, using the rationale that this will help curb anti-psychotic prescribing rates to children.  In effect, they are proposing a “juvenile bipolar light” disorder.

Given the unrestrained enthusiasm for prescribing psychotropics ‘off label’ to children exhibited by many clinicians, particularly paediatricians, the opposite is likely to occur.[10] The inevitable outcome is that more children will be diagnosed and experience tells us the more children diagnosed with a ‘psychiatric disorder’, the more children are subjected to the cheap and convenient practice of speculative ‘off label’ prescribing.

The only sensible course of action for the American Psychiatric Association is to reject out-of-hand the notion of Juvenile Bipolar Disorder or any lighter version thereof including Disruptive Mood Disregulation Disorder.  Failure to do so will drag the American Psychiatric Association into another epidemic of childhood drugging for which, unlike ADHD, they currently bear no responsibility.


[1] For a full description of the proposed diagnostic criteria see

[2] New York Times Topic Page for Professor Joseph Biederman available at]

[3] Companies belittled risks of Risperdal, slapped with huge fine, Los Angeles Times 11 April 2012. Michael Muskal available at

[4] New York Times Topic Page for Professor Joseph Biederman available at

[5] New York Times Topic Page for Professor Joseph Biederman available at

[6] For more detail see

[7] Dr Allen Frances, Huffington Post, The false epidemic of Childhood Bipolar Disorder available at

[8] There are no reliable estimates of child prescribing patient numbers. In the U.S. outpatient office visits for children and adolescents with bipolar disorder increased 40-fold from 20,000 in 1994–95 to 800,000 in 2002–03.

[9] Dr Allen Frances, Huffington Post, The false epidemic of Childhood Bipolar Disorder available at

[10] A recent study of psychiatrists in Christchurch New Zealand revealed that 96% of them prescribed antipsychotics off label. While it is unlikely that rate is replicated across the globe it is nonetheless an alarming statistic and indicates the practice is very common. M. Slezack, Psychiatry Update, 26 April 2012, 96% of psychiatrists prescribe off-label anti-psychotics

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Today (Wednesday 13 July 2011) Mental Health Minister Mark Butler announced the membership of the committee responsible for developing new Australian guidelines on ADHD. Of the ten members invited to participate, two have significant conflicts of interest that should preclude their involvement. However, this compares very favorably to previous ADHD guideline development processes which have been dominated by pharmaceutical company allies who have relied on commercially compromised research.

It is also, for the first time, an open process. We know from the start who is developing the guidelines and the details of their conflict of interest declaration. (see ) Gillard Government Mental Health Minister Mark Butler deserves credit for this. Let us hope this creates a precedent for future commonwealth government medical guidelines and advisory committee processes.

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The Boston Globe reported yesterday[1. Harvard doctors punished over pay, 2 July 2011, Liz Kowalczyk Boston Globe] (2 July 2011) that three Harvard Professors, Bierderman, Spencer and Wilens, who were referenced 82, 46 and 32 times respectively in the discredited draft Australian Guidelines on ADHD, have been sanctioned by their employer for allegedly failing to disclose millions of dollars in pharmaceutical company payments. [2. ‘On June 8 2008 the New York Times first exposed how Dr Biederman was paid US$1.6 million in consulting fees from drug makers between 2000 and 2007 but did not disclose this income to his employer Harvard University. Gardiner Harris and Benedict Carey, ‘Researchers Fail to Reveal Full Drug Pay’. New York Times, 8 June 2008.] [3. Biederman received research funds from 15 pharmaceutical companies and serves as a paid speaker or adviser to at least seven drug companies. ‘The Evolving Face of ADHD: From Adolescence to Adulthood—Clinical Implications’. Available at (accessed 2 May 2008)]

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Please see below for the full transcript from the feature program ‘Questionable Behaviour’ aired on the Channel 7 Sunday Night program on the 16th of June.

The program featured Martin discussing his views on the use of ADHD drugs to control children’s behaviour and also featured high profile ADHD advocate Dr Joseph Biederman declaring himself one promotion below god, but failing to mention that he is under investigation for allegedly not declaring his drug company financial connection to his employer Harvard University.

The transcript from Channel 7’s Sunday Night program.

For more about Biederman see The Wave of Evil: New Report on ADHD Drugs Blowback published in the Huffington Post by Bruce E. Levine, PhD  <> 


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