THE ADHD GRINDER

The opinions about ADHD in the media are divided. Sweden is no exception to that and the two sides gained each their own face in the debate the past years. On one side there's professor Christopher Gillberg, a psychiatrist from the University of Gothenburg, a pioneer in the world when it comes to ADHD as a brain disorder. On the other side stands Eva Kärfve from the University of Lund, who claims there's no evidence for such theory. The dramatic developments in this debate have caused such scandals, it could easily turn into a Hollywood movie with Russell Crowe, ending with a possible imprisonment of Gillberg.

ADHD or DAMP in Sweden (a variation without international support) seldom brings peace of mind. When Kärfve visited at the end of 2001 a hearing by the EU committee in Paris about the problems around hyperactive children, the closing statement advised the EU countries to be more careful with diagnoses and treatments with amphetamines. It caused such a tumult among medical doctors against such precaution. The staff of the committee said they had never experienced this outrage before. Kärfve also got her share of negative reactions every time she spoke about the misconceptions of ADHD. Nevertheless Kärfve - mother of five children - keeps fighting against the assumption ADHD is genetic. She claims the circumstances in which the child grows up in, at home and in school, and the interpretation of that by adults, shaped the conception of ADHD. She receives support from several sides, including the academic world. There's for example the Swedish child psychiatrist Tomas Ljungberg who discovered that a part of the children with ADHD could communicate only with one parent and not the other. A conclusion that stands opposite to the inherited causes in the child.

Christopher Gillberg, probably the authority in Sweden when it comes to ADHD/DAMP and who's also internationally recognized and respected for his research, claims the inherited brain disorder is a fact and wrote many articles and given many lectures all over the world. It annoyed Kärfve and called him his cards. He refused to give her a look at the research, that contains two decennia, because he had promised the children and their parents confidentiality and never make the research public. Kärfve went to court and after a long legal battle, which Gillberg knew constantly to postpone, it reached three times the same verdict. Gillberg had to show a part of his research to Eva Kärfve and pediatrician Leif Elinder so an independent analysis could take place. Gillberg refused and started a counter campaign. The Gillberg group composed a protest letter and mailed it to all children (who had become adults in the mean time) and their parents with the request to sign and return it with the included stamped envelope. Also phone calls were made to them to increase the pressure that the verdict would damage their integrity. It even came so far that one person from the study made a public TV appearance warning that this way your worst enemy could get access to sensitive personal information. Also a dramatic letter from Ahl Viggo, one of the former children of the study, appeared in Göteborg Posten on June 25, 2003, claiming his life was doomed to public exposure. As if Kärfve would make a docu soap out of it. However, Viggo never expressed himself when 13 other individuals from Gillberg's research had (limited) access in his research. The misconception that the verdict was meant to more people than Eva Kärfve and Leif Elinder was at least not made clear to the examined children and their parents. Eva Kärfve calculated by some reports of the ADHD/DAMP study it could possibly be 22 individuals who had given access to the documents. Even the adult children of Gillberg seem to have helped registering the research data. Nobody of the examined people actually knows how many and which ones of Gillberg's colleagues had access.

Despite the legal verdict, Elinder was refused access to the rooms at the University but didn't want to call in the police and a locksmith. Gillberg and his colleagues were even prepared to literally defend the entrance. The board of the University felt paralyzed. They had never experienced something like this.

Gillberg made the unthinkable next move; during a long weekend in May 2004 all his research material was destroyed by his wife and two colleagues, Kerstin Lamberg and Peder Rasmussen. To protect the participants of the study, was their statement, supported by their believe that ethics and morality don't surpass jurisdiction. The study material spanning a period from 1977 to 1992 and counted hundred thousand pages was thrown without pardon into the paper shredder. Gillberg nevertheless denies officially having been informed about these extreme actions before hand. He still refuses to make any comment to the case. If it was really about the confidentiality to the participants in his study, why wasn't there being looked for a compromise? They could have colored the names black, which probably would have taken less time than the long legal battle. They could have made the applicants, Eva Kärfve and Leif Elinder, sign a confidentiality contract never to release the names in public. The destruction of so much material has shocked the scientific community and caused a severe blow to Gillberg's career. One can wonder if such drastic act really served science or was it an act of panic to protect his career from the false notion ADHD is a brain disorder?

Peder Rasmussen did open his mouth in the media in which he constantly doubted the integrity of Eva Kärfve by emphasizing she wasn't part of the medical establishment and having a thorough lack of its rules. Fact is that probably the medical elite owns too much power. In any other area, political or indutrial, such an act would have had much greater consequences.

On January 18, 2005, Gillberg, the director Gunnar Svedberg and Chairman Arne Wittlöv of the University of Gothenburg have been officially indicted for breach of duty; the refusal of a legal verdict in granting access to two independent researchers. The director's main argument why he hadn't acted tougher against the Gillberg group was because he had been afraid for the risk of physical violence. The destruction of the papers by Gillberg's wife and two colleagues will be handled separately

Is the diagnosis ADHD based on unscientific subjective observations supported by an influential pharmaceutical industry? There still hasn't been any evidence ADHD is based on a brain disorder. In Sweden it seems 10 percent of the children have ADHD/DAMP, Gillberg speaks of at least 10,000 children with a severe form of ADHD/DAMP. In the Swedish town Sävsjö, 3 of the 6 primary schools had thoroughly changed their education, which resulted afterwards in a reduction of the diagnosis ADHD to almost zero in those schools. It's not scientific proof but is shows how ADHD is being dealt with.

© 2005 Dennis Rodie

The Dutch version appeared in Kleintje Muurkrant nr. 400, March 4, 2005