A 33-year controlled, prospective study conducted as a collaboration by researchers in New York, Mexico, and Verona, Italy found that men diagnosed with ADHD as children had significantly higher rates of obesity as adults. The causal link, however – whether a common neurobiological dysfunction underlies both ADHD and obesity, or a tendency toward impulsiveness, or an effect of ADHD medication – is unclear.
Schizophrenia Bulletin publishes a review of published articles that finds the use of schizophrenia subtypes (Catatonic, Disorganized, Paranoid, Residual & Undifferentiated), “while widely used in the past,” has declined over the last 20 years to the point that they should be eliminated from research and “evolving knowledge” on the topic.
Science News offers an excellent review of the the perils and pitfalls of the scientific method as it is practiced in psychology today, concluding with the story of Clever Hans, the horse that could count.
The Canadian Task Force on Preventive Health Care has reversed its 2005 recommendations, finding methodological flaws, possible bias, and uncertain generalizability in a review of the literature. “In the absence of a demonstrated benefit of screening, and in consideration of the potential harms, we recommend not routinely screening for depression in primary care settings, either in adults at average risk or in those with characteristics that may increase their risk of depression,” the task force writes in a forthcoming edition of the Canadian Medical Association Journal.
MIA reader/commenter Brett Deacon’s article in the prominent Clinical Psychology Review says that despite “widespread faith in the potential of neuroscience”, the biomedical era has produced poor mental health outcomes. He calls for an open and critical dialogue of the model, asking whether it is ethical to propound the “chemical imbalance story” in order to increase the credibility of antidepressant medication, when there isn’t “even one instance in which neurobiology alone can explain a psychological experience,” and when the model has failed to produce two of its prime objectives; the reduction of stigma, and good long-term outcomes. He calls for critical examination of the biomedical model’s effects, and mentions the vigorous dialogue taking place on madinamerica.com, among other venues.
A meta-analysis of studies of mental health websites by John Read found that 42% are either drug company owned or receive funding from drug companies, and that sites funded by drug companies are significantly more biased toward biogenetic causes and medication than sites that are financially independent of the industry.
As co-chair of the Diagnostic Summit Committee of the Society for Humanistic Psychology, I am pleased to announce that today we officially launch the Global Summit on Diagnostic Alternatives (DxSummit.org), an online platform for rethinking mental health. Our goal is to provide a place for a collegial and rigorous discussion of alternative ways to conceptualize and practice diagnosis. Today’s launch is marked by the appearance of our first eight posts. These posts come from a variety of prominent people in the field, each offering a unique perspective on the current state of diagnosis and where we might take things as we move forward. Full Article →
The decision by the National Institute of Mental Health to part company with the APA’s forthcoming DSM-5 should not be taken as evidence that biological psychiatry is entering a terminal decline. Far from it, as the Director of NIMH Thomas Insel’s blog of 29th April 2013 makes clear, the reason NIMH has opted for its own Research Diagnostic Criteria (RDoC) is because they believe psychiatric patients deserve something better. Full Article →
At the University of Minnesota, the answer is apparently $1,446. If harmless clerical errors were to blame for oddities like this, that fact should be easy to clarify simply by looking at the relevant documents. But if there are systematic issues with the administration of clinical trials that makes it possible to bill for a visit with a dead subject, those issues would be important for other universities and private trial sites as well. Full Article →
The norm in science is that there is free access to the data underpinning experiments. If free access is denied; it’s not science. In the case of branded pharmaceuticals, we do not even know what trials have been done. What is put in the public domain is not data. The selected highlights of a football game and the comments of the pundits afterwards don’t change the score. The selected highlights of pharma studies and the comments of pundits routinely change the score. Full Article →
At the 50th American Psychosomatic Society meeting in New York, Michael Shepherd was speaking. His topic – The Placebo. When the lecture finished, Lou Lasagna said “this paper is now open for questions.” Nothing happened. Nobody said anything at all. Lasagna couldn’t refrain from commenting: “There are 3 possible explanations. First, you were all asleep and therefore you heard nothing. Secondly, it was so bad that since this speaker has come 3,000 miles you didn’t want to embarrass him. Third, it is genuinely so original and new that you don’t quite know what to make of it. I’ll leave you to decide which it was”.
Researchers in Germany, China and Australia teamed up to find, through a meta-analysis of research pertaining to 1045 patients receiving antipsychotics, that augmentation with benzodiazepines did not improve outcomes. The authors recommend that benzodiazepines should be considered only for “ultra short-term sedation of acutely agitated patients but not for augmentation of antipsychotics in the medium- and long-term pharmacotherapy of schizophrenia and related disorders.”
Research into stigmatizing attitudes towards behavior, published in Early Intervention in Psychiatry, finds that most study subjects did not spontaneously apply diagnostic labels to behavior but when such labeling occurred (“paranoid/a”) respondents exhibited stronger stigmatizing attitudes compared to this employing non-psychiatric labels (“weird”).
French researchers looked at the outcomes of 467 “antipsychotic drug-naive” patients six months after a first psychotic episode (and treatment with medication), finding that the outcomes were heterogenous. A lower initial level of functioning and negative symptoms were the best predictors of worse outcomes. The sole predictor of rapid improvement, however, was employment. Results appear in Acta Psychiatrica Scandinavica. Abstract →Discuss →
Chinese researchers find, in a literature review for the International Journal of Endocrinology find an increased rate of osteoporosis among people with a schizophrenia diagnosis, and conclude that that increased risk is secondary to hyperprolactinemia caused by antipsychotics.
A study of the Swedish medical birth registry, conducted by researchers from Sweden, the U.K., and the U.S.A., found a 3.3X greater risk of autism in the offspring of women reporting antidepressant use during pregnancy. The researchers, however, urge caution as the results explain only a small percentage of the prevalence of autism.
Tension mounts across the ideological divide as D-Day (DSM-5 Day) approaches. The APA has powerful allies on its side. President Obama has just launched Decade of the Brain 2 with the announcement two weeks ago that heralds the arrival of BRAIN ( Brain Research through Advances in Innovative Neurotechnologies). If that’s not enough, those who believe that science will ultimately explain madness can always rely on the media to fawn at their feet. Full Article →
For the past 20 years, there has been a prevailing concern in psychiatry that psychosis is bad for the brain. When I read Anatomy of an Epidemic, this was one of my most pressing concerns; if I suggested to my patients that they pursue other treatments before starting drug treatment, was I helping or harming them? Full Article →
The Cochrane Library reports that “many older people with Alzheimer’s dementia and NPS (neuropsychiatric symptoms) can be withdrawn from chronic antipsychotic medication without detrimental effects on their behavior… the results of this review suggest that discontinuation programmes could be incorporated into routine practice. However, two studies of people whose agitation or psychosis had previously responded well to antipsychotic treatment found an increased risk of relapse or shorter time to relapse after discontinuation.”
The invitation from the London Review of Books to review Ben Goldacre’s Bad Pharma™ reads: “We were unsure, at first, what a review could add that isn’t already in the book – scrappy summaries and bits of praise are not for us. The book is of sufficient importance that the main thing is to get someone who knows what they’re talking about to present the material confidently… frame the discussion”. My head said it was inconceivable that the LRB wouldn’t take a review, even if it was at odds with the invitation to praise Bad Pharma. But my gut told me the inconceivable was about to take flesh. Full Article →
In a study of 6,767 reports of antidepressant trials in juveniles treated for depressive and anxiety disorders, the risk of psychopathological behavioral or mood elevation was 3.5x greater with antidepressants than with placebo. The authors (which include Giovanni Fava of the University of Bologna and Ross Baldessarini of Harvard Medical School) urge “particular caution and monitoring for potential risk of future bipolar disorder.”
Despite the integral importance of blinding and blinding assessment to randomized controlled trials (RCTs), they are rarely reported on or documented in trial reports according to this study published yesterday in Psychotherapy and Psychosomatics. The study of schizophrenia and affective disorder medication research in 2,467 publications from 2000 to 2010 found that an absence of blinding and blinding assessment was associated with an increased rate of positive findings of treatment success, industrial sponsorship, and diagnosis of schizophrenia.
A study of 442 individuals discharged from a U.K. hospital, published today in The Lancet, finds that the rate of readmission after 12 months was unaffected by the imposition of ”Community Treatment Orders”, aka; compulsory supervision. “This is the largest randomised trial of CTOs,” said Tom Burns, the lead author. “The evidence is now strong that the use of CTOs does not confer early patient benefits despite substantial curtailment of individual freedoms. Their current high usage should be urgently reviewed.”
A report from the Healthcare Cost and Utilization Project finds that hospital stays for a diagnosis of bipolar disorder in children aged 5-9 increased 696% from 1997 to 2010, 475% in children aged 10-14, and 345% in those aged 15-17. By 2010, mood disorders had become the most frequent principal diagnosis in children aged 1-17.
Acta Psychiatrica Scandinavica reviews the literature on psychological and biological findings on resilience, finding that secure attachment, the experience of positive emotions and having a purpose in life are three building blocks.