Publication Bias and Meta-Analyses: Tainting the Gold Standard with Lead

For decades the gold standard for medical evidence was the review article - an essay looking at most or (hopefully) all of the research on a particular question and trying to divine a general trend in the data toward some conclusion ("therapy X seems to be good for condition Y," for example). More recently, the format of review articles has shifted - at least where the questions addressed have leant themselves to the new style. The idea has been to look at the original data for all of the studies available, and in effect reanalyze them as though the research participants were all taking part in one gigantic study. By increasing the number of data points and averaging across the vagaries of different studies, a clearer finding might emerge. The meta-analysis has gone on to be revered as a strategy for advancing healthcare. It has vulnerabilities.

What Are You Doing WHO?

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The World Health Organisation was established in 1945 to provide leadership on global health matters. According to its Director General Dr Margaret Chan, it...

Odysseus Come Home

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Odysseus was in his 70s. Coming up to the 50th anniversary of a very happy marriage. He had formerly been a respected professional, a...

Sweeping Benzos Under the Carpet

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Being an ex-accountant I am always interested in figures (not to mention that prescribed benzodiazepine drug addiction has played such a major part in my life). According to a yearly booklet released by the Home Office in the UK, benzodiazepine drugs accounted for more deaths than ALL the so-called hard drugs put together.

American Woman

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On Thursday, May 31, 2001, a woman whose name is known only to GlaxoSmithKline emailed the company:   "My name is... I was diagnosed with panic...

The Once and Future Abilify: Depot Injections for Everyone?

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This column is partly a report on the marketing of Abilify, the atypical antipsychotic that has become America’s best-selling drug.   It’s also an appeal for advice and feedback from the RxISK and Mad in America communities, and a call for some brainstorming about strategy.  The plans laid out by drugmakers Otsuka and Lundbeck for Abilify’s future, and the cooperation they’re getting from leading universities, are alarming enough to me that reporting on them seems inadequate.  We need action, although I’m not sure exactly what kind.

Elephants and Flamingos

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I am walking through my local park in Copenhagen, Denmark, early in the morning breathing in the fresh smell of damp soil and late summer blooms. I am thinking about my thesis that I have just handed in and the fact that if it is passed I will be a certified psychologist! But, I will not be just any psychologist. I will be Denmark's first official 'Mad' psychologist, joining the ranks of others such as Rufus May, Eleanor Longden, Arnhild Lauveng, and Pat Deegan.

If Not Meds, Then WHAT?

A great deal of the information published on MadInAmerica is devoted to this very important question, so many constructive ideas are often presented. We think that nutrition and diet should always be part of the conversation.

Getting Our Anti/Critical Psychiatry Authors Read: A Case for Book Activism

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Our success as a movement depends on our ability to sway the general public—and if the mainstream press and media never afford our books their due—not even the blatantly cutting edge ones (and if anything, these are treated worse) and the general public, as a consequence, remains largely unaware of their existence, the likelihood of succeeding in our primary mission(s) is substantially reduced.

Is There a Simple Way to Use Nutrition Knowledge to Decrease Onset of Psychosis?

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In our last blog, we focused on the fact that nutrient supplementation has not only been accepted in the realm of physical health in the past, but it has actually been endorsed by reputable sources such as the Journal of the American Medical Association editors who published the Fairfield and Fletcher articles 11 years ago recommending that all adults take a multivitamin to reduce their risk of cardiovascular disease, cancer, and osteoporosis (note that this is completely inconsistent with very recent studies reported in the Annals of Internal Medicine --- but that’s just the way science works, using different nutrients and different methodologies, coming up with discrepant findings, until facts finally emerge).

Causing a Stir: Launching “Understanding Psychosis and Schizophrenia” in New York City

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Those of you who read the New York Times may have seen its coverage of the British Psychological Society’s recent report, ‘Understanding Psychosis and Schizophrenia: Why people sometimes hear voices, believe things that others find strange, or appear out of touch with reality, and what can help.’ The report has been widely welcomed and many have seen it as a marker of how our understanding of these experiences is changing. The report has not been without its critics. We (Editor Anne Cooke and co-author Peter Kinderman) are coming to New York this month to launch the report in America.

Study 329 in Japan

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By 2002 GlaxoSmithKline had done 3 studies in children who were depressed and described all three to FDA as negative.  As an old post on Bob Fiddaman’s blog reproduced here outlines, several years later they undertook another study in children in Japan. (Editor's note: This is a re-print, by David Healy, of a post by Bob Fiddaman)

Mad Economy: Let’s Change the World!

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Everyone in the world is either touched by their own mental health issues or have had a family member affected. What if they directed their buying power to an organization that would use the profits to fund exciting mental health & recovery projects both in the developing world and in their own countries; projects that would be ethical, non-coercive, personal recovery-based, and were aimed at creating recovery communities? What if they could buy products, crafts, services, art, music, books from people who had experienced mental health issues, enabling them to set up their own businesses or buy from social co-operatives that enabled distressed people to work and earn a living wage?

The Hidden Gorilla

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Three weeks ago What would Batman do Now covered the issue of suicide in the military – an issue that had Batman missing in action, and...

Study 329: Minions no Longer

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Good Pharma is the story of the Mario Negri Institute. Mario Negri was a wealthy patron who on his death in 1960 bequeathed a large sum of money to support independent pharmaceutical research to an upcoming researcher Silvio Garattini. Garattini and Alfredo Leonardi set about building an Institute centred on the new drugs and new techniques. They continue to grow without ever having patented any of their many discoveries or concealing any of the data from experiments that didn’t work out or accommodating any of their trials to industry’s wishes.

Long-Term Antipsychotics: Making Sense of the Evidence in the Light of the Dutch Follow-Up...

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In the 1950s, when the drugs we now call ‘antipsychotics’ first came along, psychiatrists recognised that they were toxic substances that happened to have the ability to suppress thoughts and emotions without simply putting people to sleep in the way the old sedatives did. The mental restriction the drugs produced was noted to be part of a general state of physical and mental inhibition that at extremes resembled Parkinson’s disease. Early psychiatrists didn’t doubt that this state of neurological suppression was potentially damaging to the brain.

Something Rotten in the State of British Psychiatry?

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Delegates attending the International Congress of the Royal College of Psychiatrists at London’s Barbican Centre in June this year will almost certainly not hear about the results of the seven-year outcome of the Dutch First Episode (FE) study widely discussed on Mad in America in recent months.

Lullaby

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On Monday a new study was published with the finding that there is a three- to four-fold increase in the rates of Autistic Spectrum Disorder and Developmental Delay in children, especially boys, born to mothers who have been on antidepressants through pregnancy. There are further studies with comparable findings in the offing. Not only this but it looks as though the SSRIs may redefine what it means to be a teratogen. Other teratogens produce their effects in the first trimester of pregnancy when organs are first being formed. But it looks like antidepressants used in the third trimester can lead to autistic spectrum disorder and developmental delay.

Do You Still Need Your Psychiatric Diagnosis?

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Do you still need your psychiatric diagnosis? The answer for practical purposes is probably ‘Yes.’ In the current system, diagnosis is essential for accessing services and benefits and, particularly in the USA, for covering your treatment costs. But do you need to believe in your diagnosis? Do you have to accept this particular attempt to explain your difficulties, and to take it on as part of your identity by becoming one of the ‘mentally ill’? since psychiatric diagnoses have been admitted to be non-valid even by the people who drew them up, professionals should not be offering people the ‘choice’ of describing their difficulties in diagnostic terms in the first place. That would still leave people with the right to adopt whatever explanation suits them as private individuals.

Winning Friends and Influencing People

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Some readers of Mad in America may be aware that Scientific American published a short blog by me on 17th November 2014 - Why We Need to Abandon the Disease-Model of Mental Health Care. This blog was rather wonderfully (and slightly embarrassingly) described by Phil Hickey on his website, Behaviorism and Mental Health, as “an important milestone.” My blog attempts to summarise many of the key points of a perspective widely shared on Mad in America: 

Raising Our Voices at TED 2013

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At the end of my TED Talk one of the conference’s co-hosts came onto the stage and asked me, with a respectful interest, whether I still hear voices. For a split second I hesitated, wondering whether to play it down with an airy “oh, not all that much now.” Instead I opted for the truth: “All the time,” I said cheerfully, “In fact I heard them while I did the talk – they were reminding me what to say!”

Psychiatrists May be Ready to Learn About Treating With Micronutrients

It was May 19, 2003, in San Francisco; the first-ever (we think) symposium on micronutrient treatment to be on the schedule for the annual meeting of the American Psychiatric Association. There was moderate interest. This year, the two of us (both psychologists) presented many, many studies on the use of micronutrients to treat anxiety, stress, depressive symptoms, ADHD, aggression, mood, and addictions. The amount of data differed dramatically from 12 years ago, but the biggest difference was the response from psychiatrists!

What Kind of Forced Treatment Would You Prefer?

The new Danish psychiatric law which has been under development for a while has just been passed by the government and is due to be implemented on 1st June 2015. However the road to this new law, ostentatiously to improve the rights of the patients, has had an interesting history. Denmark was on its way to achieving the dubious title of European champion in the number of people subjected to physical restraints according to the European Committee for the Prevention of Torture.

Wake Up and Smell the Coffee!

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"I want to change the way we think about mental health care so that any child, whether they have a mental illness or simply need support through a difficult time, can get the right help at the right time." This was said by Care Minister Norman Lamb and quoted by the BBC on March 17th 2015. Mr. Lamb is known to have a son who has suffered mental health difficulties and it may well have come from the heart as much as it did from the election fever which is beginning to infect British politicians. However it says something worth picking up upon. I want to change the way we think about mental health care… and … simply need support through a difficult time. These are important shifts of language, and doubly important when they come from a government health minister.

Governments Delivering Customers to Big Pharma

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What distinguishes the pharmaceutical industry from the producers of other potentially harmful products, is the fact that, governments have passed legislation allowing detention of potential customers and forced administration of its product to consumers who do not wish to purchase it. Imagine if goverments passed laws allowing other industries to detain potential customers and force them to use their products.