On April 19, 2014, The Lancet published an article titled Do we underestimate the benefits of antidepressants? by German psychiatrists Mazda Adli and Ulrich Hegerl. The Lancet, founded in 1823, is a weekly, general medical journal which since 1991 has been owned by Elsevier, a private, Amsterdam-based, publishing house with offices in the UK, USA, and other countries. The gist of the article can be gathered from the opening paragraph: ...
On May 16, the New York Times ran an article titled Thousands of Toddlers Are Medicated for A.D.H.D., Report Finds, Raising Worries, by Alan Schwarz. Here is the opening sentence: "More than 10,000 American toddlers 2 or 3 years old are being medicated for attention deficit hyperactivity disorder outside established pediatric guidelines, according to data presented on Friday by an official at the Centers for Disease Control and Prevention." The CDC official is Susanna Visser, MS, DrPh, Acting Associate Director of Science for the Division of Human Development and Disability, and she was speaking at the annual Rosalyn Carter Georgia Mental Health Forum. I have not been able to find the text of Ms. Visser's speech. (It will probably be published later.) Meanwhile, there is a good deal of information in Alan Schwarz's article. Here are some more quotes: "The report, which found that toddlers covered by Medicaid are particularly prone to be put on medication such as Ritalin and Adderall, is among the first efforts to gauge the diagnosis of A.D.H.D. in children below age 4. Doctors at the Georgia Mental Health Forum at the Carter Center in Atlanta, where the data was presented, as well as several outside experts strongly criticized the use of medication in so many children that young." ...
In November 2013, the journal Schizophrenia Research published a paper by Tsuji, T. et al. titled Premorbid teacher-rated social functioning predicts adult schizophrenia-spectrum disorder: A high-risk prospective investigation. Here’s the abstract: "Social functioning deficits are a core component of schizophrenia spectrum disorders, and may emerge years prior to the onset of diagnosable illness. The current study prospectively examines the relation between teacher-rated childhood social dysfunction and later mental illness among participants who were at genetic high-risk for schizophrenia and controls (n=244). The teacher-rated social functioning scale significantly predicted psychiatric outcomes (schizophrenia-spectrum vs. other psychiatric disorder vs. no mental illness). Poor premorbid social functioning appears to constitute a marker of illness vulnerability and may also function as a chronic stressor potentially exacerbating risk for illness." ...
The controversy surrounding Justina Pelletier and her family has expanded its scope in recent months, and has now become a general public scrutiny of Massachusetts’s Department of Children and Families. On April 29, State Governor Deval Patrick gave a press conference in which he announced the resignation of DCF Commissioner Olga Roche. I think there’s a very real risk of confusing some issues here. The sad fact is that, despite the enormous strides we have made as a society, there are still a great many children who are abused and neglected. Every state in the US has a social services department, one of whose statutory responsibilities is to investigate reports of abuse and/or neglect. The case workers who conduct the investigations are required to follow set procedures. Often they find that the allegation is unfounded, and the investigation is terminated. When they do find probable cause, they are required by law to present their findings to a judge, who scrutinizes the evidence in accordance with the normal judicial procedures. The social services department, the parents, and the child are usually represented by attorneys. ...
In their Fall 2013 issue, the Journal of Law, Medicine, and Ethics published a symposium of papers by members of the Harvard’s Edmond J. Safra Center for Ethics. The symposium was called Institutional Corruption and Pharmaceutical Policy. The symposium focuses on pharmaceutical products generally, but all the material is relevant and important in the context of psychiatric drugs. In this post I will highlight one of these papers: Institutional Corruption of Pharmaceuticals and the Myth of Safe and Effective Drugs, by Donald W. Light, Joel Lexchin, and Jonathan J. Darrow. ...
As my readers know, I am a great fan of Jeffrey Lieberman, MD, President of the APA. In his capacity as president, Dr. Lieberman writes a regular bulletin in Psychiatric News. These literary and intellectual gems have been a wonderful source of inspiration to me in my efforts to draw attention to psychiatry’s flaws, and I don’t think it would be an exaggeration to say that in many respects, Dr. Lieberman has been one of our greatest allies. ...
On April 22, I published a post on this general topic. In that article I pointed out that the notion of stimulant prescription drugs improving the driving of people who “have ADHD” was gaining traction. Since than I have come across two articles on this subject from Australia. (Thanks to Nanu Grewal for the links.) Both articles appeared in the Sunshine Coast Daily, and you can see them here and here. Apparently in 2009, four people, including five-year-old twin girls, died in a two-car accident. The driver of one of the cars had been prescribed dexamphetamine for the treatment of ADHD by a local psychiatrist, and was found to have had six times the prescribed dosage of dexamphetamine in his system at the time of the crash. ...
In January 2014, the journal Research on Social Work Practice ran a special issue called A Critical Appraisal of the DSM-5: Social Work Perspectives. There are fifteen articles on this general theme, and together they present a wide range of arguments against the DSM system. Social workers represent the numerically biggest group of mental health practitioners in the US, and it is particularly gratifying to see a major social work journal addressing this topic so forthrightly. ...
Alex Langford is a British trainee psychiatrist. He blogs at The Psychiatric SHO, and on April 21, he posted an article titled Antidepressants are not ‘happy pills.’ Thanks to Jean Davison for the link. The article is an impassioned attack on psychiatry’s critics. Here are some quotes, with my responses: "I am sick and tired of the way the press portrays depression as unhappiness and antidepressants as ‘happy pills’." This is interesting, though my general impression is that the mainstream media lean a good deal more towards psychiatry than towards our side of the debate. In addition, the words "depression" and unhappiness are pretty much synonymous. So it's difficult to see why that, or the characterization of antidepressants as "happy pills," should be so upsetting to Dr. Langford. We all, of course, have our linguistic likes and dislikes. I personally don't care much for the growing trend to pronounce the indefinite article as "ay," or for psychiatry's insistence on calling neuroleptic drugs "anti-psychotics." But what can you do? I just Googled the phrase "antidepressants are happy pills" and got 204,000 hits! So the notion has some traction and is probably here to stay. One can't legislate for the way people use words. Or perhaps psychiatrists imagine that they can. "For problems in other areas of health we’d only trust the experts to comment, but when it comes to mental health it seems like anyone can cast judgement." ...
On April 11, 2014, journalist Alan Schwarz (brief bio here) published an article in the New York Times on this topic, titled Idea of New attention Disorder Spurs Research, and Debate. Alan has written extensively on the rising rates of the condition known as ADHD, and on the abuse of the drugs that are used to “treat” this condition. He has drawn a good deal of criticism from psychiatry’s believers. ...