A Behavioral Approach to Mental Disorders

In 2006, Laurence Jerome, a Canadian psychiatrist, and two colleagues wrote a paper titled What We Know About ADHD and Driving Risk: A Literature Review, Meta-Analysis and Critique. It was published in the Journal of the Canadian Academy of Child and Adolescent Psychiatry in August, 2006. The primary result of the meta-analysis was: "Current data support the utility of stimulant medication in improving driving performance in younger ADHD drivers." The study is lengthy and well-referenced, but in keeping with standard psychiatric practice, it conceptualizes and presents ADHD as a "…common psychiatric disorder…" with symptoms of "…inattention, impulsiveness and hyperactivity…" In other words, they present ADHD as something that a person has rather than as something that a person does. The problem with this approach is that it creates the impression that meaningful or significant correlations/effects have been found, where in fact all that has happened is an elucidation of the terms used. For instance, the authors refer to a study by Fried et al. (2006) and state: ...

On April 1, 2014, Slate published an online article titled Mitochondrial Disease or Medical Child Abuse? The author is Brian Palmer. Slate is a daily, general interest web magazine, founded in 1996, that provides “analysis and commentary about politics, news, business, technology and culture,” and is a subsidiary of the Washington Post. Brian Palmer is Slate’s “chief explainer." As the title suggests, the article tries to explore the central question in Justina’s case: does she have mitochondrial disease or is she a victim of medical child abuse? The author does a good job of defining the various terms, unraveling the issues, and presenting both sides of the argument, though on balance he comes down in favor of Boston Children’s Hospital. Here are some quotes: ...

I have written on Dan Markingson’s death in an earlier post, and I encourage readers who are not familiar with the case to have a look. It is generally accepted by those of us on this side of the debate that psychiatry does more harm than good, and is organizationally and individually responsible for a great many deaths worldwide every day. These deaths, however, are seldom laid at psychiatry’s feet. Coroners return verdicts of suicide, homicide, heart attacks, choking, etc… Occasionally psychiatric practice is mentioned as a contributory factor, but not often. ...

About six months ago, I wrote a post called Health Care Reform and Psychiatry. In that article, I gave a brief account of the APA’s Council on Communications, and I expressed the belief that the council seemed more concerned with PR (in the most tawdry sense of the term) than with any serious examination or reform of psychiatric practices. Lately, I was browsing the APA blog Healthy Minds, Healthy Lives, and it seemed that a good deal of what I was reading seemed to have a fairly heavy PR component. So I opened the Council on Communications tab and found that their lead page is pretty much as it was six months ago. ...

In June 2011, Rif El-Mallakh, MD, et al. published an article, Tardive dysphoria: The role of long term antidepressant use in inducing chronic depression, in Medical Hypotheses. The article is a thorough and wide-ranging study review. Here are some quotes from the abstract: "Treatment-resistant and chronic depression appear to be increasing." "Depressed patients who ultimately become treatment resistant frequently have had a positive initial response to antidepressants and invariably have received these agents for prolonged time periods at high doses." [Emphasis added] ...

On March 25, Joseph Johnston, Juvenile Court Justice in Boston, Massachusetts, issued a disposition order in the case: Care and protection of Justina Pelletier. The background to the case is well-known. Justina is 15 years old. Judge Johnston did not return Justina to the care of her parents, but instead granted permanent custody to the Massachusetts Department of Children and Families (DCF), with a right to review in June. In paragraph 4, the disposition order states: ...

On March 19, a new article was posted on Aeon Magazine. It’s titled A Mad World, and was written by Joseph Pierre, MD, who works in Log Angeles as a psychiatric practitioner and professor. Dr. Pierre has authored more than fifty papers, and has received several awards. He has lectured nationally and internationally, and would, I think, be considered an eminent psychiatrist. I am grateful to several readers for the link to the article. ...

On March 27, the US House of Representatives approved by a voice vote with no debate a Medicare bill, HR 4302, Protecting Access to Medicare Act of 2014. The purpose of the bill is to avoid cutting Medicare payments to physicians, and there was, and is, general agreement on both side of the aisle that the bill needed to pass. However, tacked onto the bill was a rider which authorized $60 million to expand involuntary outpatient commitment (IOC) in states that already have provision for commitments of this sort. ...

I recently read an article by Fredric Neuman, MD, Director of the Anxiety and Phobia Center at White Plains Hospital, NY. The article is titled The Use of the Minor Tranquilizers: Xanax, Ativan, Klonopin, and Valium, and was published in June 2012 by Psychology Today. Thanks to Medicalskeptic for the link. Dr. Neuman opens by telling us that benzodiazepines are “…very commonly prescribed for any sort of discomfort.” ...

On March 5, Bruce Levine, PhD, published an interesting article on Mad in America titled Psychiatry Now Admits It’s Been Wrong in Big Ways – But Can It Change? Bruce had interviewed Robert Whitaker, and most of the article is the transcript of this interview. Bruce begins by noting that Robert, in his book Mad in America, had challenged some fundamental tenets of psychiatry, including the validity of its “diagnoses” and the efficacy (especially the long-term efficacy) of its treatments. ...