A Behavioral Approach to Mental Disorders

SSRI’S AND SUICIDE Bob Fiddaman has a post up today called MHRA Consultant Calls for Antidepressant Use in Young. The article highlights some of the dangers associated with SSRI’s, and also describes some of the attempts to suppress or discount the significance of this information. Apparently in 2010, Swedish psychiatrist Göran Isacsson, MD, PhD, published a paper in Acta Psychiatrica Scandinavica. The piece was titled Antidepressant medication prevents suicide in depression, and reported that of a group of 1,077 depressed people who had committed suicide, only 15.2% had measurable amounts of antidepressants in the blood stream at the time of the suicide. ...

On November 1, Psychiatric News published 50 Years After: Will We Realize JFK’s Vision for Mental Health Care? Psychiatric News is an APA publication, and the piece was written by APA’s President, Jeffrey Lieberman, MD. Dr. Lieberman begins by reminding us that in 1963, President Kennedy signed the Community Mental Health Act (CMHA) into law. Dr. Lieberman points out that the CMHA: "…was intended to set the foundation for contemporary mental health policy, one premised on the establishment of community-based care as an alternative to institutionalization." ...

On October 23, Psychiatric News (the APA’s media outlet) ran an article titled ‘60 Minutes’ Interviews APA President on Schizophrenia. The article was written by Mark Moran, a Psychiatric News reporter. The piece opens with a quote from Jeffrey Lieberman, MD (President of the APA): "'60 Minutes' showed a genuine interest beyond simply producing what was expected to be a popular segment and indicated a desire to do follow-up reporting on psychosis and violence." ...

 I’ve recently read an article called Safeguarding a Generation of Children from Over-diagnosis and Prescription of Psychotropic Drugs. It’s written by Dave Traxson, who works as an Educational Psychologist in the UK, and is posted on the DxSummit website, an online platform for rethinking mental health, a forum in which the concepts underlying pharma-psychiatry are questioned and challenged. Here are some quotes from the article: "I view the trend towards mass medication of children with mind altering and potentially toxic drugs and ‘drug cocktails’ as a form of psycho-economic imperialism. By that I mean that young peoples’ developing minds are being colonized, using biochemicals, for huge commercial profit and in effect, increased social control. This has resulted from carefully constructed ‘business plans’ in boardrooms which some years ago saw the population of children in the western world as a great market expansion opportunity. The pharmaceutical companies have reaped the huge financial rewards of this rich and very bitter harvest ever since." ...

On October 28, Allen Frances, MD, Chairperson of the DSM-IV task force, published an article on Psychology Today. It is titled Does It Make Sense To Scrap Psychiatric Diagnosis? and is essentially a response to the British Psychological Society’s Division of Clinical Psychology’s (DCP) call to abandon the medical model in situations where it is not appropriate, and to embrace a psychosocial approach. You can see a copy of the DCP’s May 13, 2013, statement here. ...

THE CAFÉ study was published in the American Journal of Psychiatry in July 2007, and was funded by AstraZeneca. Its stated purpose was to compare AstraZeneca’s drug Seroquel (quetiapine) with other neuroleptic products. I have discussed the CAFÉ study here. Two of CAFÉ’s participants committed suicide during the study period. Both had been randomly assigned to the quetiapine treatment. There are very strong indications that one of these individuals – Dan Markingson, who was enrolled in the study at the University of Minnesota site – was coerced into the study and, because of his psychotic state, was incapable of giving informed consent anyway. He was not doing well on the Seroquel, and his mother, Mary Weiss, made repeated attempts to have him withdrawn from the study and taken off the drug, but without success. In particular, Mary had expressed the belief that Dan was in danger of killing himself. AstraZeneca paid the University of Minnesota $15,648 for each study participant who completed the treatment course. ...

One of the criticisms that I routinely make of psychiatry is that its primary agenda during initial evaluations is the assignment of a “diagnosis,” and that ongoing “treatment” consists of 15-minute “med checks,” during which drug regimens are changed and adjusted. The essence of my criticism is that this kind of approach inevitably oversimplifies human problems, and in practice does more harm than good. My contentions in this regard have from time to time been challenged. It has been said that my portrayal of psychiatry is a kind of misleading caricature, and that in reality, psychiatrists do, in fact, concern themselves with human issues over and above “diagnosis” and drugs. This debate will, of course, continue, but I recently read an article on Psychiatric Times that has some bearing on the matter. [Thanks to Nick Stuart for the link.] The title is Conduct Disorder, ADHD – or Something Else Altogether? The author is Steven Dilsaver, MD, and the piece is dated October 11, 2013. The article is a case study of the psychiatric “treatment” of an eight-year-old boy (John). ...

There’s a new article on Psychiatric News titled Change, Challenge, and Opportunity: Psychiatry Through the Looking Glass of Research. It’s dated October 17, and was authored by Steven Hyman, MD, and Jeffrey Lieberman, MD. Thanks to Mental Health Law on Twitter for the link. Dr. Lieberman is President of the APA. Dr. Hyman was Director of NIMH from 1996 to 2001, and is now the Director of the Stanley Center for Psychiatric Research at the Broad Institute. The Broad Institute is affiliated with Harvard University, and Dr. Hyman is a Harvard Distinguished Service Professor. ...

A few days ago I came across some text on Dr. Novella’s website that appeared to be his response to my recent critique. I drafted a response to this and posted it at 5:40 this morning. Dr. Novella has commented on this and has informed me that the material in question was not written by him. Apparently it was written by one of his commenters, who is also named Steve. ...

There’s an interesting article by Christopher Lane, PhD, in his blog site Side Effects, on Psychology Today. It’s called Crazy like Us: How the U.S. Exports Its Models of Illness, and is dated October 9. Christopher Lane is the author of Shyness: How Normal Behavior Became a Sickness. I wrote a post in April of 2010 that referenced this book. Here’s the opening paragraph from the Psychology Today article. "The fears of many European psychiatrists may soon be realized. Earlier this week, Psychiatric News reported that the American Psychiatric Association has begun petitioning the various agencies overseeing changes to the ICD, or International Classification of Diseases, to request that they adopt its most-controversial changes in DSM-5." ...