A Behavioral Approach to Mental Disorders

There’s an interesting article Inquiry into the Schizophrenia Label (ISL) on Robert Whitaker’s website Mad in America. Apparently Philip Thomas, M.D. and other researchers have been asking mental health clients how they perceived the schizophrenia label. They received nearly 500 responses, and found that more than 80% of responders described the label as damaging and dangerous. They question the validity and usefulness of the “diagnosis” and tentatively suggest that it may need to be discarded. ...

Until now, I’ve pretty much steered clear of DSM-5. My reason for this is that the upcoming revision represents, to my mind, a distraction from the central issue, i.e., that the whole notion of mental illness is spurious, destructive nonsense. My position is that the purpose of DSM is to expand psychiatric turf and to legitimize the pushing of mood/behavior-altering pharmaceuticals. In the US (and I believe in most developed countries) you can’t prescribe a drug without a diagnosis. And the APA has never neglected its primary mission in this area. ...

I’ve just read Reviving the Myth of Mental Illness by Steven Morgan. This article appeared in the Personal Stories section of Robert Whitaker’s website Mad in America, and is well worth reading. Here are some quotes: "Thus, it is important to note that mental illness in itself – the idea that a mind is ill, is actually a categorical error, like saying the sky is ill or the color green is healthy. " ...

A recent commenter, Dan, suggested I check out some of Jeffrey Lacasse’s articles on ghostwriting. I’ve read two of Jeffrey’s articles: Ghostwriting and Academic Medicine and Knowledge of ghostwriting and financial conflicts-of-interest reduces the perceived credibility of biomedical research (both co-authored with Jonathan Leo), and found them excellent. Ghostwriting in this context, for readers not familiar with the term, works like this. A pharmaceutical company does a piece of research which establishes that their product is effective and safe. (There are various ways to ensure this result, and the pharmaceutical companies know them all.) Then they get one of their own technical writers to write the research up, but this writer’s name does not go on the report. Instead, the pharmaceutical company gets an eminent medical academic who has a financial link to the company to put his name on the piece, as if he were indeed the researcher and the author. ...

Earlier this year the World Health Assembly, the decision-making body of the World Health Organization, an agency of the UN, passed a resolution “to develop a comprehensive action plan covering services, policies, plans, strategies, programs and legislation to enable persons with mental disorders to live a full and productive life in the community.” The resolution recommends several strategies to promote mental health, including the integration of “…mental health into broader health policies and strategies…” and the promotion of “…mental health by targeting early childhood years, aging, prevention of domestic violence and abuse, workplace stress and suicide prevention programs.” ...

There was an interesting article recently in the International Journal of Law and Psychiatry, “Exposing conflict in psychiatry: Does transparency matter?” by Chimonas, et al. The gist of the article is as follows. Senator Chuck Grassley of Iowa has devoted a great deal of time and effort to exposing conflicts of interest in psychiatry. He has focused particularly on undisclosed financial relationships between psychiatric researchers and pharmaceutical companies. His efforts resulted in the passage of the Physician Payments Sunshine Act, which requires manufacturers to disclose payments over $100 annually to physicians and teaching hospitals. The act requiring this will become active in 2014. The hope is that exposure will reduce the incidence of problems. It was this particular hypothesis that the researchers wanted to test. ...

Duncan Double is a British psychiatrist who has a website called Critical Psychiatry. On October 12 he published a post under the heading: “The majority of psychiatrists think adult ADHD is an example of the over-medicalisation of everyday life.” Here are some quotes: “When I trained, adult ADHD was never mentioned - it's a relatively new concept, gaining popularity in the 1990s. Many psychiatrists don't feel happy diagnosing a condition in adults that they were taught children generally grow out of.” ...

Christopher Lane recently wrote an article called Anti-DSM Sentiment Rises in France. Here are some quotes: “Anger and concern about the growing influence of the DSM in France, as well as over a number of related, prominent pharmaceutical scandals here, has culminated in the creation of Stop DSM, a professional and political group that is strongly opposed to the manual’s diagnostic power and what it sees as its negative social consequences.” ...

At present the pharmaceutical companies are responsible for testing the effectiveness and safety of their own products. In recent years there have been numerous reports of dishonest practices in this area, including suppression of unfavorable results and massaging of data to create the impression that a drug is more effective than is actually the case. Recently, Christopher Lane publicized a particularly egregious example of this from England. The drug at the center of this scandal is reboxetine. It is not available in the US, but is widely prescribed in the UK and in sixty other countries for depression, panic disorder, and ADHD. ...

On August 22, thanks to the generosity of an anonymous deceased donor and his bereaved family, I received a kidney transplant. The surgery was successful, and the kidney is working very well. I have to take immunosuppressants, of course, and I am having some difficulty adjusting to these. I am still very tired, and but generally my condition is improving. I hope to be “back on the air” soon. Best wishes ...