Psychiatric "Spin"

On February 27, 2015, European Psychiatry published a paper titled EPA guidance on how to improve the image of psychiatry and of the psychiatrist. The paper was authored by D. Bhugra et al. EPA is the European Psychiatric Association. Dr. Bhugra is a psychiatrist who works at the Institute of Psychiatry, Psychology, and Neuroscience, King’s College, London, and is also President of the World Psychiatric Association. There are thirteen co-authors, most of whom are also psychiatrists. ...

On October 12, 2014, the eminent psychiatrist Allen Frances, MD, participated in a panel discussion at the Mad In America film festival in Gothenburg, Sweden. After the festival, he wrote an article – Finding a Middle Ground Between Psychiatry and Anti-Psychiatry – for the Huffington Post Blog, summarizing the positions he had discussed at the festival. The article was re-published on MIA on October 26, 2014. The article is ostensibly an attempt to find common ground between psychiatry and its critics, but the piece contains numerous distortions and omissions which I think need to be identified and discussed. ...

On April 5, 2015, Scott Alexander, MD, a trainee psychiatrist, posted an article titled Chemical Imbalance on his website Slate Star Codex. (The writer tells us that Scott Alexander is a blog handle and not his real name, but for convenience, I will refer to him as Dr. Alexander.) Dr. Alexander begins by noting that there have been a number of articles recently that have criticized psychiatry for “botching the ‘chemical imbalance’ theory.” ...

On March 16, Ronald Pies, MD, published an article in the Psychiatric Times. The article is titled The War on Psychiatric Diagnosis, and the sub-title synopsis on the pdf version reads: “A recent report that argues against descriptive diagnosis in medicine is historically ill-informed and medically naive, in the opinion of this psychiatrist.” Dr. Pies is a very prestigious and eminent psychiatrist. He is a professor of psychiatry at both Syracuse and Tufts. He was the first editor of Psychiatric Times, which, by its own account, provides “News, Special Reports, and clinical content related to psychiatry” for “…psychiatrists and allied mental health professionals who treat mental disorders…Circulation of the monthly print publication is approximately 40,000.” ...

Thomas Insel, MD, is the Director of the National Institute of Mental Health. In June of last year, he published, on the Director’s Blog, an article titled Are Children Overmedicated? The gist of the article is that children are not being overmedicated, but rather that there is an increase in “severe psychiatric problems” in this population. Here are some quotes, interspersed with my comments. "The latest estimate from the National Center for Health Statistics reports that 7.5 percent of U.S. children between ages 6 and 17 were taking medication for 'emotional or behavioral difficulties' in 2011-2012. The CDC reports a five-fold increase in the number of children under 18 on psychostimulants from 1988-1994 to 2007–2010, with the most recent rate of 4.2 percent. The same report estimates that 1.3 percent of children are on antidepressants. The rate of antipsychotic prescriptions for children has increased six-fold over this same period, according to a study of office visits within the National Ambulatory Medical Care Survey. In children under age 5, psychotropic prescription rates peaked at 1.45 percent in 2002-2005 and declined to 1.00 percent from 2006-2009." ...

On January 18, Thomas Insel, MD, published an article on The World Economic Forum Blog. The article is titled 4 things leaders need to know about mental health. Dr. Insel is the Director of the National Institute of Mental Health. The World Economic Forum “is an International Institution committed to improving the state of the world through public-private cooperation.” Dr. Insel’s paper makes a number of assertions, some of which are misleading. Here are some quotes, interspersed with my comments. ...

The current issue of Acta Psychiatrica Scandinavica is devoted to the topic of psychiatry’s poor image, and what steps might be taken to improve it. Central to the discussion is a study Images of psychiatry and psychiatrists, by H. Stuart et al, - and seven commentaries on this study by various authors. The Stuart et al paper describes a survey of 1057 teaching medical faculty members from 15 sites in Europe and Asia. The overall response rate was 65%, and the results indicate clearly that general medical teaching staff have a poor opinion of psychiatry and psychiatrists. For instance, 90% of respondents endorsed the item “Most psychiatrists are not good role models for medical students.” ...

On October 15, psychiatrist Allan Tasman, MD, published an article in Psychiatric Times. The title of the article is The Most Exciting Time in the History of Psychiatry. Psychiatric Times describes itself: “Our Focus: News, special Reports, and clinical content related to psychiatry. Our Audience: Psychiatrists and allied mental health professionals who treat mental disorders.” According to Wikipedia: “Psychiatric Times is a medical trade publication written for an audience involved in the profession of psychiatry.” It is published by UBM Medica and is distributed to about 50,000 psychiatrists monthly. ...

On October 23, Simon Wessely, MD, a British psychiatrist, published an article, The real crisis in psychiatry is that there isn’t enough of it, at the online site The Conversation. Dr. Wessely is the Professor of Psychological Medicine at King’s College, London, and is also the President of the Royal College of Psychiatrists. The Conversation is an independent non-profit online media outlet that delivers “…news and views from the academic and research community…” directly to the public. Their aim is “…to promote better understanding of current affairs and complex issues.” ...

On September 9, 2014, the BMJ published an article by Sophie Billioti de Gage et al. The article was titled Benzodiazepine use and risk of Alzheimer’s disease: case-control study, and concluded: “Benzodiazepine use is associated with an increased risk of Alzheimer’s disease. The stronger association observed for long term exposures reinforces the suspicion of a possible direct association, even if benzodiazepine use might also be an early marker of a condition associated with an increased risk of dementia. Unwarranted long term use of these drugs should be considered as a public health concern.” [Emphasis added] ...