Psychiatry is bogus

Chuck Stone

CiaranMT wrote: »

Just jumping in back here to point out yet again that disease =/= disorder.

I personally don't get too hung up on the disease thing. I mean disease just means dis-ease.

My concern is the bio-medical framing of depression. Which has little or no foundation in objective scientific observation.

The Depressing News About Antidepressants
Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse.

.... people scowl and ask how anti-depressants—especially those that raise the brain's levels of serotonin—can possibly have no direct chemical effect on the brain. Surely raising serotonin levels should right the synapses' "chemical imbalance" and lift depression. Unfortunately, the serotonin-deficit theory of depression is built on a foundation of tissue paper. How that came to be is a story in itself, but the basics are that in the 1950s scientists discovered, serendipitously, that a drug called iproniazid seemed to help some people with depression. Iproniazid increases brain levels of serotonin and norepinephrine. Ergo, low levels of those neurotransmitters must cause depression. More than 50 years on, the presumed effectiveness of antidepressants that act this way remains the chief support for the chemical-imbalance theory of depression. Absent that effectiveness, the theory hasn't a leg to stand on. Direct evidence doesn't exist. Lowering people's serotonin levels does not change their mood. And a new drug, tianeptine, which is sold in France and some other countries (but not the U.S.), turns out to be as effective as Prozac-like antidepressants that keep the synapses well supplied with serotonin. The mechanism of the new drug? It lowers brain levels of serotonin. "If depression can be equally affected by drugs that increase serotonin and by drugs that decrease it," says Kirsch, "it's hard to imagine how the benefits can be due to their chemical activity."

http://www.newsweek.com/2010/01/28/the-depressing-news-about-antidepressants.html

Naikon

CiaranMT wrote: »

Just jumping in back here to point out yet again that disease =/= disorder.

So a "disorder" could have the potential to be simply invented? If I told you that you had CiaranMT "disorder", would you believe me? You can't claim an actual abnormality exists in the brain without hard clinical proof. Why has this not been addressed by both jsuited or yourself? Do criminals suffer from a brain disorder? No, they just exhibit certain patterns of thought. That in itself is not a biological problem.

CiaranMT

Naikon wrote: »

So a "disorder" could have the potential to be simply invented? If I told you that you had CiaranMT "disorder", would you believe me? You can't claim an actual abnormality exists without hard clinical proof. Why has this not been addressed by both jsuited or yourself?

It has, over and over, and over.

You acknowledged this.

We moved on.

Long, long ago.

CiaranMT

Chuck Stone wrote: »

I personally don't get too hung up on the disease thing. I mean disease just means dis-ease.

My concern is the bio-medical framing of depression. Which has little or no foundation in objective scientific observation.

Depression is a hugely complex topic, I'm sure you'll agree. Psychiatric help is by no means a panacea to all who suffer from it, clearly.

Naikon

CiaranMT wrote: »

It has, over and over, and over.

You acknowledged this.

We moved on.

Long, long ago.

I still think it's worth discussing the clinical distinction. Diseases are not open to abuse due to the burden of evidence. While I am not saying a disorder may not exist, there is a risk that a disorder could simply be designed as a social label to describe behavior. It's not really a great indication that anything has gone wrong. A criminal is not automatically "sick" because he decides to kill people. Am I correct that the term "disorder" is commonly used in Psychiatry but less so in conventional medicine, where an underlying pathology is generally observed?

CiaranMT

Naikon wrote: »

I still think it's worth discussing the clinical distinction. Diseases are not open to abuse due to the burden of evidence. While I am not saying a disorder may not exist, there is a risk that a disorder could simply be designed as a social label to describe behavior. It's not really a great indication that anything has gone wrong. A criminal is not automatically "sick" because he decides to kill people. Am I correct that the term "disorder" is commonly used in Psychiatry but less so in conventional medicine, where an underlying pathology is generally observed?

.... What? Seriously?

Chuck Stone

That's fine but what do we do when someone presents with severe symptoms?

Do we say 's'all in your head off you go'?

Naikon

For instance, take at look at this: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002504/

Now, could this "disorder" simply be an observation of normal human behavior? If a kid pisses off their peers due to a missed birthday, does that qualify the child for this bogus label? This description is pretty vague and too general, would you agree?

Who is to say ODD isn't simply a social construct designed to keep children in line? It's more a case of lack of conformity to expected social norms, rather than an actual underlying clinical problem. The only reference in that page links to...you guessed it, a well balanced, 100% objective Psychiatric source. Peer review is generally required to test theories. I can't see an objective test for this "disorder".

Naikon

Chuck Stone wrote: »

Do headaches exist? There is no biological test for a headache yet we accept pain killers work to ameliorate headaches.

There is no single 100% conclusive explanation. However, unlike ODD for example, there is at least some real peer reviewed research out there to support the underlying causes of Headache/Migraine. Cerebal Vasodilation and it's effects lie within the domain of Neurology. A nice key point follows the data:

In patients where cerebral blood flow falls below a critical value, the corresponding aura symptoms may appear. The reduced cerebral blood flow is then followed by a vasodilatation during headache, probably due to changes in the activity of the neurones innervating cranial arteries (e.g. in the dura mater, base of the skull and scalp).

Chuck Stone

Chuck Stone wrote: »

That's fine but what do we do when someone presents with severe symptoms?

Do we say 's'all in your head off you go'?

So what do with people who are clearly distressed and present themselves for medical attention?

Naikon

Chuck Stone wrote: »

So what do with people who are clearly distressed and present themselves for medical attention?

Calm them down by acknowledging their distress, give em some weed, and put away that liberal labelling gun. We should aim to help people overcome external stressors, not stigmatize every little trait. Stuff like depression is the result of complex socioecomic factors, ODD is something made up to please shareholders. Who is to say Depression isn't normal if you grew up in a hostile enviorment? Your upbringing generally shapes your person well into adulthood. It's to be expected. More rigour, less bull**** in Psychiatry.

jtsuited

jesus naikon, have you read anything referenced in this thread?

jtsuited

Naikon wrote: »

Who is to say Depression isn't normal if you grew up in a hostile enviorment? Your upbringing generally shapes your person well into adulthood. It's to be expected. More rigour, less bull**** in Psychiatry.

God almighty, go and read a book on the subject ffs.

It's a medical discipline thankfully so the chances of someone like you ever getting into it are fairly low.

Naikon

jtsuited wrote: »

jesus naikon, have you read anything referenced in this thread?

Yes, just questioning some commonly held assumptions. Feel free to point out any points and I will my best to justify my stance.

jtsuited

Chuck Stone wrote: »

I personally don't get too hung up on the disease thing. I mean disease just means dis-ease.

My concern is the bio-medical framing of depression. Which has little or no foundation in objective scientific observation.

seriously, newsweek? Good reference. Credible.

jtsuited

btw, Naikon, go into a psychiatric hospital, you'd be eating your words fairly quickly when you see what proper mental illness is.

Naikon

jtsuited wrote: »

So, if you're not a doctor, shut the fcuk up with this type of bullsh1t. If we were discussing AIDS, there wouldn't be so many ignorant people thinking they have a qualified opinion on the subject

AIDS unlike most "mental disorders" has a grounding in real scientific practice. Pick out a disorder randomly from the ICD-10 or the latest DSM revision and I will try my best to point out that it's a load of nonsense. Where are the tests for homosexuality or ODD? Jesus, even "Fetishism" references some pretty questionable sources. What the **** is with the stated 6 month period? Did they just pull that out of their arses, or is there any data to back up that classification criterion? Just because something appears to be abnormal to a group of people, does not mean someone is ill. Morals should not be confused with Science.

Naikon

This article is worth a read. http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100301crat_atlarge_menand?currentPage=all#ixzz0gkeBqHWs

Chuck Stone

jtsuited wrote: »

seriously, newsweek? Good reference. Credible.

Don't shoot the postman.

Here's the guy who did the study, putting his credibility on the line, by saying:

Depression is not a brain disease, and chemicals don't cure it.

http://www.huffingtonpost.com/irving-kirsch-phd/antidepressants-the-emper_b_442205.html

Tell me, do you still cling to the 'brain disease' hypothesis?

jtsuited

newsweek and huffington post (which has a famous bias towards quackery)as your references?

I'm out.

edit: so as not to be rude,
http://www.sciencebasedmedicine.org/?p=473

Chuck Stone

jtsuited wrote: »

newsweek and huffington post (which has a famous bias towards quackery)as your references?

I'm out.

edit: so as not to be rude,
http://www.sciencebasedmedicine.org/?p=473

Okay then straight to the article.

PloS Medicince
An peer-reviewed open-access journal published by the Public library of science.

Irving Kirsch1*, Brett J. Deacon2, Tania B. Huedo-Medina3, Alan Scoboria4, Thomas J. Moore5, Blair T. Johnson3


1 Department of Psychology, University of Hull, Hull, United Kingdom, 2 University of Wyoming, Laramie, Wyoming, United States of America, 3 Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut, United States of America, 4 Department of Psychology, University of Windsor, Windsor, Ontario, Canada, 5 Institute for Safe Medication Practices, Huntingdon Valley, Pennsylvania, United States of America
Abstract


Background

Meta-analyses of antidepressant medications have reported only modest benefits over placebo treatment, and when unpublished trial data are included, the benefit falls below accepted criteria for clinical significance. Yet, the efficacy of the antidepressants may also depend on the severity of initial depression scores. The purpose of this analysis is to establish the relation of baseline severity and antidepressant efficacy using a relevant dataset of published and unpublished clinical trials.
Methods and Findings

We obtained data on all clinical trials submitted to the US Food and Drug Administration (FDA) for the licensing of the four new-generation antidepressants for which full datasets were available. We then used meta-analytic techniques to assess linear and quadratic effects of initial severity on improvement scores for drug and placebo groups and on drug–placebo difference scores. Drug–placebo differences increased as a function of initial severity, rising from virtually no difference at moderate levels of initial depression to a relatively small difference for patients with very severe depression, reaching conventional criteria for clinical significance only for patients at the upper end of the very severely depressed category. Meta-regression analyses indicated that the relation of baseline severity and improvement was curvilinear in drug groups and showed a strong, negative linear component in placebo groups.
Conclusions

Drug–placebo differences in antidepressant efficacy increase as a function of baseline severity, but are relatively small even for severely depressed patients. The relationship between initial severity and antidepressant efficacy is attributable to decreased responsiveness to placebo among very severely depressed patients, rather than to increased responsiveness to medication.

Still Quackery?


I think you'll find that quacks are people who dismiss intellectual rigour when it doesn't suit them.

Dudess

What about people who are extremely mentally ill OP and a danger to themselves and others, but then no longer so once they're taking medication? Neither is fun but surely the second is the lesser of two evils?

jtsuited

Chuck Stone wrote: »

Okay then straight to the article.




Still Quackery?


I think you'll find that quacks are people who dismiss intellectual rigour when it doesn't suit them.

That meta-analysis says exactly what all meta-analyses say about SSRIs versus placebo versus the spectrum of severity of the disorder. And what I and others have said in this thread......of course the Huff Po interpretation of it (or more specifically the psychologist phd guy who wrote the article and WAS INVOLVED IN THE STUDY) is nonsense.

On the severe end of the spectrum (as per the meta-analysis above), SSRIs have clinically significant efficacy.

So the thing you've actually referenced as a rebuttal turns out to prove my point.....and this is why you should never ever read interpretations of real data written by psychology phds in the Huffington Post.

jtsuited

wow, read through the aids thread on this forum and almost the exact same type of debate is going on.

Chuck Stone

jtsuited wrote: »

And what I and others have said in this thread......of course the Huff Po interpretation of it (or more specifically the psychologist phd guy who wrote the article and WAS INVOLVED IN THE STUDY) is nonsense.

On the severe end of the spectrum (as per the meta-analysis above), SSRIs have clinically significant efficacy.

So the thing you've actually referenced as a rebuttal turns out to prove my point.....and this is why you should never ever read interpretations of real data written by psychology phds in the Huffington Post.

You do know that it wasn't written for the Huff post, Newsweek or the New Yorker don't you?

I guess you're going to tell me that these people:

Irving Kirsch1*, Brett J. Deacon2, Tania B. Huedo-Medina3, Alan Scoboria4, Thomas J. Moore5, Blair T. Johnson3

And the institutions they operate from

1 Department of Psychology, University of Hull, Hull, United Kingdom, 2 University of Wyoming, Laramie, Wyoming, United States of America, 3 Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut, United States of America, 4 Department of Psychology, University of Windsor, Windsor, Ontario, Canada, 5 Institute for Safe Medication Practices, Huntingdon Valley, Pennsylvania, United States of America

are engaged in some sort sort of conspiracy theory?

Either you're deliberately being obtuse, have some sort of emotional attachment to your beliefs (let's face it belief is all you have) or you just don't understand the article.

jtsuited

So yeah, that huffington post article is once again quackery as it's a psychology phd plugging his book. didn't we see this exact same thing with yer mand Breggin earlier writing some 'psychiatry is nonsense' (while plugging a similar book) in the Huff Po?

They have a serious editorial agenda against evidence based medicine, and this is just another example of it.

jtsuited

Chuck Stone wrote: »

You do know that it wasn't written for the Huff post, Newsweek or the New Yorker don't you?

I guess you're going to tell me that these people:



And the institutions they operate from



are engaged in some sort sort of conspiracy theory?

Either you're deliberately being obtuse, have some sort of emotional attachment to your beliefs (let's face it belief is all you have) or you just don't understand the article.

Departments of Psychology not having a vested interest? First things first.... read the article.....now read the conclusion of the meta-analysis. I'm not particularly disagreeing with the meta-analysis. I'm disagreeing with the ridiculous article in the Huff Po that completely distorts the actual conclusions reached.

And anyway, in their conclusion, they found the exact same thing as every other meta-analyses did on the subject (which i'm imagining they would have known if they were medical doctors) but just put a very slightly different slant on it.

My 'beliefs' are based on reading far far far far more meta-analyses on the subject than you evidently have.

Seriously....go straight to source and skip the psychology phds writing in the Huffington Post....Go to the cochrane.org library and start going through it yourself.

Naikon

Dudess wrote: »

What about people who are extremely mentally ill OP and a danger to themselves and others, but then no longer so once they're taking medication? Neither is fun but surely the second is the lesser of two evils?

Convincing people to take drugs that work no better than a placebo for the most part has the potential to cause even more harm once the person grows attached to the perception that the drug isn't doing anything. Depression is more than just a simple clinical illness as far as I am concerned. Depression is influenced by socioeconomic factors far outside the grasp the "drug em, move em along" policy most Psychiatrists appear to subscribe to today. To peddle the idea that the problem is purely "chemical" is wrong. The Chemical imbalance theory does not really have any basis in conventional scientific practice, as evidenced by the links I provided. I will try to dig up some more research related to this point.

Chuck Stone

jtsuited wrote: »

So yeah, that huffington post article is once again quackery as it's a psychology phd plugging his book. didn't we see this exact same thing with yer mand Breggin earlier writing some 'psychiatry is nonsense' (while plugging a similar book) in the Huff Po?

They have a serious editorial agenda against evidence based medicine, and this is just another example of it.

This is a classic diversion tactic which is practiced by people who feel threatened in their beliefs, don't like alternative view points and basically try to deny reality.

You move the debate away from the substance of the article and instead try to discredit the authors.

You effectively say 'I don't want to talk about the findings I want to talk about the people who made the findings'

You do yourself no favours by taking this path, honestly.

jtsuited

Chuck Stone wrote: »

Either you're deliberately being obtuse, have some sort of emotional attachment to your beliefs (let's face it belief is all you have) or you just don't understand the article.

yeah me and most of the world's medical establishment are clutching at 'belief' when it comes to mental illness...

feck thousands and thousands of trials and all that, we're up against a psychology phd writing in the Huffington Post. May as well wave the white flag now. :rolleyes: