Sunday, March 27, 2011
Challenging myths about psychiatry
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Nada Stotland was the 2008-9 President of the American Psychiatric Association. She writes on Huffpost Health challenging "myths about psychiatry". The trouble is she has promoted just such a myth. She writes, "Using brain scans ... we now can distinguish between the brain of a person with depression and a person who is not depressed". Evidence please. And perhaps she could explain what the "many, many other such observations" are.
Moving from an outdated physical disease model of mental illness to a more relational mental health practice
5 comments:
Well, even if brain scans do show differences between "depressed" and not "depressed" people's brains, i.e. even if brain scans can tell us something about what kind of mood a person experiences, who says experiencing sadness equals to an illness called "depression"? This brain scan bs hasn't brought psychiatry as much as one step closer to being able to prove any of its labels more valid in terms of biomarkers. To believe anything else, as Nada Stotland and the vast majority of her colleagues seem to think, isn't scientific, but the result of wishful thinking. Unfortunately, a lot of people happily rise to the bait, and do not challenge the brain scan myth.
As a psychiatrist, I believe that psychiatric conditions are real. However, as scientists we should adopt a skeptical approach towards all data. Many of our diagnoses do not have inter-rater reliability. Very few our treatments have long-term efficacy studies. Joanna Moncreiff makes a great argument that there is more evidence that psychotropic medications create, rather than correct, abnormal states. While the rest of medicine may face similar challenges, having skepticism does not make us prejudiced.
In Evidenced-Based Dermatology, Hywel C. Williams is honest enough to state "In the field of dermatology, valid and repeatable disease definitions are rarely to be found in prevalence surveys." We should hope for as much honesty from our APA president.
Hey Stotland: I bet you can find differences between the erectile strength of men who are depressed and those who are not depressed. Should we then conclude that a limp penis causes depression?
Jeff Johns there may well be other medical professions who do not have much evidence for all that they do, but they do not have their own laws to forcibly medicate, electrucute and even labotmoise the brains or bodies of their patients.
If psychaitrists want to be treated and respected the same as other doctors, then they need to be willing to practice the same as every other doctor. That means you must actually get FULLY INFORMED CONSENT BEFORE you actually put any substances into their bodies, that you do not have police officers or security guards holding them down while they are treated and that you do not claim that seclusion is an evidenced based treatment, but is in fact a form of cruel and inhumane treatment.
Perhaps it is time that psychiatrists are forced to undergo at least a month of each such treatment that they insist on putting on vulnerable people, before they are allowed to do it.
As for these been evidenced based conditions can someone please tell me what psychosis actually is, because the last I heard it was anything that cannot be proven. Doesn't that mean that every body who believes in god is psychotic, you can hardly prove that god is real, does it not mean that believing in santa is psychosis, etc??
That sounds like a good basis for the mother of all lawsuits--someone who was irreparably damaged by psychotropic drugs who sues on the basis of not having been informed of the risks?
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