(1) Neurostimulation: Current evidence for the management of depression. The evidence base for transcranial magnetic stimulation (rTMS) (see previous post), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS) will be described. rTMS uses a magnet to stimulate the brain, tDCS passes electrical current through two electrodes placed over the head, and in DBS a pair of electrodes is implanted in the brain and controlled by a generator placed in the chest. The idea seems to be that stimulation of the brain, however crude, will stop it causing depression. And, there's no need to cause an epileptic fit, as with ECT. Exciting stuff apparently!
(2) Disorders at the interface of neurology and psychiatry. A day course on neuropsychiatry - this must be proper medical psychiatry. Better learn about new disorders such as autoimmune encephalitis and c9orf72 gene mutation, in case they are relevant to mainstream psychiatry. Huntington's Disease features in a session and is probably only regarded historically as a psychiatric disorder, rather than neurological disorder, because some of these people ended up in asylums. I'm not quite sure why factitious disorder features so prominently in another session, as I would have thought whether symptoms are functional or feigned is a psychiatric rather than neurological problem. As I said in a previous post, "Psychiatry, unlike neurology, is not based on treating a physical lesion". Trouble is psychiatrists are attracted to neuropsychiatry because they want to believe there's no difference between neurological and psychiatric disorders. That's a specialist way of avoiding having to deal with mainstream psychiatric problems, and apparently popular and far more interesting.
(3) Immune pathogenesis of psychosis. Surely there's no evidence that schizophrenia is an immunological disorder. This sessions sets out to suggest otherwise. The MRC has even funded the PiPP study to look at the prevalence of neuronal cell surface antibodies in patients with psychotic illness. There is even a hypothesis that cytokine-mediated events are the key pathogenic event in schizophrenia. Immune based treatment studies are considered a realistic option. I suppose it's fun that such speculations are followed up, and it keeps researchers in a job. I guess they just shrug off their disillusion when they don't make progress.
Academic psychiatry seems to have been well and truly remedicalised, in the sense that it focuses on what it thinks is the expertise of psychiatrists as medical doctors. I find it sad that psychiatry has so narrowed itself to a physicalist perspective and now presents this as an exciting advance.
Critical psychiatry doesn't get any space in RCPsych congresses. In fact, submitted proposals have been turned down. It's a shame that mainstream psychiatry can't be more broadminded.
Yes Dr Double, I agree with your strapline and go further in criticism of the push to do anterior cingulotomy or ACING as a valid treatment for the drugs and ECT not working.
ReplyDeleteThe Dundee Advanced Interventions Service:
http://advancedinterventions.org.uk/
are spearheading this work, under the leadership of Prof Keith Matthews, ably assisted by his colleague Dr David Christmas, whose MD Thesis I have devoted a whole page to on my main blog:
http://chrysmuirheadwrites.blogspot.co.uk/p/blog-page.html
I am planning to work my way through Dr Christmas's 431 page thesis doing a critique from the psychiatric survivor perspective. 3 blog posts done so far and I've hardly got past the abstract and introduction.
My latest post, Wednesday past, has title: "going back to the abstract @dchristmas (the first cut is the deepest)", where I look at the research targets, the 28 people over a 14 year period who were subject to ACING or ACAPS (the capsulotomy version not now done in Dundee).
What bothered me was the two patients who had things go a bit wrong, a haemorrhage during and a seizure after the surgery. A risky business. And I'm not hearing any voices of patients in the writing, as yet. What made them ask for it? Was it all the attention that made a difference.
I know of one woman who had the ACING, wrote a book about it, how she had an amazing recovery (Life After Darkness), 2004/5 time, Cathy Wield, doctor by trade. And then in 2012/13 the suicidal depression came back, worse than ever. She said the ECT worked this time around, done in Aberdeen, plus the prayer and support from her church. Here is my blog post about it, with links:
http://chrysmuirheadwrites.blogspot.co.uk/2014/07/life-after-darkness-nmd-ninewells.html
I have great concerns about the focus on the brain and fiddling among the grey cells. Looking in the wrong place for the cause of "mental illness" as I see it. They need to look at the whole person, body, mind, spirit/soul, call it what you like. The bit about us that asks "why are we here? what is the point of it all?". The existential angst common to anyone with a thinking mind and brain.
"Academic psychiatry seems to have been well and truly remedicalised, in the sense that it focuses on what it thinks is the expertise of psychiatrists as medical doctors. I find it sad that psychiatry has so narrowed itself to a physicalist perspective and now presents this as an exciting advance."
ReplyDeleteI don't find it sad at all, more failed biological "research" from psychiatry can only serve to destroy more and more of psychiatry's credibility. Bring it on!
I want a thin majority of the public to finally see your profession for the hideous, dangerous, terrifying threat that it is, and then action will be able to be politically taken to strip your profession of its unearned power to rape and molest the brains of the innocent, powerless inmates of your "wards".
The more bizarre psychiatry-led scatter-gun "electrical stimulation" crap being pushed, the more psychiatry looks like a pathetic pack of quacks randomly meddling with the most advanced object in the known universe.
The internet's rise the last 20 years, and more people gaining scientific literacy, hasn't been good for psychiatry's credibility. For centuries, it could hide its utter quackery away from the public eye, and only the true believer psychiatric cult members would lay eyes on this crap, now we can all see it, and now the whole world can hear the first person testimonies of the lives destroyed by wanton psychiatric interference.
A few more generations of this and it is bye bye psychiatry psychiatry's credibility.
Am I worried that the pathetic "science" is going to "prove" that a brain just spontaneously makes someone believe they are Jesus? Hell no. These quacks can't even prove how their brain decided they'd choose to become a psychiatrist or choose who to marry. Clue, their brain didn't decide it at all.
The opponents of psychiatry need to nothing but sit back, catalog the failed claims, and communicate them in digestible form to the public. Psychiatry has always been a danger to itself, and one day it will finally do itself in.