Archive for August, 2011

Stahl’s first question…

In my last post, a minimalistic formulary of generic medications rolled off my tongue. A friend read it and asked, "Do you keep score?" No, I don’t keep score, but I do keep up. In the adult clinic, we see only indigent and uninsured people. We have a pharmacy with donated drugs, a few purchased, […]

panhandled blockbusters…

In the last post, the rant of Dr. Stephen Stahl is obviously the product of someone injured by what he sees happening around him to the world that he’s known throughout his career. He creates a "Straw Man" argument in which the heterogeneous collection of critics of the pharmaceutical industry are portrayed as if they […]

myopia – uncorrected…

Some rants deserve to be read in full. This one will linger long as an example of the genre: Are future psychiatric treatments doomed? Be careful what you ask for…you just might get it. NEI Blog Neuroscience Education Institute by Stephen Stahl August 23, 2011 Nobody likes drug companies these days. Worse than tobacco companies […]

3. when n=a few needs n=a few more

I think we should give credit where credit is due. Drs. McGorry, Yung, and their colleagues have focused our attention on practical ways of identifying patients at risk for developing manifest Schizophrenic Illness. Even though the predictive power of their criteria is lower than we’d all like at its best [and sometimes downright disappointing as […]

2. when n=a few

This post takes a look at what others have found using the idea of an "ultra high risk" group of people that may develop ouvert Schizophrenia. The first study is from The University of Manchester, UK. They looked at the effect of Cognitive Therapy in the high risk group [four articles]: Randomised controlled trial of […]

1. when n=a few

I apologize for the length of this post in advance. The question on the table is an expansive and expensive program in Australia to intervene in people at "ultra high risk" for developing Schizophrenia. I think it’s important to look at the science itself rather than base opinions of secondary sources. First, here’s Dr. McGorry’s […]

3. when n=many

McGorry aborts teen drug trial Sydney Morning Herald by Jill Stark August 21, 2011 THE FORMER Australian of the year Patrick McGorry has aborted a controversial trial of anti-psychotic drugs on children as young as 15 who are ”at risk” of psychosis, amid complaints the study was unethical. The Sun-Herald can reveal 13 international health […]

2. when n=many

Dr. Patrick McGorry had convinced the Australian government to fund a $400 M Program – Early Psychosis Prevention and Intervention Centres [EPPIC] which provoked a brisk reaction – a lot of it negative. One of his critics was Dr. Allen Frances, former Chairman of Psychiatry at Duke, and Chair of the DSM-IV committee who has […]

1. when n=many

In the case mentioned in the last few posts, our discussions of her earlier life suggested to me that the process that later became manifest Schizophrenia had always been present. But had we seen her as a child, we wouldn’t have thought that. She didn’t even really fit the schizoid personality type described by Eugen […]

3. from n equals one

In the case I was talking about, there wasn’t any question about diagnosis. She met the criteria of the day as they changed when the manual was revised. When she was psychotic, she had it all – voices, disjointed thought, paranoia, odd affect, magical thinking, automatisms, thought broadcasting, etc. In between, she had some version […]