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Archive for December, 2013

from within…

It would be a gross understatement to say that I see psychiatry in need of reform. So I would’ve thought that on the last day of this particular year, the DSM-5 year, I would look back and feel like Job – sackcloth and ashes. The DSM-5 is many things, but a failed opportunity for reform […]

insider trading…

This is the lead-in to the Introduction [but it’s not the story] Back in February 2012 [a book review…], I read an article by statistician Robert Gibbons et al that purported to be a meta-analysis showing that antidepressants are effective in adolescent depression and are not associated with suicidality as a side effect. It turned […]

anachronistic inertia…

Earlier this year, I had what I called the you-really-are-an-old-man-now tests. Included were a stress test and an echocardiogram – all suprisingly normal. But in both instances, the technicians learning that I was a doctor and wanted to look proudly showed off their equipment and my results. My 1960s vintage Internist self was amazed. In […]

somewhere else…

The article about the homeless mentally ill in Raleigh NC [“just a mental health patient living on the street”…] is in part related to the closing of the Dorthea Dix hospital last year. This is a bit of history about Dorthea – the irony and parallels to today won’t be lost on anyone: Dorthea Dix […]

“just a mental health patient living on the street”…

E.R. Costs for Mentally Ill Soar, and Hospitals Seek Better Way New York Times By JULIE CRESWELL December 25, 2013 As darkness fell on a Friday evening over downtown Raleigh, N.C., Michael Lyons, a paramedic supervisor for Wake County Emergency Medical Services, slowly approached the tall, lanky man who was swaying back and forth in […]

non·random missing·ness…

In the last post [almost inevitable…] proposing that the CAFE study was cloned from the CATIE study without considering the different populations being studied, I mentioned the many similarities between them. Well here’s another similarity: In spite of their age, neither study had results posted on clinicaltrials.gov… Despite Law, Fewer Than One In Eight Completed […]

almost inevitable…

Will the U review or whitewash a research subject’s death? Star Tribune by MATT LAMKIN December 18, 2013 As scholars of medical ethics and proud alumni of the University of Minnesota, we have been pained by the cloud that has hung over our alma mater in the decade since Dan Markingson killed himself while enrolled […]

$9,199,613.00 [and counting]…

Moving from left to right, first there was TMAP [1998], the PHARMA scheme originating in Texas that had seventeen States paying top dollar for psychotropic drugs instead of using the equivalent generics – finally busted by Allen Jones blowing the whistle. It was followed by STAR*D [2001], the $35 M sequencing study of antidepressants that […]

inertia…

I’ve underlined everything new in this article as a reading aid: A New Focus on Depression New York Times By RICHARD A. FRIEDMAN, M.D. December 23, 2013 When will we ever get depression under control? Of all the major illnesses, mental or physical, depression has been one of the toughest to subdue. Despite the ubiquity […]

pharmastats

hat tip to Uri …