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Archive for June, 2015

in a rut…

( OPINION )

Gregor Mendel was an Augustinian Monk in Moravia whose studies of plant inheritance brought such things into the realm of science. My sister’s blue eyes meant that both of our brown-eyed parents carried recessive blue-eye genes. The postman was out of the picture. Mendel’s schemes of inheritance were like that – very precise statistical predictions […]

some other things…

( OPINION )

At the beginning of the week, I worked in the clinic. One of the patients I saw was a woman in her early thirties with increasing depression over the last year. She’d been seen several weeks earlier by a Nurse Practitioner and started on Citalopram which had helped "some." Her story: In spite of being […]

incremental marker…

( OPINION )

I suppose most Southerners have something to say about  the goings on after the Charleston shooting and all the media attention about the battle flag. As a boy growing up in Chattanooga Tennessee literally in an area peppered with cannons and Civil War Monuments, I had no idea that the Civil War was even about […]

down pat…

( OPINION )

This Age of Meta-Analyses in matters of the psyche is poking holes in some broadly held paradigms, nowhere more apparent than those relating to the notion of the monolithic Major Depressive Disorder. The efficacy and safety of the SSRIs are being widely re-considered. The DSM-5 Field Trials made an assault on the bedrock reliability that […]

added for completeness…

( OPINION )

In the course of things, I ran across this report which seems relevant to the recent discussion of the Collaborative Care model [and likely has as much to do with its construction as any other factor mentioned]:

comment on a comment…

( OPINION )

This comment on the last post [a requiem in the key of infrequent interaction…] might clarify some of my visceral aversion to the discussions of Collaborative and/or Integrative Care. I don’t think the APA leadership support of this is financially motivated. I think it is ideologically motivated. Which in this case is worse, because if […]

a requiem in the key of infrequent interaction…

( OPINION )

The goals of Integrated Care: Working at the Interface of Primary Care and Behavioral Health are to educate psychiatrists about the fundamental shift underway in health care and to prepare them to be successful and effective in the new health care arena. The passage and implementation of the Patient Protection and Affordable Care Act presents […]

the Age of the Decepticons…

( OPINION )

The Treatment for Adolescents with Depression Study [TADS] was an NIMH funded clinical trial including 439 adolescents that ran from September 1998 though March 2004. The study compared Placebo [PBO], Prozac [FLX], Cognitive Behavior Therapy [CBT], and Prozac+Cognitive Behavior Therapy [COMBO] for 12 weeks in a blinded RCT. But that’s not all folks.  They then […]

the business of doing business….

( OPINION )

In looking at the history of psychiatry, 1980 marks a radical change with the introduction of the DSM-III. But that was hardly the only thing happening in 1980, not by a long shot. Probably the most remarkable event was the election of Ronald Reagan which marked a dramatic change in our way of doing capitalism […]

darwin 101…

( OPINION )

Five years ago, I was trying to explore the factors behind our medical schools tolerating all of the Academic Psychiatrists that were so allied with the pharmaceutical industries. I could find no way to quantitate how much money was flowing into the Universities from industry. But I could find out about NIMH money,  so I […]