Sir Winston Churchill called his depression ‘the black dog’ – a term that apparently reaches back into antiquity and resonates with the experience of the afflicted. It’s a noun, an entity, something that’s always there, sometimes biting, but at other times just lurking on the side as in Albrect Dürer’s woodcut Melancholia. And when you […]
I ordered a DSM III online a month or so ago [I couldn’t locate an online version]. Since I got it, I’ve periodically looked through it and my reaction is always the same. I start moving back and forth through the pages, thumbing for an anchor to what I’m reading, confused [actually a bit anxious]. […]
I wrote that last piece in the spirit of full disclosure. This business of the changes that occurred in psychiatry thirty years ago remains almost as contentious today as when it happened, and it’s impossible to read anything about what people write about it without wondering about the authors’ orientation and history. I thought it […]
So looking at the DSM and DSM II, one might say that Involutional Melancholia, Manic-Depressive Illness, and Depressive Neurosis were discrete categories. The confusion was in single episodes of severe depressions prior to the Involutional period: Precipitated depressions that were severe and/or associated with psychosis Severe depression that had no precipitant without psychosis Psychotic depressions […]
FOREWORD Ernest M. Gruenberg, M.D., Dr. P.H. Chairman, Committee on Nomenclature and Statistics American Psychiatric Association This second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) reflects the growth of the concept that the people of all nations live in one world. With the increasing success of the World Health Organization in […]
Psychiatry as a distinct medical specialty in the United States came into being at the turn of the last century, heavily influenced by the thinking of a number of Europeans: Emil Kraepelin Prior to Kraepelin, the psychotic disorders were classified by symptoms, and there were too many syndromes to be useful. Kraepelin began to look […]
There is no question that Study 329 and the reporting paper [Efficacy of Paroxetine in the Treatment of Adolescent Major Depression: A Randomized, Controlled Trial] is a paradigm for selective reporting, pharmaceutical industry’s interference in medical science, and a direct disavowal of the Hippocratic Oath. In addition, it reaches an indefensible conclusion – "Paroxetine is […]
colorized for clarity The real story started back in the days of the SSRIs. A lot of it happened in those days before there was this thing [the Internet], so it’s harder to look back. But there is one study that stood out from them all – Study 329, Paxil in adolescents [vs Imiprimine]. It […]
Do we believe that this category, Major Depressive Disorder, is a unity or a collage [those tables are pieced from the National Comorbidity Survey]? I’m obviously in the collage camp – in fact, I can’t imagine otherwise. I guess I’m still arguing with the DSM III [which is now 31 years old]. And when I […]