Conclusions and recommendations On clinical trials We were surprised and concerned to discover that information is routinely withheld from doctors and researchers about the methods and results of clinical trials on treatments currently prescribed in the United Kingdom. This problem has been noted for many years in the professional academic literature, with many promises given, […]
“Eventually, all things merge into one, and a river runs through it. The river was cut by the world’s great flood and runs over rocks from the basement of time. On some of the rocks are timeless raindrops. Under the rocks are the words, and some of the words are theirs. I am haunted by […]
No retrospective of the DSM-5 process would be complete without a commentary from the summer of 2009, when things moved into the public arena. And there’s no better ringside commentator than Danny Carlat who was blogging the whole thing blow by blow. Senator Grassley’s Investigation was still in the news, and a few weeks before, […]
In DSM-5 retrospective I… I reviewed some of the story of the DSM-5 beginning with Kupfer et al’s 2002 book, A Research Agenda for the DSM-V [I continue to think that one can’t understand the DSM-5 without reading, or at least scanning that book – it’s a free pdf]. I thought it was a trick […]
Something very unusual happened in the process of the revision of the psychiatric diagnostic manual – the DSM-5 revision published last May. The leaders of the previous revisions, Robert Spitzer [DSM-III, DSM-IIIR] and Allen Frances [DSM-IV], both became outspoken critics of the enterprise and went public with their dissatisfaction. Dr. Spitzer was refused access the […]
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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 […]
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 […]
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 […]
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 […]