\nThe Neurobiology of Child Abuse and Neglect <\/strong><\/a><\/div>\n<\/p>\n
Since the days of Sigmund Freud, clinicians have observed that early-life trauma may lead to adult psychopathology. At the 161st Annual Meeting of the American Psychiatric Association, Charles Nemeroff, MD, PhD, presented recent research that suggests a neurobiologic underpinning for this association.<\/sup><\/div>\n… <\/div>\nDr. Nemeroff concluded, “We need to educate parents on how to take care of children and reduce the rate of child abuse. The adolescent brain isn’t fully mature and is uniquely vulnerable to insult from alcohol, drugs of abuse, and abuse and neglect. An improved environment can have tremendous beneficial effects, including increased sprouting and synaptogenesis. Psychosocial interventions early can buffer the consequences of inheriting unfavorable genetic polymorphisms.”<\/sup><\/div>\n<\/blockquote>\nIt’s easy to be intimidated by science with its statistics and peculiar jargon, but I pulled just the first and last paragraphs [introduction and conclusion] from one of Dr. Nemeroff’s presentations [at the American Psychiatric Association right before he got in trouble at Emory]. Independent of what he talked about in-between these paragraphs, his conclusion is trivial. I would have been glad to tell you that child abuse is bad for children and predisposes them to mental health problems without spending the National Institute of Mental Health<\/strong>‘s money. Sigmund Freud would have told us that 100 years ago [and did]. Read the paper if you like. It’s not that dense – a questionaire or two, a rat study, some hormone measurements in a few patients. Some blood tests in some others. Certainly there’s nothing that supports those last two sentences other than common sense [I’m withholding judgement on "increased sprouting and synaptogenesis"]. <\/div>\n<\/p>\n
This<\/a><\/strong> is how Dr. Nemeroff describes his plans at the University of Miami:<\/div>\n\nOver the course of his career Dr. Nemeroff has compiled a remarkable record of scientific contributions to the field of psychiatry. For the past two decades he has focused his research on the relationship between child abuse and neglect as a risk factor for the development of depression and anxiety disorders in adulthood. In particular, he has examined through brain imaging and neurochemical testing what happens to children’s brains when they are exposed to traumatic life events that leave them vulnerable in adulthood. “It turns out that individuals with depression and a history of child abuse or neglect physically have a different brain than patients with depression without child abuse,” explains Dr. Nemeroff. “In patients with chronic depression, two years or longer, two-thirds of those patients had a history of child abuse [sexual or physical], loss of a parent or severe neglect.”<\/sup><\/div>\nDr. Nemeroff plans to use brain imaging, along with genetic markers, to tackle one of the big issues in psychiatry today — the failure of patients to respond to treatment. Dr. Nemeroff explains that it is critical because “antidepressants take three to five weeks to work, and during that time a patient’s family is affected, their work suffers, and the risk for suicide increases. It is very important to match a patient with a treatment that will work, and hopefully one day soon we will be able to predict who will respond to what treatment.”<\/sup><\/p>\n
Another key area of research for Dr. Nemeroff is what he calls the “curious” relationship between depression and heart disease. “I am very excited about moving this area forward at UM because of the very strong cardiology program already in place at the medical school,” says Dr. Nemeroff. “Surprisingly, depression is as great a risk factor for developing heart disease as is smoking, and even one episode of depression can increase that risk.”<\/sup><\/p>\n
Many patients with cancer have concurrent depression, and treatment of their depression improves their quality of life and adherence to their cancer treatment. “There is some evidence that treatment of depression might even increase survival time,” adds Dr. Nemeroff. “I am particularly interested in studying whether depression, with all of its biological effects, is a risk factor for the development of certain forms of cancer.”<\/sup><\/div>\n<\/blockquote>\nI recognize that I’m piling on here, but I think it’s important to point out that the problems in academic psychiatry Dr. Nemeroff represents are not just selling out to drug companies, there’s a lot of junk science in there too. Paragraph 1<\/u><\/strong>: Children with bad childhoods have unhappier lives than the rest of us. Duly noted [and obvious]. Paragraph 2<\/u><\/strong>: Brain Imaging, an expensive and unrefined procedure, to pick out people who might respond to yet undiscovered treatments? So people won’t have to wait for drugs to work [as if there’s another choice]? This is just not "one of the big issues in psychiatry today" [or tomorrow]. Paragraph 3<\/u><\/strong>: Suppose depression turns out to have some association with heart disease. I suppose the recommendation would be to treat the depression [which we would do anyway]. Paragraph 4<\/u><\/strong>: People with cancer get depressed, so maybe depression predisposes one to cancer? I kind of doubt it. But if it does, so what? Tell people not to get depressed?<\/div>\nIt’s easy to do what I just did, poke fun at scientific studies. I’m doing it here because I’ve spent a couple of days reading some of the papers in Dr. Nemeroff’s very long Curriculum Vitae. I think I felt guilty about saying I hadn’t learned anything from his time at Emory [much ado…<\/a><\/strong>]. Maybe I was being unfair because I hadn’t read many of his papers. So I gave it a shot [skipping the obviously compromised papers about psychotropic drugs]. It was all like the stuff above – nothing particularly explanatory, nothing much creative, certainly nothing justifying comments like "fundamental contributions to the understanding and treatment of depression and other mood and anxiety disorders over many years<\/font><\/strong><\/a>" or "accomplished an extraordinary amount of work in a very important area of psychology<\/font><\/strong><\/a>".<\/p>\n
When I think about the current flurry of worry that Dr. Nemeroff did an end-around to escape Emory’s ban on his applying for NIMH funding by moving to Miami, helped by the Chief of the NIMH himself, it’s a worry because it restores his access to government money and the opportunity to continue his PHARMA connections. I should actually feel relieved, because none of what he suggests doing seems worthy of very much notice by the NIMH. But I know that’s not true. Nemeroff is an insider, and very likely to get funding. That’s just how things work, or have worked in recent years. It sure worked for him at Emory<\/font>.<\/strong> <\/p>\n
Therein lies the problem. Dr. Nemeroff was more than a person who reaped personal reward for himself by hawking the products of his sponsors. He was more than a guy who funded his department from these questionable PHARMA connections. He was an expert at getting NIMH grants for projects that were neither particularly creative nor particularly relevant to the biology that underpins Psychiatry. Like his relationship with Industry, his dealings with research funding sources has been largely political, rather than scientific. It’s called grantsmanship. Scientists and administrators need to have that skill, but there’s supposed to be something of scientific substance to go with it – and, oh yeah, integrity. The latter two are badly lacking here [and lots of other places].<\/p>\n
Pharmacologic research by industry is important. Government support of medical research is essential. Medical training of Psychiatrists is crucial. But without thoughtful oversight, they can all be quickly compromised and corrupted as they have been in this instance. Let’s hope that this debacle makes enough noise to bring about some badly needed reform…<\/div>\n","protected":false},"excerpt":{"rendered":"The Neurobiology of Child Abuse and Neglect Since the days of Sigmund Freud, clinicians have observed that early-life trauma may lead to adult psychopathology. At the 161st Annual Meeting of the American Psychiatric Association, Charles Nemeroff, MD, PhD, presented recent research that suggests a neurobiologic underpinning for this association. … Dr. Nemeroff concluded, “We need […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[2],"tags":[],"class_list":["post-4190","post","type-post","status-publish","format-standard","hentry","category-politics"],"_links":{"self":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/4190","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/comments?post=4190"}],"version-history":[{"count":0,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/posts\/4190\/revisions"}],"wp:attachment":[{"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/media?parent=4190"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/categories?post=4190"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/1boringoldman.com\/index.php\/wp-json\/wp\/v2\/tags?post=4190"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}