{"id":4557,"date":"2010-12-16T11:33:50","date_gmt":"2010-12-16T16:33:50","guid":{"rendered":"http:\/\/1boringoldman.com\/?p=4557"},"modified":"2010-12-16T14:21:03","modified_gmt":"2010-12-16T19:21:03","slug":"proof-3","status":"publish","type":"post","link":"https:\/\/1boringoldman.com\/index.php\/2010\/12\/16\/proof-3\/","title":{"rendered":"proof…"},"content":{"rendered":"\n
I usually don’t cogitate much, I just write and move on. But this time I did cogitate, even sent off a trial balloon along the way. I’ve got a conflict of interest in the mix. It’s not the usual kind – democrat writing about republicans or liberal-ish guy writing about conservatives. This one effected my life, so my opinion can’t be anything but colored. That’s actually the whole problem with conflicts of interest. If you’ve got a horse in the race, you start with a conclusion and work your way back through the logic rather than the other way around.<\/div>\n

I hold a resentment for the invasion of Psychiatry by the Psychopharmacologists. I believe they belong, but when they came in the 1980’s, it was to the exclusion of everyone else. That’s not even true, it was more like "get on the bus or hit the road." Over the years, I’d largely accepted their need to dominate the field for a time as a reality. I assumed it was a paradigm having a heyday that would find its place in time. But I’ve been increasingly aware that some of it was an invasion financed by the pharmaceutical industry who were essentially trying to "buy" Psychiatry – and that parts of it have been an inside job. That’s infuriating to me. <\/font> <\/p>\n

My topic has to do with something specific. Drs. Nemeroff and Schatzberg have mounted a vigorous legal campaign against the charge in the recent POGO Letter to NIH on Ghostwriting Academics<\/font><\/strong><\/a><\/u><\/font><\/strong>. They claim that the evidence that they lent their names to a ghost-written textbook is invalid because the evidence is circumstantial and doesn’t prove<\/font><\/strong> the charge beyond any reasonable doubt – a legal standard. I’ve figured out why that defense makes me so angry. That’s what this post is about.<\/font><\/p>\n

If you search the NIH repository of scientific article abstracts [PubMed<\/strong><\/a>] for Nemeroff CB<\/font><\/strong>, you find a number of entries – six hundred and twenty eight! Is that possible? Apparently. Some are "review" articles that mostly say the same things as the last review article. That’s pretty common in science where the length of one’s CV is not only downright Freudian, it is a big plus in getting jobs and grants. I’ve reproduced one such abstract and referenced three other clones.
<\/font> <\/div>\n

The burden of severe depression:<\/font><\/strong><\/a>
a review of diagnostic challenges and treatment alternatives<\/font><\/a><\/strong>
J Psychiatr Res. 2007 Apr-Jun;41(3-4):189-206. Epub 2006 Jul 25.
by Nemeroff CB.
Department of Psychiatry and Behavioral Sciences
Emory University School of Medicine
ABSTRACT<\/font><\/strong><\/u><\/font>
<\/font><\/p>\n

Among the factors making recognition of severe depression problematic for clinicians are the heterogeneous nature of the condition, lack of standardized definitions, and concomitant comorbidities that confound differential diagnosis of symptoms. The spectrum of severity in depressive disorders is extraordinarily broad, and severity assessment is comprised of several metrics including symptom intensity, diagnostic subtypes, suicidality risk, and hospitalization status. The overall diagnosis is achieved through consideration of symptom types and severities together with the degree of functional impairment as assessed by the psychiatric interview. It is likely that no single fundamental neurobiological defect underlies severe depression.<\/font><\/strong> The chronicity and heterogeneity of this disorder lead to frequent clinic visits and a longer course of treatment; therefore, successful approaches may require an arsenal of treatments with numerous mechanisms of action. The categories of drugs used to treat severe depression are detailed herein, as are several non-pharmacologic options including a number of experimental treatments. Pharmacotherapies include tricyclic antidepressants, selective serotonin reuptake inhibitors, atypical antidepressants such as serotonin-norepinephrine reuptake inhibitors and monoamine oxidase inhibitors, and combination and augmentation therapies. Drugs within each class are not equivalent, and efficacy may vary with symptom severity. Patient adherence makes tolerability another critical consideration in antidepressant choice. The role of non-pharmacological treatments such as electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation remain active avenues of investigation. <\/font><\/strong>Improved knowledge and treatment approaches for severe depression are necessary to facilitate remission, the ideal treatment goal.<\/sup><\/font><\/div>\n