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posted by CoolHand on Friday April 24 2015, @03:11AM   Printer-friendly
from the the-big-corps-would-never-lie dept.

The British Medical Journal provides an editorial from Professor David Healy, Head of Psychiatry at the Hergest psychiatry unit in Bangor in which it is stated:

When concerns emerged about tranquilliser dependence in the early 1980s, an attempt was made to supplant benzodiazepines with a serotonergic drug, buspirone, marketed as a non-dependence producing anxiolytic. This flopped. The lessons seemed to be that patients expected tranquillisers to have an immediate effect and doctors expected them to produce dependence. It was not possible to detoxify the tranquilliser brand.

Instead, drug companies marketed SSRIs for depression, even though they were weaker than older tricyclic antidepressants, and sold the idea that depression was the deeper illness behind the superficial manifestations of anxiety. The approach was an astonishing success, central to which was the notion that SSRIs restored serotonin levels to normal, a notion that later transmuted into the idea that they remedied a chemical imbalance. The tricyclics did not have a comparable narrative.

Serotonin myth

In the 1990s, no academic could sell a message about lowered serotonin. There was no correlation between serotonin reuptake inhibiting potency and antidepressant efficacy. No one knew if SSRIs raised or lowered serotonin levels; they still don’t know. There was no evidence that treatment corrected anything.

[More...]

This lack of evidence-based practice was apparent to Thomas Insel, Director of the US National Institute Of Mental Health who announced in 2013 that the institute would abandon funding towards the DSM:

While DSM has been described as a "Bible" for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been "reliability" - each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure.

In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.

Does this mean that psychiatry is finally moving away from a practice akin to leeches for everything?

 
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  • (Score: 5, Interesting) by frojack on Friday April 24 2015, @03:38AM

    by frojack (1554) on Friday April 24 2015, @03:38AM (#174523) Journal

    As long as I have been aware of it the DSM has had major problems in classifications.
    I first ran into it while working on a mental health system for a state government, and even the clinicians hated the DSM because of the ambiguity and redundancy of the coding. Some viewed it as total bull, and openly said so. (Most just looked at it as something they had to do to get paid).

    I think the DSMs, at least since DSM III, have done a lot to discredit Psychiatry, while appearing to prop it up. The field now ranks right up there with Homeopathy in the eyes of a lot of people.
    The difference being most Psychiatrists is (in the US at least) a physician, who should have some medical knowledge to fall back on. Homeopaths might end up tending their herb gardens when people start seeing through the quackery.

         

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  • (Score: 1, Flamebait) by tathra on Friday April 24 2015, @04:05AM

    by tathra (3367) on Friday April 24 2015, @04:05AM (#174535)

    I think the DSMs, at least since DSM III, have done a lot to discredit Psychiatry, while appearing to prop it up. The field now ranks right up there with Homeopathy in the eyes of a lot of people.

    it needs to be discredited. psychiatry is a load of bullshit spewed from a coked-up nutjob with an oedipus complex. none of it ever had any scientific backing or supporting evidence, and now that we're getting evidence, its showing that its always been bullshit. i say good riddance.

    • (Score: 2) by aristarchus on Friday April 24 2015, @07:03AM

      by aristarchus (2645) on Friday April 24 2015, @07:03AM (#174563) Journal

      it needs to be discredited. psychiatry is a load of bullshit spewed from a coked-up nutjob with an oedipus complex. none of it ever had any scientific backing or supporting evidence, and now that we're getting evidence, its showing that its always been bullshit. i say good riddance.

      Well, at least we know what username Tom Cruise is using on Soylent News. Or is Tom smart enough to be the rant prior, and draw attention from himself? Frojack!!!!

      • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @07:24PM

        by Anonymous Coward on Saturday April 25 2015, @07:24PM (#175134)

        Stop the habit of accusing random people of made up bullshit.

        • (Score: 2) by aristarchus on Saturday April 25 2015, @07:46PM

          by aristarchus (2645) on Saturday April 25 2015, @07:46PM (#175142) Journal

          Stop the habit of accusing random people of made up bullshit.

          I know, crazy, isn't it? I wonder what they call it in the DSM? But to your complaint:

          Not a habit. Only as needed when it is definitely needed. Perfectly deliberate and intentional, and I can stop whenever I want.

          accusing random people

          They are not random people, they are Tom Cruise! You know, public persons of whom criticism is perfectly reasonable. And people who seems to be saying exactly the same things as these celebrities, but cannot jump on a couch but cause this is Soylent, not Oprah. But it is the fact that they bullshit that brings the accusation, so it is not random at all.

          Stop the habit of accusing random people of made up bullshit.

          Now here is where there is a problem. Are you suggesting the we not challenge "made up bullshit" on SN? Or are you suggesting I am in error and the bullshit in this instance is not made up, but it would be alright to call it in cases where it were? Or are you possibly suggesting, at the far reaches of intelligible rationality, that this incoherent attack on psychiatry is somehow not bullshit? Sorry, can't follow you there, that's just crazy talk.

          • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @08:40PM

            by Anonymous Coward on Saturday April 25 2015, @08:40PM (#175161)

            Your post shows you can't even if you wanted to and you'll say it's because you never want to.

          • (Score: 0) by Anonymous Coward on Saturday April 25 2015, @08:52PM

            by Anonymous Coward on Saturday April 25 2015, @08:52PM (#175163)

            Crazy people do not understand what crazy is. You are just as crazy in the future when I meet you in the jail where we will be wearing blue ponchos with white butterfly emblems. I'm not looking forward to finding out why they reanimated you but they only did it once.

          • (Score: 2) by tathra on Sunday April 26 2015, @02:21PM

            by tathra (3367) on Sunday April 26 2015, @02:21PM (#175345)

            Or are you possibly suggesting, at the far reaches of intelligible rationality, that this incoherent attack on psychiatry is somehow not bullshit?

            are you suggesting that Sigmund Freud wasn't a coked-up nutjob, that he wasn't obsessed with fucking his mother and didn't project that on to everyone else, or that he didn't influence modern psychiatry more than anyone else?

  • (Score: 2) by kaszz on Friday April 24 2015, @04:10AM

    by kaszz (4211) on Friday April 24 2015, @04:10AM (#174539) Journal

    Use ICD? better, not good?

  • (Score: 0) by Anonymous Coward on Friday April 24 2015, @04:38AM

    by Anonymous Coward on Friday April 24 2015, @04:38AM (#174546)

    That's because DSM is a shopping catalog for drug company, that's why.

  • (Score: 2, Insightful) by OrugTor on Friday April 24 2015, @05:01PM

    by OrugTor (5147) Subscriber Badge on Friday April 24 2015, @05:01PM (#174731)

    YES. Psychiatry is almost entirely empirical. There are no substantive models that explain the hardware/software complex that is the human brain. Don't knock DSM; of course it's just a dictionary, that's how clinicians can at least use the same diagnosis for the same cluster of symptoms. If ever psychiatry becomes a science then DSM will have to shape up.
    On a side note (mark me troll) I have no use for a DSM that has no code for religious belief.

    • (Score: 1, Insightful) by Anonymous Coward on Saturday April 25 2015, @07:14PM

      by Anonymous Coward on Saturday April 25 2015, @07:14PM (#175129)

      You must have meant to say “not empirical” since empiricism [wikipedia.org] is based on experience, revision, and falsification.