This is the headline of the editorial in the most recent edition of Current Psychiatry. It is written by Henry A. Nasrallah, MD, a prominent psychiatric researcher. This is one of the free journals sent to, I assume, every psychiatrist in the US. Although it says it has a subscription cost of $113/year, I know I have never been asked to pay. I assume it is supported by its advertisements, 18 pages of which in this 54 page journal were from drug companies.Read More
Please note: If you are a state mental health commissioner, this blog could be hazardous to your continued tenure.
Recently at a neighborhood Fourth of July celebration, I talked with several people who live in nearby residential “treatment” homes. They almost all had tardive dyskinesia and most looked as if their emotions were so dampened down that they sat staring at the street in front of them, only incidentally aware of the sparklers and firecrackers. And all but one looked like they were well on their way to a prolonged case of “chronic mental illness”.Read More
Last week, an important study was published in JAMA Psychiatry. Wunderink and colleagues published results of a follow up study to one he had completed several years ago. In the initial study of first episode psychosis, subjects were randomized to one of two treatment strategies: maintenance treatment (MT) in which they were maintained on drugs for the two year study or drug discontinuation (DR) in which the drugs were stopped and then restarted if symptoms recurred.Read More
Erick Turner has published an important piece in CNS Drugs entitled “Publication Bias, with a Focus on Psychiatry: Causes and Solutions.” It should be required reading for any medical student, non-medical helping professional, or practicing prescriber. Rather than being an unbiased reflection of the underlying data, the psychiatric literature is instead sort of a funhouse mirror – the published results are consistently, overwhelmingly, positive – no matter what the actual data are. The implications are enormous. Note that the methodology in such trials is often deliberately constructed to bias such trials in favor of the sponsor’s drug – even so, publication strategies are used to minimize any bad news resulting from such trials, and to maximize the impression that the drug is effective.Read More
Today I read Psychiatric News, the newspaper of the American Psychiatric Association, and I was drawn to an article about the new APA President, Jeffrey Lieberman, because the front page teaser announced that “he is ‘mad as hell’”.What, I wondered, is he so mad about?
In the article, which reports on Dr. Lieberman’s address at the opening session of the annual APA meeting in May, we learn that he is angry not only about “stigma associated with mental illness” but also “the lack of respect toward psychiatry as a medical specialty”.Read More
There are many dictionary definitions of strength. “Being strong in body or in numbers, mental force, potency, cogency of argument, effective action, intensity, endurance, sturdiness, efficacious, and vitality.”1,2 After nearly 140 years of looking for deficits, damage, problems, and pathology, mental health care is beginning to turn upside down and is now learning to focus on strengths to build recovery from serious and persistent psychiatric problems.3.4Read More
An interesting thing has been happening in Canada. In late 2011, the British Columbia Ministry of Health issued a report entitled, “A Review of the Use of Antipsychotic Drugs in British Columbia Residential Care Facilities.” The family of a senior living in such a facility raised the issue of over-medication and, instead of reacting defensively, the provincial government set about studying the prescribing practices of physicians in these residential programs.Read More
Children’s mental health matters! Right now, until Friday May 15, 2013 at 5pm EDT, you can help children by participating in the public comment process on seven pediatric antipsychotic medication use measures. The National Collaborative for Innovation in Quality Measurement (NCINQ) seeks feedback on seven proposed Antipsychotic Medication Use measures being developed for use by state and federal programs.Read More
Back in 2011, I met with a group of mental health providers from diverse backgrounds who converged in Phoenix for a retreat to share ideas and vision of integrative mental health. From that shared time, the International Network of Integrative Mental Health (INIMH) was born.One of our mandates was to connect with other countries regarding the shared wealth of knowledge about integrative mental health. James Lake MD, our current president of INIMH, had reconnected with a long-lost cousin in Cuba about 2 years before. They worked hard to pull the opportunity together.Read More
I have recently put together a talk in which I summarize my current thinking on the optimal use of neuroleptic drugs, primarily focusing on the treatment of individuals who are experiencing psychotic symptoms. In order to foster conversation on this topic, I will be posting the content of this talk in a series of blogs.Read More