Cruise vs. the American Psychiatric Association
The leadership of the American Psychiatric Association is quite arrogant. They are so certain that they are right about the biological model of mental illness, even though it's not been proved, that they issue this statement in response to Tom Cruise's comments:
"Rigorous, published, peer-reviewed research clearly demonstrates that treatment (of mental illness) works," the APA statement said. "It is unfortunate that in the face of this remarkable scientific and clinical progress that a small number of individuals and groups persist in questioning its legitimacy."
First, I guess they forgot about the study that found that placebos work as well as anti-depressants. Second here are citations gathered right from the scientific literature that showing that this issue is far from decided (as compiled by mindfreedom.org):
Mental Health: A Report of the Surgeon General (1999) is explicit about the absence of any findings of specific pathophysiology:
p. 44: "The diagnosis of mental disorders is often believed to be more difficult than diagnosis of somatic, or general medical, disorders, since there is no definitive lesion, laboratory test, or abnormality in brain tissue that can identify the illness."
p. 48: "It is not always easy to establish a threshold for a mental disorder, particularly in light of how common symptoms of mental distress are and the lack of objective, physical symptoms."
p. 49: "The precise causes (etiology) of mental disorders are not known."
p. 51: "All too frequently a biological change in the brain (a lesion) is purported to be the 'cause' of a mental disorder ... [but] The fact is that any simple association -- or correlation -- cannot and does not, by itself, mean causation."
p. 102: "Few lesions or physiologic abnormalities define the mental disorders, and for the most part their causes remain unknown."
In the third edition of Textbook of Clinical Psychiatry (1999), we find similar statements:
p. 43: "Although reliable criteria have been constructed for many psychiatric disorders, validation of the diagnostic categories as specific entities has not been established."
p. 51: Most of these [genetic studies] examine candidate genes in the serotonergic pathways, and have not found convincing evidence of an association."
In Andreasen and Black's (2001) Introductory Textbook of Psychiatry, we find, in the chapter on schizophrenia:
p. 23. "In the areas of pathophysiology and etiology, psychiatry has more uncharted territory than the rest of medicine...Much of the current investigative research in psychiatry is directed toward the goal of identifying the pathophysiology and etiology of major mental illnesses, but this goal has been achieved for only a few disorders (Alzheimer's disease, multi-infarct dementia, Huntington's disease, and substance-induced syndromes such as amphetamine-related psychosis or Wernicke-Korsakoff syndrome)."
p. 231: "In the absence of visible lesions and known pathogens, investigators have turned to the exploration of models that could explain the diversity of symptoms through a single cognitive mechanism."
p. 450: "Many candidate regions [of the brain] have been explored [for schizophrenia] but none have been confirmed."
The ironic thing is that I actually believe that medicine helps people under the right circumstances, it's forcing it on them that I object to. But this obnoxious, childish arrogance makes me doubt the APA more than I would otherwise. They are a professional organization, not a kid in the schoolyard. If they were confident of the past and their present, they wouldn't feel the need to speak in such a way. I think it's the ghosts of both Walter Freeman and Henry Cotton that makes the American Psychiatric Association so nervous.
"Rigorous, published, peer-reviewed research clearly demonstrates that treatment (of mental illness) works," the APA statement said. "It is unfortunate that in the face of this remarkable scientific and clinical progress that a small number of individuals and groups persist in questioning its legitimacy."
First, I guess they forgot about the study that found that placebos work as well as anti-depressants. Second here are citations gathered right from the scientific literature that showing that this issue is far from decided (as compiled by mindfreedom.org):
Mental Health: A Report of the Surgeon General (1999) is explicit about the absence of any findings of specific pathophysiology:
p. 44: "The diagnosis of mental disorders is often believed to be more difficult than diagnosis of somatic, or general medical, disorders, since there is no definitive lesion, laboratory test, or abnormality in brain tissue that can identify the illness."
p. 48: "It is not always easy to establish a threshold for a mental disorder, particularly in light of how common symptoms of mental distress are and the lack of objective, physical symptoms."
p. 49: "The precise causes (etiology) of mental disorders are not known."
p. 51: "All too frequently a biological change in the brain (a lesion) is purported to be the 'cause' of a mental disorder ... [but] The fact is that any simple association -- or correlation -- cannot and does not, by itself, mean causation."
p. 102: "Few lesions or physiologic abnormalities define the mental disorders, and for the most part their causes remain unknown."
In the third edition of Textbook of Clinical Psychiatry (1999), we find similar statements:
p. 43: "Although reliable criteria have been constructed for many psychiatric disorders, validation of the diagnostic categories as specific entities has not been established."
p. 51: Most of these [genetic studies] examine candidate genes in the serotonergic pathways, and have not found convincing evidence of an association."
In Andreasen and Black's (2001) Introductory Textbook of Psychiatry, we find, in the chapter on schizophrenia:
p. 23. "In the areas of pathophysiology and etiology, psychiatry has more uncharted territory than the rest of medicine...Much of the current investigative research in psychiatry is directed toward the goal of identifying the pathophysiology and etiology of major mental illnesses, but this goal has been achieved for only a few disorders (Alzheimer's disease, multi-infarct dementia, Huntington's disease, and substance-induced syndromes such as amphetamine-related psychosis or Wernicke-Korsakoff syndrome)."
p. 231: "In the absence of visible lesions and known pathogens, investigators have turned to the exploration of models that could explain the diversity of symptoms through a single cognitive mechanism."
p. 450: "Many candidate regions [of the brain] have been explored [for schizophrenia] but none have been confirmed."
The ironic thing is that I actually believe that medicine helps people under the right circumstances, it's forcing it on them that I object to. But this obnoxious, childish arrogance makes me doubt the APA more than I would otherwise. They are a professional organization, not a kid in the schoolyard. If they were confident of the past and their present, they wouldn't feel the need to speak in such a way. I think it's the ghosts of both Walter Freeman and Henry Cotton that makes the American Psychiatric Association so nervous.
posted by Christine at Monday, June 27, 2005
2 Comments:
I suffered from depression for many years. My own extensive research on the subject tells me some things: that it doesn't matter whether the origin of depression is environmental and then has biological effects which prolong it, or if the origin of depression is biological and that in turn creates a difficult environment.
What matters is treatment. I remember, when I was a teenager, my therapist told me that when someone had been unhappy for as long as I had been (extensive abuse as a child) that sometimes their brain chemicals became altered, which made it very difficult for someone to recover from depression. My research since then has verified this, although I chose not to use medication at that time, I have since used St. John's Wort and it has helped me (I am now recovered from depression; it took many hard years.)
I don't think that medications are a solution for depression, but they can be used as an aid, combined with therapy, to recovery from depression. This, imo, would be a correct use of medication. Unfortunately, the insurance and pharmaceutical companies are not encouraging correct use of medications.
I also think that you, and Tom Cruise, do the cause a disservice when you criticize someone for making a perosnal choice to improve their own life. Ms. Shields's choice was HERS to make. If the medications helped her, whose business is it to criticize and tell her she did the wrong thing? Obviously, what she chose was right for her.
btw, I don't know if you are aware, but recently a new possible biological source for schizophrenia: they've found that it may be caused by an antibody response to a Human Endigenous Retrovirus. It's certainly food for thought.
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