The Ongoing Failure of Pyschiatry
When I was a kid I watched The Snake Pit, featuring Olivia de Havilland as a raving loony who gets locked in a padded cell during the 1920s.
We've come such a long way since then. A case has come to light of an autistic man who has not been convicted of crimes, but who has been held in a small cell in solitary confinement for 5 years because psychiatric medicine can't calm the bloke down enough to handle. This is rightly causing national outrage, especially since an unknown number of other people are held in similar circumstances, and that over 7000 people were held in solitary confinement due to mental illness in NZ last year. To me, this is an indictment on an industry that has failed to make progress in the past century. They're still using ECT, they're still locking people up in solitary whose only crime is to be sick, and they're still prescribing drugs that are worse than the "cure". Physician, heal thyself! |
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Strictly speaking the patient, Ashley, has been not in solitary confinement for 5 years. That would mean no leaving his room or contact with people for 5 years! Ashley has been in seclusion for 5 years. That means a mental health unit which he can only leave for 90 minutes a day. He does spend more than half the time locked in his room which is totally inadequate for that purpose. That is a failure of the health system, not psychiatry. The reviewers in his last review pinpointed a lack of staff. Quote:
Locked in isolation: Lack of clarity around patient seclusion Quote:
Psychiatry still uses electroconvulsive therapy because it works (generally used as a last resort) despite its reputation and past history. An analogy: Doctors do not refuse to use morphine because its association with addicts or any past misuse :eek:! Psychiatrists lock people up in seclusion because they cannot cure them and the legal system demands that potentially violent people be locked up safely. Overuse of benzodiazepines: still an issue? is about the overuse by all doctors. The consultant for the article is Dr Jeremy McMinn, Consultant Psychiatrist and Addiction Specialist, Wellington. One of the references about adverse effects was published in J. Psychiatry (the other J. Psychiatry reference was about withdrawing patients from long-term use). |
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Psychiatry is still using the equivalent of cupping. Quote:
90 minutes a day and you're disputing solitary confinement? Each to their own, I guess, but you're also avoiding an unknown number of days where he did not get his 90 minutes, as noted in the original article. I'm amused by the fact that actual criminals have been financially compensated for spending as little as two weeks in solitary, while Ashley just gets locked away in a shed. Quote:
The health system is charged with handling the meat; the psychiatric industry is charged with developing treatments, and there are none. If you're going to blame those who get left the dregs of the psychiatric industry to look after, you may as well blame Ashley or his parents. Quote:
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It is known that some Alzheimer's patients are restrained, but christ knows how many. One is too many. Quote:
Yes, it works for short-term help in acute cases - in other words, it delays the inevitable onset of the next episode. It isn't a cure; it's a stop-gap for an industry incapable of real progress. Quote:
That psychiatry cannot even mitigate the effects of the illness is an indictment on their lack of progress. |
AIDS was an international crisis, and massive amounts of money were poured into drug research.
H1N1 was an international time bomb, and massive amounts of money were poured into development of the already existing flu drugs. By contrast there's very little money in psychiatric drug research, largely because not enough people give a crap. It's not like psychiatric illness is contagious or anything, you can't catch madness from an infected person! There's no imminent crisis, no need for international cooperation, and the vast majority of seriously ill mental patients are pretty much invisible. Hence no research money. So here's a suggestion, instead of spouting off to an Internet forum where nobody has any power or ability to make any difference, why don't you petition your parliament and help to get the psychiatrists the funding to run proper drug trials, and develop effective treatment? Sent from my iPhone using Tapatalk |
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Psychiatry has made a lot of progress in the approximately 50 years since the introduction of the first pharmaceuticals. It's one of the newest specialties within medicine, and arguably the most complex subject matter. Vaccines, by comparison, are the medical low hanging fruit. Having done HIV research (MSc) and psychology research (BA), I can say that HIV research is an order of magnitude less difficult - the subject matter isn't trying to trick you, for one thing. (caveat - I worked in study design, so yeah, sometimes trials volunteers are trying to trick us, but HIV itself isn't) Quote:
I think progress against a particular category of illness can also mean it's a bugger to cure, not necessarily a lack of competence or interest. Quote:
Scientology has a pretty well funded 'rage machine' that cranks out these edge cases in the guise of journalism, and tries to paint the entire psychiatric landscape with them, because that's their idee fixe these days. There's another example they've been championing here in Canada. It's a guy who cut up his wife's face and his lawyers successfully obtained a defense of mentally ill and unable to understand his actions. So, he's been in an institution in Ontario for almost ten years... if he had been found criminally responsible for his actions, he'd be out of prison by now. |
Crank nonsense of the most ignorant and arrogant kind. Another genius that knows better than the scientific community. Little regard for objective argument or research, due diligence has not been done on claims.
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Autism is NEUROLOGICAL disorder with multiple manifestations and functional differences.
It can NOT be treated by psychiatry. Some manifestations can be reduced in a pallative fashion. Autism is not a mental illness |
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HIV has killed an estimated 650,000 Americans. The first HIV death in USA was around 1980. Since 1980, at least 1,500,000 Americans have died as a result of mental illness. The number of HIV deaths is decreasing very quickly; the number of deaths from mental illness is not. 1.2M Americans live with HIV; almost 10,000,000 Americans live with serious mental illness. Do you really want to argue maths on this? Quote:
The number one prescription in USA is for an anti-psychotic tablet, and many psychiatric drugs make up the top 100 prescribed. The industry is immense, and since people are much likely to be on psychiatric drugs for much longer than antibiotics or cancer treatment, the idea that the industry lacks money is laughable. The nobody cares part is correct. Quote:
Anyone reading that out of context would need to be unaware of what discussion forums actually are. Quote:
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He does not get to go to cafes and almost all of his times out of his shed are on his own, barring his two guards. He almost never interacts with other humans and has spent over half of his five years in a single cell. That's close enough to solitary for me. I'm surprised you didn't spot the slight analogy after having been so brilliant at spotting hyperbole. Quote:
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I think the health board could do a bit more in terms of comfort and life, but the issue is with the shrinks who can't even begin to control the disability. Quote:
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They're still prescribing the exact same drugs all this time later. In time frames, penicillin only pre-dates psychiatric drugs by a decade or so, so the time argument falls flat on its face there. Antibiotics have almost come full circle while doctors are still prescribing Valium. Anti-psychotic drugs have extremely high incidence rates of adverse side effects (up to 50%); as shown recently, are so much more likely to lead to suicidal thoughts that drug companies lied about their research, and also carry increased risk of cardiac arrest and sudden death. Quote:
In 250 years, life expectancy has almost doubled. The progress made in cancer & cardiac treatment is immense. You don't even need me to point that out, but if you wish, I'm quite happy to back up the case with plenty of examples. Quote:
I'm picking the former, since we [generally] don't insist loonies be locked up and kids with autism have a much greater emphasis on normalisation, achieved by attending normal schools and getting lots of help that did not previously exist. |
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However, treatment of it still rests within the psychiatric industry, so it's another difference that makes no difference. Saying " It can NOT be treated by psychiatry" is patently incorrect. What branch of medicine do you think it should attach to? Obstetrics? Gynaecology? Proctology? |
"psychiatric industry"
Crank language, weasel words. Psychiatry is a medical science, the application of which requires money. When the regulations are as thick as the earth's crust, calling it an industry is just hilarious. Watch, I'm gonna google "Psychiatric industry" and the top 3 sites will be crank sites. HAHAHAHAHAHA I am right about my prediction. Your thread sucks really bad. |
Any company that could create a low-side-effect drug that, taken daily, effectively treated depression, with little potential for abuse, would be worth billions. Occam's razor suggests that companies are desperately trying but haven't been able to succeed, rather than that this (and similar needs) need pointed out to them as something important to work on.
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As to your comments on medical specialties involving the pelvic area (freudian?), perhaps neurology is the word you were searching for? Neurological research is probably the specialty most likely to reach an understanding of, and more effective treatment for autism. |
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Insulting an area of medicine do not impress me nor I suspect other posters. Some dictionary English for you, The Atheist: Solitary confinement Quote:
It is irrelevant that some NZ criminals in 2005 were compensated for actual and illegal solitary confinement Denying what you cited is bad, The Atheist: Autistic man locked in isolation for five years Quote:
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Pipedreams about what psychiatry should be able to do, does not reflect the real world. There is no cure for AIDS Quote:
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I am heartily pleased that people with the OP views have little to no influence over the care I or my loved ones receive. Certainly, I have the 'Psychiatry Industry' to thank for the continued health and well being of a couple of family members and for assisting me in understanding their needs.
I've learned that trying to reason with people having the OP view is like trying to reason with a delusional person (and I have tried to reason with a delusional person). |
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I actually understand the subject matter. I'm hoping to educate you about the definitions, you seem either to not understand them, or to not care. eg: solitary vs seclusion, for example. Quote:
Personally, I think he has a case against the facility, based on the information available. A failure of capitalism, IMO. Quote:
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That's why I'm curious about your opinion about medicine in general, which has failed to make much more than a dent in cancer rates. This has come up on the list before... cancer is a family of conditions (similar to mental illness), some of which are easier to treat than others and have seen incredible progress (similar to mental illness), while others are stubbornly resistant to any treatment to the point of despair and global statistics for incidence are getting even worse (similar to mental illness). Quote:
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My wife is prescribing what are called 3rd generation antipsychotics that are less than a decade old, they're now the first line in BC. Quote:
Is this evidence of an 'ongoing failure' in cancer treatment? Quote:
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However autism has historically been a psychiatric disorder (Leo Kanner who named it was a psychiatrist). The treatment is considered as part of psychiatry when it really should be a branch of neurology (autism spectrum sometimes appears as a neurological disorder). |
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The most effective treatment fro autism is early identification and intervention not psychiatry |
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It is developmental and neurological. :) . |
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RationalWiki has an entry: [Mental Illness Denial], and Dr. Novella has chimed in: [Mental Illness Denial] I have some expectation that the future of Psychiatry Denial is one of declining popularity, as I suspect the prime driver is Scientology dollars, and they're on their last ropes these days. When I was at APA last month, Scientology had their usual protest. They brought back their 'house of horrors' popup experience. It's like a carney haunted house, they guide groups through the temporary structure, with dioramas of trepanation, electrocutions, people tied to beds with rope, &c. |
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All I see is continuing push of drugs that already fail. Quote:
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Let's have a look at the facts, shall we? Every single demographic under age 44 has seen at least a 50% reduction in death rate since 1950. An 80% reduction in child cancer mortality is enormous. "Failed to make a dent in" is absolute crap. Quote:
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Your lack of data in support of your position is revealing. Quote:
We agree there - it is physical. not medical improvement. Quote:
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In the case of Ashley, he missed that bus, and some people aren't content to let him rot. |
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Ashley spent time outside the facility. Ashley had visitors, e.g. his family. The article starts with Ashley walking with his family. Ashley might interact with other patients. |
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In contrast, your post is making accusations about the field. This is the logical fallacy of hasty generalization. Quote:
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In contrast, mental illness incidence has been pretty stable (makes sense - not a lot of environmental causes, mostly strikes in early life so longer lifespans does not increase incidence much), and the portion of people who are able to manage a condition like schizophrenia has gone from 0% in 1955 to a 68% 'recovery rate' (meaning: no further incidents while maintaining their regimen). (The American Journal of Psychiatry (Vol. 144, No. 6, p. 718-735)) Based on your above stats, it sounds like psychiatry has had more success with schizophrenia than oncology has had with cancer... so why is oncology not an even bigger 'failure' ? Quote:
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[quote=The Atheist;11323142]Yep, talking is distinctly new.[/qutoe] Certainly you can't possibly believe that therapy is no different than 'talking' ? (this is where the Psychiatry Denial becomes more evident) |
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One can search at https://clinicaltrials.gov/ to get an idea what's currently being researched, but there are generally hundreds of trials, not all for drugs, for any given condition. Articles like this are better for a quick overview: 20 New Antidepressants in the Pipeline 2015A google search for the condition (autism, depression, etc.) and drug pipeline will usually bring up the latest research. |
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There are a lot more people in the world, and they're living a lot longer, so there being more cancer is no great leap. Since it's not even known whether some of them are preventable, the comparison is plain stupid. Rates of lots of cancers have decreased and there's enormous effort to educate people out of dangerous behaviours - smoking and obesity being top of the list. The fact is that progress in cancer treatment over the exact same time period is immense. Quote:
I do agree schizo is one area where the psychiatric industry has a rare win, though. Quote:
The drugs appear to be a broad range of antipsychotics. Quote:
You want details of the reduction in deaths from epidemics in the past century? Happy to provide, but I bet you know the answer anyway. Quote:
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https://clinicaltrials.gov/ct2/resul...&Search=Search Quote:
Yep, they could certainly improve. It seems to be more a case of fine-tuning existing drugs than anything novel. It did give me one laugh though - dextromethorphan being used. How long has that sucker been on the market? Patented 76 years ago. |
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I actually think it's a good thing; they're trying something new. |
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Nitpick anyway, since I've admitted that schizo is the glaring success story of psychiatry. Despite the obvious: Quote:
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Look, the outcome of this is obvious. No one cares what you think except for that idiot you keep telling us about that listens to you at the coffee shop.
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Meanwhile, back to the actual topic, another point that shows the total lack of progress of the psychiatric industry is the fact that depression is probably better served by prescribing exercise than drugs.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC474733/ |
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For that matter what is the actual subject? The title suggests a fantasy about "The Ongoing Failure of Pyschiatry" when all medicine has ongoing failures (where is the cure for cancer :p!). The OP is about the use of long-term seclusion which is a practice which is not recommended by psychiatrists any more - an Ongoing Success of Psychiatry! |
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It is known that many depression treatment drugs cause increased suicidal feelings. That's why the drug companies lied about that. It is a serious flaw in drug treatment that exercise does not have. To me, that alone makes any successful treatment "better" than drugs. I'm happy to list more reasons if you continue with your silly defence of the drugs. Just to clarify - the thread is about reasons the psychiatric industry should hang its collective head in shame and the lack of progress made in the past 70 years, since the first use of antipsychotics. Compared to surgery, oncology and most other parts of medicine, psychiatry is in the dark ages. |
Oh, and from a convenient thread on a similar subject on the efficacy of anti-depressives:
https://www.statnews.com/2016/06/08/...ts-teens-kids/ Exercise is better, the end. |
The Atheist: Can you understand that this paper is not exercise is better than drugs
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An adjunct treatment is one that is added to an existing, primary treatment. The paper you cited is about the adjunct + primary treatments together being better than the primary treatment by itself: The Benefits of Exercise for the Clinically Depressed Thus it is a lie to state that this paper shows that exercise is better than "drugs". Adding ignorance is also bad - the primary treatment for the clinically depressed is not only drugs. 10 June 2016 The Atheist: Can you understand that this paper does not state that exercise is better than drugs? |
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10 June 2016 The Atheist: A paper showing continued testing of drugs used in psychiatry is not a failure of psychiatry 10 June 2016 The Atheist: A paper not about exercise is not about exercise! 10 June 2016 The Atheist: Can you understand that this paper does not state that exercise is better than drugs? So far the answer is no. |
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I have since posted more, and have offered as much more as you like, there is ample evidence. For some reason you seem to be unable to grasp that. Quote:
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You are building strawmen yet again. |
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I explained your mistake and so far have no acknowledgement that you understand it. 10 June 2016 The Atheist: Can you understand that this paper does not state that exercise is better than drugs? So this thread is about your opinion that there has been a "lack of progress" in psychiatry in the last 70 years :jaw-dropp? The fact that psychiatry has progressed in the past 70 years makes that opinion a fantasy. If the opinion is a demand that psychiatry should be able to cure all psychiatric disorders then we have a delusion. The best we have is a demand that psychiatry should cater to your idea of the progress it should make. |
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I can only speak for myself. I have been on Venlafaxine since last summer. It has helped alleviate my depression and anxiety. I used to have episodes where I was convinced that I was visiting alternate universes; however, I don't have those episodes anymore. The first couple of weeks on the medicine, I had some moderate stomach discomfort. Those symptoms disappeared. Before that, I was on Celexa for many years. Before that, I was on Prozac for many years. Although all three medicines have helped me, I think that my newest medicine is the most helpful.
Because of these medicines, I am able to be married, hold a job, do volunteer work, have hobbies, and do other things that I might not be able to do if I weren't on those medicines. This is only my experience. Other people have other experiences. |
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