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Tags depression , psychiatry

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Old 12th September 2016, 12:00 PM   #321
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Originally Posted by The Atheist View Post
Let's play "Bait the Shill"!

1 Pick notoriously anti-psychiatry organisations... No, not Scientology, organisations like The Guardian, Bloomberg, Nature, New Scientist and the Florida Citizens Commission on Human Rights.

Richard Friedman:
Yep. So? I think you're rewinding back to an earlier conversation about how you think psychiatry is a failure because of a lack of progress? You're just repeating yourself now? We're going in circles. Despite investment in a cure for cancer, we have little to show for it. Does that make oncology a failure? If not, why not?



Originally Posted by The Atheist View Post
Nature:
The Nature citation is a book review. It's not a study or even considered factual claims. This is not Nature endorsing a view.



Originally Posted by The Atheist View Post
The author is an economist. From what I read in the article, it's an indictment of the US capitalist based approach to medicine. The psychiatrists were being asked to work for free, so they declined. This is not a special problem in psychiatry.



Originally Posted by The Atheist View Post
One of the most damning things I've ever read. Wouldn't even see him...

Hard luck, mum & dad!

Guardian:
An op/ed by John Hoggett, where the complaint is similar to screeds we can read about other NHS specialties, none of which you seem to single out as 'failures' - what's special about public dissatisfaction with psychiatry specifically that makes it a failure?
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Old 12th September 2016, 12:03 PM   #322
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Originally Posted by The Atheist View Post
Anonymous claims are easy to make.
What, now we're reversing the burden of proof?

You're allowed to call him a shill, he's not allowed to say he's not a shill?

Do you even hear yourself?
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Old 12th September 2016, 12:25 PM   #323
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'The Citizens Commission on Human Rights' was founded by and is funded by the Church of Scientology.
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Old 12th September 2016, 12:42 PM   #324
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Originally Posted by The Atheist View Post
Let's play "Bait the Shill"!

1 Pick notoriously anti-psychiatry organisations... No, not Scientology, organisations like The Guardian, Bloomberg, Nature, New Scientist and the Florida Citizens Commission on Human Rights.

Richard Friedman:



Nature:



Bloomberg:



One of the most damning things I've ever read. Wouldn't even see him...

Hard luck, mum & dad!

Guardian:
Are you aware that all four of those are opinions, right? And that opinions aren't the same thing as evidence?
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Old 12th September 2016, 12:42 PM   #325
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Originally Posted by Elaedith View Post
'The Citizens Commission on Human Rights' was founded by and is funded by the Church of Scientology.
Yes, good point: Atheist, you didn't cite it, but one of your references ( Florida Citizens Commission on Human Rights ) is a Scientology organization. Particularly sad in light of your claim that you don't use Scientology as a resource: yes, yes you do.

Basically: your attitude is understandable, as it is the result of Scientology propaganda, and that's one of the main organizations that fuels psychiatry denialism. Their vested interest is that they're a competitor for patient dollars, if it's not obvious why they spend money on these campaigns.
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Old 12th September 2016, 12:44 PM   #326
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I'd like to make a really brazen attempt to shift the conversation.

The Atheist, what in your personal experience has led to your dislike and distrust of the psychiatric field? From whence comes your viewpoint?
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Old 12th September 2016, 12:58 PM   #327
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Originally Posted by The Atheist View Post
Bloomberg:

One of the most damning things I've ever read. Wouldn't even see him...

Hard luck, mum & dad!
It seems odd to argue both that psychiatry is fundamentally flawed and useless and then cite a bad outcome when when someone doesn't see a psychiatrist.
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Old 12th September 2016, 01:44 PM   #328
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Originally Posted by blutoski View Post
Yep. So? I think you're rewinding back to an earlier conversation about how you think psychiatry is a failure because of a lack of progress? You're just repeating yourself now?
No, someone else was saying it.


Originally Posted by Emily's Cat View Post
Are you aware that all four of those are opinions, right? And that opinions aren't the same thing as evidence?
Yes, and I see one of them is invalid. Hoisted on my own petard, I think you'd call it!

...

Originally Posted by blutoski View Post
Yes, good point: Atheist, you didn't cite it, but one of your references ( Florida Citizens Commission on Human Rights ) is a Scientology organization.
Ok, as above, fair cop, and serves me right. I knew I should've checked an organisation with a name like that, but lazy gets you. Bloomberg, Guardian, Nature... impeccable, but no, I have to **** in my own nest by linking to garbage.

I shall go and self-flagellate for a couple of hours - worst mistake I've made in a long time.

I'm kicking myself, trust me.

Originally Posted by marplots View Post
It seems odd to argue both that psychiatry is fundamentally flawed and useless and then cite a bad outcome when when someone doesn't see a psychiatrist.
The point was the number of psychiatrists who chose to not try to help.
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Old 12th September 2016, 02:40 PM   #329
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Originally Posted by The Atheist View Post
Yes, and I see one of them is invalid. Hoisted on my own petard, I think you'd call it!
I'm sure we've all fallen victim to it at one time or another.
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Old 12th September 2016, 02:47 PM   #330
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Originally Posted by The Atheist View Post
No, someone else was saying it.
What I mean is: you're repeating the unsupported claim?

(Meaning: this is like saying that bigfoot exists because other people say bigfoot exists - it's just repeating the claim, not supporting it with evidence).


Originally Posted by The Atheist View Post
The point was the number of psychiatrists who chose to not try to help.
Their reason appears to be that some of them confirmed there was no insurance coverage, and others did not have the combination of specialties required (the patient had medical complications as well - why were the medical doctors not also being accused of not helping?) This sounds more like the patient was doctor-shopped to the wrong places than any problem with the psychiatrists who could not take on the patient. It's called going to the pigpen for wool. Not the pig's fault.
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Old 12th September 2016, 07:26 PM   #331
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Question Produce your evidence that "either money or self-interest" is driving my posts

Originally Posted by The Atheist View Post
Anonymous claims are easy to make.
That is correct which is why the Shill gambit is so stupid, The Atheist - you have no evidence to support it. And as pointed put by other posters, that is your burden of proof because that is your unsupported assertion so:
13 September 2016 The Atheist: Produce your evidence that "either money or self-interest" is driving my posts.
I can tell you what is driving my posts - you misleading me and other posters with unsupported assertions when the science says that you are wrong.

12 September 2016 The Atheist: A "either money or self-interest" fantasy (Shill gambit?) does not excuse quote mining.

Last edited by Reality Check; 12th September 2016 at 07:36 PM.
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Old 12th September 2016, 07:29 PM   #332
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Thumbs down The Atheist: A list of cherry picked quotes says nothing about the thread topic

Originally Posted by The Atheist View Post
Let's play "Bait the Shill"!
Let us be rational and not play the cherry picked quote game.
13 September 2016 The Atheist: A list of cherry picked quotes says nothing about the success or failure of psychiatry which is the thread topic.

A Nature book review is not science.
A New Scientist editorial is opinion, not science. I agree with the editor. It would be great if personality disorders were as clearly diagnosable as medical disorders such as the example of angina. The DSM practice of making degrees of severity of a disorder into separate disorders looks confusing to me.

How Psychiatrists Are Failing the Patients Who Need Them Most
Quote:
A growing number of mental health-care providers are filling their practices with easy-to-treat, cash-paying patients — and leaving the desperately ill with few options
Primarily about the mental health-care providers, e.g. hospitals with long waiting lists. The main and valid complaint is that there are not enough specialist psychiatrists to cope with patients with complex needs. A comparison would be not enough heart transplant specialists to cope with the demand for heart transplant patients. That is not "The Ongoing Failure of Surgery" !

The other valid complaint is the dropping number of psychiatrists and other medical professions willing to take private insurance or Medicare. The % was never high compared to other specialists but it got down to 55% in 2010. That is about half the article.

A minor point is that "more than a dozen doctors and patient advocacy groups" say that "Many psychiatrists, particularly those in private practice, won’t take appointments with more complex patients...", one doctor because of fear of violence.

Last edited by Reality Check; 12th September 2016 at 08:04 PM.
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Old 12th September 2016, 08:55 PM   #333
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I don't know how much of an appreciation most people have that the science that underlies psychiatry is relatively weak, when compared to cardiology, for example. Does anyone else think this is a problem?
Are unwary patients victim to spending money on unnecessary, ineffective or dangerous therapies and drugs? Is there any study about this? My own (admittedly) superficial look at psychiatric studies and some anecdotal experiences lead me to believe that it is a problem.
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Old 12th September 2016, 11:09 PM   #334
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Originally Posted by Perpetual Student View Post
Are unwary patients victim to spending money on unnecessary, ineffective or dangerous therapies and drugs? Is there any study about this? My own (admittedly) superficial look at psychiatric studies and some anecdotal experiences lead me to believe that it is a problem.
I don't know how authoritative NPR is, but they seem to be agreeing with you.

http://www.npr.org/sections/health-s...nt-study-finds
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Old 13th September 2016, 12:13 AM   #335
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Originally Posted by The Atheist View Post
The point was the number of psychiatrists who chose to not try to help.
Maybe they secretly know psychiatry is bunk.
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Old 13th September 2016, 02:07 AM   #336
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Originally Posted by Reality Check View Post
Argument by YouTube video is not advised in a science thread, SashatheMagnificent, because they are not scientific literature.

What you have is a personal opinion of a Dr Thomas Szasz (based on his personal meaning of the word "disease") and an unhelpful Wikipedia link.
Why are you so confrontational?
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Old 13th September 2016, 08:53 AM   #337
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Originally Posted by blutoski View Post
Yep. So? I think you're rewinding back to an earlier conversation about how you think psychiatry is a failure because of a lack of progress? You're just repeating yourself now? We're going in circles. Despite investment in a cure for cancer, we have little to show for it. Does that make oncology a failure? If not, why not?
Of course oncology is a total failure, it is so much simpler than psychiatry in that the outcome is easy to know what you want to have happen, you want to kill off the cancer cells. Given all the money spent on that and the total failure of an effective way to do this it has to be viewed as a total failure and only a fool would trust them to treat their cancer.
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Old 13th September 2016, 12:26 PM   #338
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Originally Posted by Perpetual Student View Post
I don't know how much of an appreciation most people have that the science that underlies psychiatry is relatively weak, when compared to cardiology, for example. Does anyone else think this is a problem?
The American College of Cardiology (ACC) and the American Heart Association (AHA) grade evidence according to these criteria, with A being the highest level and C effectively meaning no conclusive supporting evidence:

Level of evidence A: recommendation based on evidence from multiple randomized trials or meta-analyses
Level of evidence B: recommendation based on evidence from a single randomized trial or nonrandomized studies
Level of evidence C: recommendation based on expert opinion, case studies, or standards of care.

According to the article linked below which was published in 2009, only 11% of recommendations in ACC/AHA clinical practice guidelines were based on level A evidence, and 48% were based on level C. In valvular heart disease guidelines, 71% of clinical recommendations were based on evidence level C. In other words, a high percentage of recommendations for clinical practice in cardiology were based on expert opinion with no conclusive evidence.

http://jama.jamanetwork.com/article....ticleid=183453

Hopefully things have improved since this review was published. It remains a mystery why so many people seem to consider such issues a problem only in psychiatry.
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Old 13th September 2016, 12:49 PM   #339
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Quote:
It remains a mystery why so many people seem to consider such issues a problem only in psychiatry.
There is no mystery. We know a lot more about the physiology and functioning of the cardiovascular system than we do about the brain.
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Old 13th September 2016, 01:46 PM   #340
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Originally Posted by Perpetual Student View Post
There is no mystery. We know a lot more about the physiology and functioning of the cardiovascular system than we do about the brain.
Wouldn't that suggest that it's a BIGGER problem with cardiology? I mean, if we know so much more about the physiology and functioning of the cardiovascular system, shouldn't significantly more than 29% of the recommendations be based on some sort of hard evidence?

If we know so much less about the brain, wouldn't we expect a commensurately lower proportion of recommendations to still be in the hypothetical stage?
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Old 13th September 2016, 02:34 PM   #341
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Originally Posted by Perpetual Student View Post
I don't know how much of an appreciation most people have that the science that underlies psychiatry is relatively weak, when compared to cardiology, for example. Does anyone else think this is a problem?
This is not a problem when the probable alternative is to not treat patents with psychiatric disorders. A counter-example: there are cancers with "unnecessary, ineffective or dangerous therapies and drugs" and yet patients are treated with these therapies and drugs because there are better outcomes than without treatment.

Or to put it another way - it is not a problem, it is an opportunity to expand the science that underlies psychiatry and produce more effective therapies and drugs.
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Old 13th September 2016, 02:38 PM   #342
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Originally Posted by Emily's Cat View Post
Wouldn't that suggest that it's a BIGGER problem with cardiology? I mean, if we know so much more about the physiology and functioning of the cardiovascular system, shouldn't significantly more than 29% of the recommendations be based on some sort of hard evidence?

If we know so much less about the brain, wouldn't we expect a commensurately lower proportion of recommendations to still be in the hypothetical stage?
No, it simply means that even the level C evidence for cardiology is on a firmer foundation than for psychiatry.
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Old 13th September 2016, 02:40 PM   #343
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Originally Posted by SashatheMagnificent View Post
Why are you so confrontational?
I pointed out fact that your sources were not good so that you can learn that they were not good
  • YouTube videos are not scientific literature.
  • One persons opinion is not scientific literature (Dr Thomas Szasz).
  • A Wikipedia link not about the fallacy that "mental illness is an illness with an organic basis" is not helpful.
    Mental illness is not considered an "illness with an organic basis, say, same as pneumonia or cancer".

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Old 13th September 2016, 02:40 PM   #344
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Originally Posted by Perpetual Student View Post
No, it simply means that even the level C evidence for cardiology is on a firmer foundation than for psychiatry.
How do you reach that conclusion?
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Old 13th September 2016, 02:42 PM   #345
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Originally Posted by Reality Check View Post
I pointed out fact that your sources were not good so that you can learn that they were not good
  • YouTube videos are not scientific literature.
  • One persons opinion is not scientific literature (Dr Thomas Szasz).
  • A Wikipedia link not about the fallacy that "mental illness is an illness with an organic basis" is not helpful.
    Mental illness is not considered an "illness with an organic basis, say, same as pneumonia or cancer".
tbf, you do come across as pretty confrontational though. It has more to do with your style than the content.
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Old 13th September 2016, 03:05 PM   #346
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Originally Posted by Emily's Cat View Post
How do you reach that conclusion?
Simply because we understand in great detail the function of the heart, vascular system, the lungs, the kidneys, etc. Much of the basic chemistry and detailed structure of these organs are very well understood and a plethora of therapies have been extremely well tested and have a solid scientific foundation. New drugs and treatments are usually based on large solid double blind studies.
The same cannot be said of psychiatry -- not even close!
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Old 13th September 2016, 03:13 PM   #347
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Originally Posted by The Atheist View Post
I don't know how authoritative NPR is, but they seem to be agreeing with you
Depression Treatment Often Doesn't Go To Those Most In Need is not really about Perpetual Student's post.

The article is about the difficulty of "aligning depression care with patient needs" for all primary health providers. A couple of surveys showed that 29% of the people who suggested that they were depressed did not receive treatment. There is a link with income levels, insurance, race and ethnicity. There is a tendency for people with less serious distress or no depression to receive antidepressants but studies show that their effects are placebo effects in mild cases.

The study being reported on is Treatment of Adult Depression in the United States
Quote:
Importance Despite recent increased use of antidepressants in the United States, concerns persist that many adults with depression do not receive treatment, whereas others receive treatments that do not match their level of illness severity.

Objective To characterize the treatment of adult depression in the United States.
...
Conclusions and Relevance Most US adults who screen positive for depression did not receive treatment for depression, whereas most who were treated did not screen positive. In light of these findings, it is important to strengthen efforts to align depression care with each patientís clinical needs.
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Old 13th September 2016, 03:20 PM   #348
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Originally Posted by Reality Check View Post
This is not a problem when the probable alternative is to not treat patents with psychiatric disorders. A counter-example: there are cancers with "unnecessary, ineffective or dangerous therapies and drugs" and yet patients are treated with these therapies and drugs because there are better outcomes than without treatment.

Or to put it another way - it is not a problem, it is an opportunity to expand the science that underlies psychiatry and produce more effective therapies and drugs.
I cannot agree with that conclusion. A diagnosis of cancer is almost always accurate and usually a death sentence. A combination of surgery, radiation and chemotherapy keeps patients alive -- sometimes for decades. The side effects of these therapies can sometimes be severe -- so it is up to the patient to reject or accept therapy.
A diagnosis of a psychiatric problem can often be inaccurate and even unwarranted. Patients are often not in a position to evaluate recommended therapies.
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Old 13th September 2016, 03:38 PM   #349
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I question the ADHD diagnosis and whether it's beneficial to medicate children but I also believe this has to be done on a case by case basis. More severe forms of mental illness are hard to miss and they do warrant medication if the person is a danger to others or to themselves.
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Old 13th September 2016, 04:18 PM   #350
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Originally Posted by Perpetual Student View Post
Simply because we understand in great detail the function of the heart, vascular system, the lungs, the kidneys, etc. Much of the basic chemistry and detailed structure of these organs are very well understood and a plethora of therapies have been extremely well tested and have a solid scientific foundation. New drugs and treatments are usually based on large solid double blind studies.
The same cannot be said of psychiatry -- not even close!
So, your opinion? So far as I know the only statistics given are for Cardiac stuff. You've simply assumed that the numbers for Psychiatry must be significantly worse?
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Old 13th September 2016, 04:31 PM   #351
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Originally Posted by Perpetual Student View Post
Simply because we understand in great detail the function of the heart, vascular system, the lungs, the kidneys, etc. Much of the basic chemistry and detailed structure of these organs are very well understood and a plethora of therapies have been extremely well tested and have a solid scientific foundation. New drugs and treatments are usually based on large solid double blind studies.
The same cannot be said of psychiatry -- not even close!
That's not true according to the NIH.

http://www.nimh.nih.gov/health/trials/index.shtml
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Old 13th September 2016, 04:45 PM   #352
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Originally Posted by Jodie View Post
That's not true according to the NIH.

http://www.nimh.nih.gov/health/trials/index.shtml
This is a general description of clinical trials. Could you be more specific?
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Old 13th September 2016, 04:47 PM   #353
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Originally Posted by Emily's Cat View Post
So, your opinion? So far as I know the only statistics given are for Cardiac stuff. You've simply assumed that the numbers for Psychiatry must be significantly worse?
No, I have looked at many studies. They are indeed worse. The studies are typically much smaller. The conclusions are more subjective and the results and efficacy of therapies are less tangible.
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Old 13th September 2016, 05:06 PM   #354
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Originally Posted by Perpetual Student View Post
This is a general description of clinical trials. Could you be more specific?
There are thousands of drug trials for psychiatric medications if you go to the NIH website and search. I linked you their criteria which is no different than any other criteria for other types of drugs that are tested before they are marketed. If you want something specific, name a psych med and I'll see what I can find.
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Old 13th September 2016, 09:50 PM   #355
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Originally Posted by Jodie View Post
There are thousands of drug trials for psychiatric medications if you go to the NIH website and search. I linked you their criteria which is no different than any other criteria for other types of drugs that are tested before they are marketed. If you want something specific, name a psych med and I'll see what I can find.
I doubt that there are thousands of such trials; however, there is no need. My comment:
Quote:
The same cannot be said of psychiatry -- not even close!
referred to the whole paragraph, not only the last sentence of my post.
In any case, my own casual familiarity with drug trials is that the trials for physchiatric drugs are generally smaller, include shorter timeframes, and are less rigorous regarding the criteria for efficacy.
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Old 13th September 2016, 10:46 PM   #356
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Originally Posted by Reality Check View Post
One persons opinion is not scientific literature
You must be kidding me

He served for most of his career as professor of psychiatry at the State University of New York Upstate Medical University in Syracuse, New York.[4] A distinguished lifetime fellow of the American Psychiatric Association and a life member of the American Psychoanalytic Association, he was best known as a social critic of the moral and scientific foundations of psychiatry, as what he saw as the social control aims of medicine in modern society, as well as scientism. His books The Myth of Mental Illness (1961) and The Manufacture of Madness (1970) set out some of the arguments most associated with him.

Notable awards the Award for Greatest Public Service Benefiting the Disadvantaged (1974),[2] the Martin Buber Award (1974), the Humanist Laureate Award (1995), the Great Lake Association of Clinical Medicine Patients' Rights Advocate Award (1995), the American Psychological Association Rollo May Award (1998)[3]

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Old 14th September 2016, 06:12 AM   #357
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Originally Posted by Emily's Cat View Post
Wouldn't that suggest that it's a BIGGER problem with cardiology? I mean, if we know so much more about the physiology and functioning of the cardiovascular system, shouldn't significantly more than 29% of the recommendations be based on some sort of hard evidence?

If we know so much less about the brain, wouldn't we expect a commensurately lower proportion of recommendations to still be in the hypothetical stage?
That depends on what one defines as a problem. By the standards being presented all medical care is pretty much a failure and not worth bothering with. Or we need to start not letting perfect be the enemy of good.
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Old 14th September 2016, 06:17 AM   #358
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Originally Posted by SashatheMagnificent View Post
You must be kidding me

He served for most of his career as professor of psychiatry at the State University of New York Upstate Medical University in Syracuse, New York.[4] A distinguished lifetime fellow of the American Psychiatric Association and a life member of the American Psychoanalytic Association, he was best known as a social critic of the moral and scientific foundations of psychiatry, as what he saw as the social control aims of medicine in modern society, as well as scientism. His books The Myth of Mental Illness (1961) and The Manufacture of Madness (1970) set out some of the arguments most associated with him.

Notable awards the Award for Greatest Public Service Benefiting the Disadvantaged (1974),[2] the Martin Buber Award (1974), the Humanist Laureate Award (1995), the Great Lake Association of Clinical Medicine Patients' Rights Advocate Award (1995), the American Psychological Association Rollo May Award (1998)[3]
And Dr Oz is a well respected surgeon that is why you know homeopathy really works or he wouldn't cover it on his show.
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Old 14th September 2016, 08:54 AM   #359
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Originally Posted by SashatheMagnificent View Post
You must be kidding me

He served for most of his career as professor of psychiatry at the State University of New York Upstate Medical University in Syracuse, New York.[4] A distinguished lifetime fellow of the American Psychiatric Association and a life member of the American Psychoanalytic Association, he was best known as a social critic of the moral and scientific foundations of psychiatry, as what he saw as the social control aims of medicine in modern society, as well as scientism. His books The Myth of Mental Illness (1961) and The Manufacture of Madness (1970) set out some of the arguments most associated with him.

Notable awards the Award for Greatest Public Service Benefiting the Disadvantaged (1974),[2] the Martin Buber Award (1974), the Humanist Laureate Award (1995), the Great Lake Association of Clinical Medicine Patients' Rights Advocate Award (1995), the American Psychological Association Rollo May Award (1998)[3]
That still doesn't mean he is right:
https://www.google.com/search?q=fred...mental+illness
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Old 14th September 2016, 08:57 AM   #360
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Originally Posted by ponderingturtle View Post
That depends on what one defines as a problem. By the standards being presented all medical care is pretty much a failure and not worth bothering with. Or we need to start not letting perfect be the enemy of good.
I can't quite tell if you're disagreeing with my position, supporting my position, or simply throwing in an additional perspective at right angles.

I'm not very good at implied meaning and subtext
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