The New York Times has run a piece about a historic turnabout in psychiatry: Most psychiatrists in the US do not offer talk therapy of any sort to their patients, but only medication. This will not come as news to most who are close to psychiatry or clinical psychology, but it is interesting that the main driving force behind this change is not an important shift in theory or evidence but, rather, simply cost.
Of the psychiatrist featured in the article, Donald Levin of Pennsylvania, the article says:
Dr. Levin, 68, first established a private practice in 1972, when talk therapy was in its heyday. Then, like many psychiatrists, he treated 50 to 60 patients in once- or twice-weekly talk-therapy sessions of 45 minutes each. Now, like many of his peers, he treats 1,200 people in mostly 15-minute visits for prescription adjustments that are sometimes months apart. Then, he knew his patients’ inner lives better than he knew his wife’s; now, he often cannot remember their names. Continue reading Psychiatrists Stop Talking→
The January issue of the widely read e-zine Wired has published an article about Allen Frances’ (pictured left) vocal opposition to the process by which the 5th edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disroders (DSM-5) is being written. There are, or course, many people who are discontented with the ways in which psychiatry goes about its professional business. What makes Frances’ critique so notable is not only that he is himself a psychiatrist, but that he was one of the editors of the last edition of the selfsame book, DSM-IV.
But Frances’ doubts go far beyond the 5th edition. They appear to extend to all of psychiatry, including his own participation in writing its most important and influential reference work. “There is no definition of a mental disorder. It’s bullshit,” he declares at one point. “We made mistakes that had terrible consequences,” he concedes at another. Continue reading DSM-IV Editor Says Psychiatry “Going Off a Cliff”→
Conan O’Brien has done a great take-off on pushy pharmaceutical ads, in commemoration of the $2.3 billion fine that Pfizer was recently made to pay for advertising its drugs for things they haven’t been shown to effectively treat.
It’s not quite as funny as The Onion‘s hilarious Despondex ad (which unfortunately forces you to watch a real ad first now), but it is along the same lines.
(Thanks to Mind Hacks for alerting me to the Conan piece.)
AP reports that the US Department of Justice has fined Big Pharma giant Pfizer a record amount for illegal promotions of a variety of their drugs, including the schizophrenia treatment Geodon and the popular antidepressant Zoloft.
Pfizer was cited for being a “repeating corporate cheat for illegal drug promotions that plied doctors with free golf, massages, and resort junkets.” Pfizer also openly marketed drugs for “off-label” usages — i.e., as treatments for which the drug had not been approved — which is contrary to US law.
Since this blog has often noted revelations of psychiatry’s conflicts of interest involving Big Pharma, it is only fair that we also report when psychiatry makes efforts to cut out some of the pork. According to Medical News Today,
The American Psychiatric Association Board of Trustees voted this month to phase out industry-supported symposia along with industry-supplied meals at its annual meetings. With this move, the APA remains at the leading edge of a trend throughout medicine to increase transparency and reduce potential financial conflicts of interest.
Of course, some don’t see this move in such glowing terms. As Mind Hacks put the matter last week: “The American Psychiatric Association starts to remove the drug company teat from its mouth.”