MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'american psychiatric association'. Sat, 03 Sep 2011 02:30:52 +0100 http://www.medworm.com/index.php?rid=5107891&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FGVab88opJB4%2F The ongoing controversy over ghostwriting appears to be accelerating amid ongoing disclosures that various papers - and in one case, a book - were allegedly written or largely crafted by paid editors who were not credited. The issue has even generated debate about the definition of ghostwriting, but meanwhile, has embroiled various drugmakers, universities and high-profile academics in scandal. To find a solution, a growing number of proposals are popping up (read this). One pair of academics - Jonathan Leo, a professor at the DeBusk College of Osteopathic Medicine at Lincoln Memorial University, and Jeff Lacasse a professor at the Center for Applied Behavioral Health Policy at Arizona State University - have just published a paper in Society in which they suggest that all authors should b... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=5107891 Tue, 09 Aug 2011 13:42:15 +0100 5107891 http://www.medworm.com/index.php?rid=4992755&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F07%2F02%2Fhow-the-dsm-developed-what-you-might-not-know%2F The Diagnostic and Statistical Manual of Mental Disorders (DSM) is widely known as the bible of psychiatry and psychology. But not many people know how this powerful and influential book came to be. Here’s a brief look at the DSM’s evolution and where we are today. The Need for Classification The origins of the DSM date back to 1840 — when the government wanted to collect data on mental illness. The term “idiocy/insanity” appeared in that year’s census. Forty years later, the census expanded to feature these seven categories: “mania, melancholia, monomania, paresis, dementia, dipsomania and epilepsy.” But there was still a need to gather uniform stats across mental hospitals. In 1917, the Bureau of the Census embraced a publication called the Statistical Manual for ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4992755 Sat, 02 Jul 2011 10:43:12 +0100 4992755 http://www.medworm.com/index.php?rid=4968489&cid=t_134004_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffda-approved-drugs-are-not-always-effective-the-benefits-of-alternative-medicine%2F2011.06.25 On Saturday, while thousands of Boston Bruins fans gathered at Government Center to celebrate the team’s recent Stanley Cup victory, a hundred or so true die-hards met a few blocks away at a Massachusetts General Hospital conference to talk about complementary and alternative medicine for psychiatric disorders. While I hated to miss the Bruins parade, I’m glad I attended the MGH conference. I’ve always been a bit of a skeptic about so-called natural therapies for one simple reason: they don’t have to go through the same rigorous testing in clinical trials that medications do. At the same time, I realize that FDA-approved drugs don’t work for everyone. One in three adults with major depression, for example, can’t completely improve their mood and other symptoms even after trying... Better Health blogs http://www.medworm.com/rss/comments.php?id=4968489 Sat, 25 Jun 2011 21:00:31 +0100 4968489 http://www.medworm.com/index.php?rid=4704956&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FPhLfP23_6gY%2F File this under The Case of The Missing Book. When last seen, Scientific Therapeutics Information was at the center of an ongoing controversy over an allegedly ghostwritten book - yes, an entire book - that was published in 1999 by the American Psychiatric Association. Funding came from a grant provided by SmithKline Beecham, which is now part of GlaxoSmithKline (back story). The listed co-authors were Charles Nemeroff, who chairs the psychiatry department at the University of Miami medical school, and Alan Schatzberg, who until recently chaired the psychiatry department at the Stanford University School of Medicine. Both men were at the center of a long-running probe by the US Senate Finance Committee into undisclosed conflicts of interest among academic researchers. They were also regul... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4704956 Tue, 12 Apr 2011 12:13:27 +0100 4704956 http://www.medworm.com/index.php?rid=4704589&cid=t_134004_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Fthem-or-your-lying-eyes.html …THEM OR YOUR LYING EYES? A few days ago I discussed stonewalling by the American Psychiatric Association over charges that they were partners in a ghostwritten textbook. The issue resonated with many people, including Daniel Carlat, John Nardo, the POGO blog, Alison Bass, Ed Silverman, and others. The APA has not seen its way clear to releasing key documents that might clear up the charges. By stonewalling, the APA just does more damage to its image and credibility. They come across as uninterested in transparency, and they appear to be fighting a rearguard action to defend the indefensible. What kind of key documents could the APA have released? In our letter last January we suggested several, including the contract involving the American Psychiatric Press, the medical communications c... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4704589 Tue, 12 Apr 2011 04:18:00 +0100 4704589 http://www.medworm.com/index.php?rid=4676731&cid=t_134004_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F04%2Fwho-you-gonna-believe.html WHO YOU GONNA BELIEVE? Ghostwriting Charges and Stonewalling at the American Psychiatric Association The American Psychiatric Association came under a searchlight this past December over allegations of ghostwriting. The story originated with a public letter from Project on Government Oversight (POGO) to the Director of NIH, and it was picked up by Duff Wilson writing in the New York Times. The book was Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care. The named authors were Charles Nemeroff, now chairman of psychiatry at the University of Miami, and Alan Schatzberg, formerly chairman of psychiatry at Stanford University. Both are well known for ethical controversy – see here and here. Soon, these allegations were being dissected in the bl... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4676731 Tue, 05 Apr 2011 04:44:00 +0100 4676731 http://www.medworm.com/index.php?rid=4429059&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F02%2F02%2Fdoes-schizophrenia-need-a-new-name%2F I was very nervous when my editorial about schizophrenia — there we go, a word I ought not to be using — appeared Open Access online in the December 2010 Journal of Mental Health (published by Informa Healthcare, New York). It contains personal details which it is not customary to reveal. Having got over that I had more anxiety when the printed journal was delayed by a month for unknown reasons. Now that it’s out I am calm again. Why should I not be using the ‘S’ word? What’s in a name? The answer is that it has acquired a stigma in the course of a hundred years owing to the small minority of people with our condition who are violent and attack or kill other people. Furthermore, according to Jim van Os, a professor of psychiatry at Maastricht University in the Neth... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4429059 Wed, 02 Feb 2011 11:13:17 +0100 4429059 http://www.medworm.com/index.php?rid=4394529&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F24%2Fects-final-days%2F We may be witnessing electroconvulsive therapy’s final days. This week, a U.S. Food and Drug Administration (FDA) panel will review whether there’s enough evidence to downgrade electroconvulsive therapy (ECT) devices into the Class II medical device category — that is, a medical device that carries only “medium risk.” Like a syringe. That’s right, a device that can send electricity directly into your brain is being considered to be placed in the same medical device category as a syringe. And guess who doesn’t mind that reclassification? Why, the American Psychiatric Association, of course — they are right on board with this re-classification (PDF). Currently ECT devices are classified as Class III devices — high risk. Yet they have neve... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4394529 Mon, 24 Jan 2011 18:30:56 +0100 4394529 http://www.medworm.com/index.php?rid=4355718&cid=t_134004_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpsychiatric-diagnosis-and-the-dsm-5-controversy%2F2011.01.16 I’ve followed in bits and pieces — sometimes for Shrink Rap, sometimes because the issues fill my email inbox, sometimes because there’s no escape. Oh, and lots of the players have familiar names. In the December 27th issue of Wired magazine, Gary Greenberg writes a comprehensive article on the debates around the revision of the American Psychiatric Association’s (APA) upcoming revision of the Diagnostic and Statistical Manual (DSM) entitled “Inside the Battle to Define Mental Illness.” Do read it. Here’s an excerpt: I recently asked a former president of the APA how he used the DSM in his daily work. He told me his secretary had just asked him for a diagnosis on a patient he’d been seeing for a couple of months so that she could bill the insur... Better Health blogs http://www.medworm.com/rss/comments.php?id=4355718 Sun, 16 Jan 2011 17:00:00 +0100 4355718 http://www.medworm.com/index.php?rid=4302886&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F01%2Fpsych-central-by-the-numbers-2010%2F In October 2010, according to comScore Media Metrix, Psych Central had 820,000 unique U.S. visitors to the site, and in November 2010, we had 933,000 visitors. That puts us in the top 50 most-visited of all health websites on the Internet today — a first for us! Combined with our international audience, Google Analytics tells us we reach over 1.5 million unique visitors each and every month. Astounding, considering our humble beginnings of indexing other psychology and mental health resources online 15 years ago. To put this in some context, more people visit Psych Central every month than any one of these sites: The American Cancer Society The American Psychological Association and the American Psychiatric Association combined The American Medical Association The American Diab... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4302886 Sat, 01 Jan 2011 23:00:52 +0100 4302886 http://www.medworm.com/index.php?rid=4225252&cid=t_134004_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fprison-overcrowding-does-it-affect-mental-health%2F2010.12.02 In California, the U.S. district court has ordered that tens of thousands of prisoners be released to reduce overcrowding. The case, Schwarzenegger v. Plata, was argued this past Tuesday and the transcript is online. This is relevant to a psychiatry blog because one of the arguments used in support of the releases is the contention that overcrowded facilities reduce access to mental health and medical services and that overcrowding causes mental deterioration and breakdown. The APA filed an amicus brief in the case, but the brief isn’t available online yet. (Keep an eye out for it here.) The challenge with this case is that there is no (or extremely little) actual research to support the link between overcrowding and psychological problems. Correctional systems have spent a lot of ti... Better Health blogs http://www.medworm.com/rss/comments.php?id=4225252 Thu, 02 Dec 2010 23:00:00 +0100 4225252 http://www.medworm.com/index.php?rid=3907642&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F08%2F26%2Fthe-transition-year-an-interview-with-courtney-knowles%2F Earlier this year, The Jed Foundation and the American Psychiatric Foundation launched one of the newest mental health resources on the Web, The Transition Year. Recently, I was able to talk with Courtney Knowles, the Executive Director of The Jed Foundation, to get the skinny on this one-stop shop and why its contents are so beneficial for both students and parents before, during, and even after the college years. There’s a never-ending line at the bookstore. Posters announcing football schedules and Greek rush events are posted every couple of feet. Meal cards are being swiped every few minutes and music is blasting down the hall from the room where two longtime roommates are, once again, haggling over who’s in charge of buying the toilet paper. Yep, it’s that time of year again: ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3907642 Thu, 26 Aug 2010 12:36:42 +0100 3907642 http://www.medworm.com/index.php?rid=3665926&cid=t_134004_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F06%2Finsel-and-nemeroff-what-sanctions.html INSEL and NEMEROFF – WHAT SANCTIONS?Thomas Insel, Director of NIMH, has another posting in his own defense on his official blog today. He has been widely criticized lately for the appearance of cronyism in his relationship with Charles Nemeroff. For the past three months, Insel has been trying to put some distance between himself and Nemeroff, but the public isn’t buying it. I have called his statements disingenuous here and here. Dr. Insel’s statements today are equally disingenuous. Negative reactions are already appearing from those familiar with Nemeroff’s history.There is no argument that Nemeroff was instrumental in Insel’s move to Emory in 1994, that Nemeroff was Insel’s department chairman at Emory, that Nemeroff helped Insel again when Insel’s initial term as directo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3665926 Wed, 16 Jun 2010 04:30:00 +0100 3665926 http://www.medworm.com/index.php?rid=3659155&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F8fG5oNlG4M0%2F Under scrutiny for relationships with drugmakers, the American Psychiatric Association has issued its long-awaited code of conduct, although specifics are lacking. For now, the APA says financial relationships between developers of continuing medical education programs and research activity and outside organizations must be “clearly stated;” APA educational programs must follow ACCME standards (see this) and advertising in APA publications, meetings, or websites does not include endorsements of any particular medicine or drugmaker. More than some other specialties, psychiatry has been singled out as part of a US Senate Finance Committee probe into financial conflicts of interest among academic psychiatrists who accept federal funding while simultaneously maintaining relationshi... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3659155 Mon, 14 Jun 2010 13:28:28 +0100 3659155 http://www.medworm.com/index.php?rid=3635862&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F06%2F07%2Fdsm-5-sleep-disorders-overhaul%2F The DSM-5 Sleep Disorders workgroup has been especially busy. They are calling for a nearly complete overhaul of the sleep disorders category in the Diagnostic and Statistical Manual of Mental Disorders (“DSM”). According to a presentation at the annual meeting of the American Psychiatric Association in May, Charles Reynolds, MD, suggested that the reworking of this category will make sleep problems easier for professionals to diagnose and discriminate between different sleep disorders. He stated that the current DSM-IV puts too much emphasis on presumed causes of symptoms, something that the rest of the DSM-IV does not do. Bringing the sleep disorder section more in line with the other sections in the DSM should make it less confusing. Primary and commonly diagnosed sleep diso... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3635862 Mon, 07 Jun 2010 09:35:07 +0100 3635862 http://www.medworm.com/index.php?rid=3621774&cid=t_134004_109_f&fid=38951&url=http%3A%2F%2Fcarlatpsychiatry.blogspot.com%2F2010%2F06%2Frosenberg-covers-apa-meeting.html I enjoyed Chicago journalist Martha Rosenberg's take on the APA meeting in New Orleans, which you can read at Scoop Independent News. Although Rosenberg is obviously a partisan, her coverage is entertaining and brimming with telling little details.For example, she found it ironic that after all of the damning press on Charles Nemeroff's undisclosed conflicts of interests with pharmaceutical companies (which led him to resign his chairmanship at Emory), where should he show up? In the same hallowed location where Mina Dulcan became apoplectic toward me--namely, the book-signing dias at the American Psychiatric Press.To quote Rosenberg: "Nemeroff was signing the Textbook of Psychopharmacology which he co-edited with Schatzberg, also investigated by Congress. Schatzberg, psychiatry chairman a... The Carlat Psychiatry Blog blogs http://www.medworm.com/rss/comments.php?id=3621774 Tue, 01 Jun 2010 20:39:00 +0100 3621774 http://www.medworm.com/index.php?rid=3611938&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F30%2Fyou-do-make-a-difference-in-the-dsm-5%2F Good news — you can make a difference! According to a presentation at the annual meeting of the American Psychiatric Association last week, the 8,600 comments submitted in response to the draft of the new version of the Diagnostic and Statistical Manual for Mental Disorders (called the “DSM-5″ for short — the 5 stands for the 5th edition of the book) helped spur changes in the draft. To me, this kind of change demonstrates a fundamental shift in the ability to engage in a meaningful scientific/clinical dialogue. Twenty years ago, there was no easy feedback mechanism for a project of this scale. Back then, significant time and resources would be needed in order to get legitimate and critical feedback (e.g., setting up focus groups in multiple geographic locations, ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3611938 Sun, 30 May 2010 12:55:55 +0100 3611938 http://www.medworm.com/index.php?rid=3607597&cid=t_134004_109_f&fid=38951&url=http%3A%2F%2Fcarlatpsychiatry.blogspot.com%2F2010%2F05%2Fhot-city-empty-exhibit-hall-and-stern.html The annual meeting of the American Psychiatric Association was held in New Orleans this past week. The weather was hot (in the mid-90s) though the meeting was somewhat tepid and under-attended.The exhibition hall in particular had an empty and echoey feel that I had not seen in years past. I talked to one exhibitor, my friend Dr. David Robinson, the prolific author of several books and the owner of Rapid Cycler Press, who told me that ever since the drug companies had stopped giving out free gifts, the attendance at exhibit halls was down. “In the past, they used to line up before the hall opened in the morning. No more.” This is not terribly good news for the publishers, but on the other hand publishing is undergoing unrelated and much more far-reaching changes with the advent of e-bo... The Carlat Psychiatry Blog blogs http://www.medworm.com/rss/comments.php?id=3607597 Fri, 28 May 2010 10:53:00 +0100 3607597 http://www.medworm.com/index.php?rid=3603651&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F27%2Fdo-you-think-you-smell-olfactory-reference-syndrome%2F Do you think you smell? Well, if we assume for a moment that you actually don’t smell or emit some sort of stinky odor, you’re like most people. In this modern world where many don’t think twice about showering each and every day, our bodies often have little chance to work up any kind of odor. However, if you’re amongst a small group of people who think they smell even when they don’t, then you might be suffering from Olfactory Reference Syndrome. Olfactory Reference Syndrome is a “new” syndrome coined by researchers who’ve discovered that amongst people who think they smell bad — even when they don’t — suicidal thinking and behavior is rampant. And it’s no wonder — if you think you smell bad and others are not... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3603651 Thu, 27 May 2010 13:37:40 +0100 3603651 http://www.medworm.com/index.php?rid=3603652&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F26%2Femail-not-that-effective-with-college-depression%2F I’m always on the lookout for how technology can better help people with mental health issues. But some uses of technology leave me scratching my head. Take, for instance, this one: If you email a depression assessment quiz to college students, some will take it. Some of those who take it will have depression. Those are the astounding findings from a research study presented the other day at the annual meeting of the American Psychiatric Association. But few of the students who received the email at four different colleges bothered taking the quiz — only 691 students — suggesting that it remains an ineffective way of reaching students (except those who may already believe they have or may be at risk for depression). Worse yet, the email quiz did nothing to encourage stude... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3603652 Wed, 26 May 2010 16:35:24 +0100 3603652 http://www.medworm.com/index.php?rid=3573753&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F18%2Fblogging-for-mental-health-and-psychology-2010%2F The [American Psychological Association's] Your Mind, Your Body “Mental Health Month” Blog Party represents the aim of APA’s bloggers to bring mental health writing to the web. We love that the American Psychological Association (APA) has decided to designate today as some sort of “blog party” to increase mental health awareness, but their press release and related marketing materials on this “blog party” make it pretty clear they don’t have a clue. I’ve never seen bloggers “organized” through a press release before. First of all, it kind of sounds like the APA doesn’t believe there’s any mental health writing on the web. Of course, nothing could be further from the truth… Mental health writing has been on... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3573753 Tue, 18 May 2010 15:00:02 +0100 3573753 http://www.medworm.com/index.php?rid=3404140&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FY7R5qT0ZpKI%2F Two essays published in separate periodicals this week raise troubling questions about the extent to which psychiatrists may be unduly influenced by the pharmaceutical industry, and how this relationship may effect public trust in psychiatry. The upshot? The concern about corruption, or at least the appearance of corruption is palpable. Sigmund Freud (see photo) would not be pleased. Interestingly, one of the authors if Tom Insel, the director of the National Institute of Mental Health (click on read more below). For instance, Lisa Cosgrove and Harold Bursztajn write in Psychiatric Times that they looked at the two philanthropic arms of the American Psychiatric Association - the American Psychiatric Foundation and the American Psychiatric Institute for Research and Education - and found th... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3404140 Thu, 25 Mar 2010 16:23:54 +0100 3404140 http://www.medworm.com/index.php?rid=3266986&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F02%2F11%2Fa-review-of-the-dsm-5-draft%2F The new DSM-5 draft is out (and it appears the APA is finally dropping the silly roman numeral designations). Analysis is starting to pour in from around the country about the ramifications of the new diagnoses and proposed changes. To start with, however, I want to congratulate the American Psychiatric Association for reaching this milestone and embracing the ability for the public to comment on the proposed changes. We first called for such an option back in December of last year and it appears somebody at the APA was listening. Kudos for being willing to take the barrage of criticism that is coming your way, APA. However, we wish it was an open commentary model, where the comments appears online for all to read (it appears to be a closed model, where your comments disappear into cybers... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3266986 Thu, 11 Feb 2010 21:22:23 +0100 3266986 http://www.medworm.com/index.php?rid=3259027&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F02%2F09%2Fa-look-at-the-dsm-v-draft%2F Tomorrow will mark the release of the first public draft of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition — also known as the DSM-V. (As you can see, we have an exclusive first-copy of it to the right!) Because we were not on the American Psychiatric Association’s media list, we didn’t receive a copy of the news releases that the mainstream media will be basing a lot of their stories around that will be published tomorrow. We also weren’t invited to the conference call today, despite our repeated attempts to contact the APA’s media office. This turns out to be good news for our readers. I’m free to talk about what I suspect will be in the draft that appears on the dsmv.org website tomorrow. I gathered this information from num... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3259027 Tue, 09 Feb 2010 23:55:57 +0100 3259027 http://www.medworm.com/index.php?rid=3096902&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F12%2F17%2Fdsm-v-suggestions-for-change%2F With the recent announcement (PDF) by the American Psychiatric Association of a one year delay for the latest revision of the Diagnostic and Statistical Manual of Mental Disorders (the DSM, as it’s known), a new round of commentary and articles have appeared questioning the usefulness of the DSM. The DSM is used by clinicians in the mental health field to diagnose mental disorders according to the symptom lists contained in the book. The DSM is also used by researchers to ensure that when one researcher is talking about treatments for “major depression,” another researcher will use the same definition for “major depression.” I’m no defender of the DSM revision process, as previous blog entries have noted. But I’ve noticed that sometimes the criti... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3096902 Thu, 17 Dec 2009 13:09:35 +0100 3096902 http://www.medworm.com/index.php?rid=2963154&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F11%2F05%2Fbye-bye-aspergers-syndrome%2F Is the diagnosis of Asperger’s Syndrome — a mild form of autism mostly diagnosed in boys — heading the way of the dodo bird? A new article in the New York Times suggests that the new revision of the diagnostic manual — the DSM-V — is likely to do away with the diagnosis. How can you just delete an entire diagnosis and do away with a diagnostic label that hundreds of thousands of clinicians use everyday and millions identify with? If you’re the American Psychiatric Association, the folks behind the latest DSM revision, you can pretty much do anything you want. Before I get to Asperger’s, I have to note what’s really cringe-worthy in this article — how it completely misrepresents how mental disorders are diagnosed in practice today. Take... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2963154 Thu, 05 Nov 2009 10:29:03 +0100 2963154 http://www.medworm.com/index.php?rid=2678683&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F08%2F07%2Fdsm-v-update-and-transparency%2F Discussion: Is the Risk Syndrome for Psychosis Risky Business?”, this describes in detail the proposal for a new disorder called “Risk Syndrome for Psychosis.” You can access the proposed criteria for the disorder, including the text discussing characteristics, associated features, differential diagnosis, etc…. So far, there are 23 comments posted, constituting a rigorous debate about the pros and cons of the proposal. Whether or not 23 comments constitutes a “rigorous debate” anywhere, I’d point out of the seven work group members featured at the top of this article, only two of them bothered to engage in this live discussion. What’s that say about their interests in engaging in actual, legitimate scholarly discussion? (On a side note, if y... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2678683 Fri, 07 Aug 2009 12:42:50 +0100 2678683 http://www.medworm.com/index.php?rid=2786009&cid=t_134004_109_f&fid=38951&url=http%3A%2F%2Fcarlatpsychiatry.blogspot.com%2F2009%2F08%2Fnew-bbc-program-rewriting-psychiatrists.html Several months ago, a BBC producer contacted me to ask if I'd like to be interviewed for a planned radio program examining the DSM and related topics, such as the relationship between the drug industry and the American Psychiatric Association. Being the shameless self-promoter that I am, I assented, and that program is now available on the BBC website.Aside from listening to me ramble on about things that you've read about in this blog, you'll hear some very thought-provoking interviews of Michael First, the editor of DSM-IV, Lisa Cosgrove, the U Mass professor who published this influential article about the industry ties of members of DSM committees, Peter Tyrer, a professor at Imperial College in London who talks about the validity problems in DSM disorders, David Kupfer, chair of the D... The Carlat Psychiatry Blog blogs http://www.medworm.com/rss/comments.php?id=2786009 Thu, 06 Aug 2009 12:57:00 +0100 2786009 http://www.medworm.com/index.php?rid=2786011&cid=t_134004_109_f&fid=38951&url=http%3A%2F%2Fcarlatpsychiatry.blogspot.com%2F2009%2F08%2Fdsm-v-transparency-case-study.html Discussion: Is the Risk Syndrome for Psychosis Risky Business?", this describes in detail the proposal for a new disorder called "Risk Syndrome for Psychosis." You can access the proposed criteria for the disorder, including the text discussing characteristics, associated features, differential diagnosis, etc.... So far, there are 23 comments posted, constituting a rigorous debate about the pros and cons of the proposal.At this point, the diagnosis may or may not make it into DSM-V. It really depends on whether there is strong enough research indicating that treatment of early forms of psychosis can head off the later development of schizophrenia. My understanding is that the research is unconvincing, but I'm willing to defer to these specialists, who clearly know a lot more about psychosi... The Carlat Psychiatry Blog blogs http://www.medworm.com/rss/comments.php?id=2786011 Tue, 04 Aug 2009 16:34:00 +0100 2786011 http://www.medworm.com/index.php?rid=2517273&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F06%2F25%2Ftransparency-kupfer-and-the-dsm-v%2F Why is the new revision of Diagnostic and Statistical Manual of Mental Disorders (the “DSM-V”) — the reference book used to diagnose mental disorders in the U.S. — being updated in secrecy? That’s a legitimate question, and one asked by the previous head of the other modern DSM revisions (III, III-R and IV), Dr. Allen Frances in an upcoming Psychiatric Times article: The secretiveness of the DSM-V process is extremely puzzling. In my entire experience working on DSM-III, DSM-III-R, and DSM-IV, nothing ever came up that even remotely had to be hidden from anyone. There is everything to gain and absolutely nothing to lose from having a totally open process… You’d have to ask Dr. David Kupfer, the head of the DSM-V revision process, or the American Psy... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2517273 Thu, 25 Jun 2009 16:05:02 +0100 2517273 http://www.medworm.com/index.php?rid=2473573&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F06%2F11%2Fwomens-mental-health-hit-hard-by-recession%2F Many thanks to Molly McVoy, M.D. of the American Psychiatric Association who forwarded me a new survey recently released by the American Psychiatric Association regarding the negative affect of the economy on women’s mental health. You can read the survey results by clicking here. Some highlights: More than two-thirds (68%) of women feel the current economic crisis has had a negative impact on them and their families. More than half (55%) said the current problems with the economy have had a negative impact on their mental health. Despite the negative impact on their mental well-being, most of the women prioritized others’ needs and other responsibilities over their own mental and physical health. Although 76 percent of women polled say they are participating in more positi... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2473573 Thu, 11 Jun 2009 12:56:50 +0100 2473573 http://www.medworm.com/index.php?rid=2441692&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F05%2F26%2Fupdate-dsm-v-major-changes%2F At the American Psychiatric Association’s annual meeting last week, a presentation covered some of the likely major changes that will be incorporated into the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders, commonly referred to as the DSM by mental health professionals. The DSM provides professionals with the symptom checklists that allow for a mental disorder diagnosis to be made. The most significant change proposed has to do with the inclusion of dimensional assessments for depression, anxiety, cognitive impairment and reality distortion that span across many major mental disorders. So a clinician might diagnose schizophrenia, but then also rate these four dimensions for the patient to characterize the schizophrenia in a more detailed and descriptive m... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2441692 Tue, 26 May 2009 18:41:05 +0100 2441692 http://www.medworm.com/index.php?rid=1871104&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F416746621%2F For the past several months, the US Senate Finance Committee has been investigating undisclosed conflicts of interest involving academic researchers who receive NIH grants and pharma funding. At issue is whether universities are fulfilling their requirements to adequately monitor these disclosures in an effort to maintain scientific integrity and objectivity (back story here, here, here, here and here. Nature Medicine spoke with Chuck Grassley, the ranking Republican on the committee, about the probe. This is an excerpt… Nature Medicine:What are you hoping to accomplish? Grassley: NIH gives $24 billion worth of grants…The law requires the universities to have their researchers report outside income. We found out the law wasn’t being followed. The universities were not doi... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1871104 Fri, 10 Oct 2008 12:23:26 +0100 1871104 http://www.medworm.com/index.php?rid=1779677&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F386878184%2F Two months ago, the US Senate Finance Committee widened its probe into conflicts of interest involving drugmakers and federally funded academic researchers to include the American Psychiatric Association, since many of the academics already being investigated happen to be psychiatrists (back story). Among those probed are Brown University’s Martin Keller, Harvard University’s Joe Biederman, Stanford University’s Alan Schatzberg and the University of Cincinnati’s Melissa DelBello. Psychiatrists, of course, prescribe antidepressants and antipsychotics, both of which have stirred controversy. And psychiatrists have frequently shown up at the top of lists of doctors receiving pharma money. Today, the APA sent a letter to Chuck Grassley, the ranking Republican on the co... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1779677 Mon, 08 Sep 2008 18:00:00 +0100 1779677 http://www.medworm.com/index.php?rid=1779680&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F386609971%2F For the first time since Stanford University last month reassigned his National Institutes of Health grant to another principal investigator (look here), the chair of the school’s psychiatry department is responding to the episode, which actually began earlier this year when the US Senate Finance Committee named him as an example of federally funded academics with conflicts of interest. You may recall that Schatzberg, who is also president-elect of the American Psychiatric Association, owns about $6 million in stock in Corcept Therapeutics, which is studying the development of mifepristone for treating psychotic depression. He is also a co-patent holder for the drug and he received an NIH grant to oversee the research. Stanford insisted he had no role in dealing with patients or anal... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1779680 Mon, 08 Sep 2008 11:50:15 +0100 1779680 http://www.medworm.com/index.php?rid=1655670&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F345833615%2F The ranking Republican on the Senate Finance Committee wants the National Institutes of Health to revoke grants to academic scientists who fail to report financial conflicts of interest to their institutions, the Iowa Senator tells The Chronicle of Higher Education. His remarks come after targeting Harvard University, Stanford University and the University of Cincinnati, because some academics underreported their own financial interests in research projects supported by the NIH. Institutions are required by federal regulation to report the existence of those conflicts to the agency. Grassley is seeking info from 20 other institutions about financial conflicts among their scientists, including Brown University’s Martin Keller, and the American Psychiatric Association. Since 1995, an N... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1655670 Fri, 25 Jul 2008 17:01:05 +0100 1655670 http://www.medworm.com/index.php?rid=1618035&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F07%2F13%2Famerican-psychiatric-association-under-scrutiny%2F Last night I watched Good Night, And Good Luck, a compelling drama about Edward R. Murrow’s out-on-a-ledge decision to ask questions about Joe McCarthy. Joe McCarthy, if you remember your U.S. history, was the junior senator from Wisconsin who somehow managed to get himself appointed to lead a Senate committee investigating the spread of Communism in the U.S. It led to the infamous McCarthy hearings, where innuendo and hearsay were all the evidence needed to convict people in the media. It was a chilling reminder that government can sometimes turn a legitimate investigation into corruption or scandal and simply take it one step too far. As we now fight our “war on terrorism,” U.S. citizens are reminded of this every time government imposes another restriction on its peop... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1618035 Sun, 13 Jul 2008 11:52:32 +0100 1618035 http://www.medworm.com/index.php?rid=1616429&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F333128131%2F The investigation by the Senate Finance Committee, where Chuck Grassley is the ranking Republican, into the ties between drugmakers and medicine is expanding. After targeting grants issued to academic psychiatrists, Grassley now wants the American Psychiatric Association to open its books for a look-see at pharma funding. Psychiatrists, of course, prescribe antidepressants and antipsychotics, both of which have stirred controversy. And psychiatrists have frequently shown up at the top of lists of doctors receiving pharma money. This week, for instance, Vermont’s Attorney General released its annual report showing that, of the top 100 recipients, psychiatrists received the highest level of payments, and 11 psychiatrists received a total of about $626,000, or approximately 20 percent o... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1616429 Sun, 13 Jul 2008 02:42:39 +0100 1616429 http://www.medworm.com/index.php?rid=1432424&cid=t_134004_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F05%2F09%2Fdsm-vs-conflicts-of-interest%2F Earlier this week, the Boston Globe’s health blog dived into the issue of conflicts of interest for the latest mental disorder diagnostic manual being formulated. The diagnostic manual is known as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and a fifth version of it is currently in development. How a disorder makes it into the DSM — which is used by mental health professionals and insurance companies to legitimize and pay for a mental health concern — has been the subject of numerous research papers and essays. It is a messy process, like sausage-making, and involves a combination of expert testimony (often given by the same experts who lead a subcommittee on the specific disorder), research on the disorder, and, of course, a healthy dollop of politi... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1432424 Fri, 09 May 2008 15:27:43 +0100 1432424 http://www.medworm.com/index.php?rid=1420664&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F283936523%2F More than half the 28 new members of writers of the next edition of the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM) have ties to the drug industry, according to the Center for Science in the Public Interest’s Integrity in Science Watch. The conflicts of interests were posted online by the APA last week (look here). They ranged from small to extensive. Leading the pack was William Carpenter Jr., director of Maryland Psychiatric Research Center at the University of Maryland, who over the past last five years worked as a consultant for 13 drugmakers, including Pfizer, Lilly, Wyeth, Merck, Astra Zeneca, and Bristol-Myers Squibb, according to CSPI. APA president Carolyn B. Robinowitz claimed in a statement that “we have ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1420664 Mon, 05 May 2008 13:33:33 +0100 1420664 http://www.medworm.com/index.php?rid=1126436&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F209955350%2F Most of the 27 members of an American Psychiatric Association task force that is updating the psychiatrist’s bible - the Diagnostic and Statistical Manual of Mental Disorders, or DSM, have financial ties to pharma, and several failed to disclose significant aspects of their relationships when the panel was announced last July, according to a recent story in US News and World Report. The APA sought to pursue the “most transparent” policy possible, after the last edition of the DSM contained newly named disorders that were seized on by drugmakers and a 2006 study showed that more than half of the researchers who worked on that manual had at least one financial tie to pharma, the mag writes. But the summaries of the disclosure statements that were recently released to the pu... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=1126436 Wed, 02 Jan 2008 15:46:34 +0100 1126436 http://www.medworm.com/index.php?rid=1120708&cid=t_134004_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F12%2Fnew-dsm-task-force-members-ties-to.html The latest reminder of the pervasiveness of financial entanglements among physicians and medical researchers and health care corporations comes from a story in US News and World Report. The topic was how the American Psychiatric Association is attempting to make the development of the new edition of The Diagnostic and Statistical Manual of Mental Disorders the "most transparent" ever. The impetus behind the new transparency may have been criticism that the last edition was written by a group of authors heavily financially entangled with health care corporations (see post here, based on early reports of the results of this article: Cosgrove L, Krimsky S, Vijayaraghavan M et al. Financial ties between DSM-IV panel members and the pharmaceutical industry. Psychother Psychosom 2006; 75: 154-16... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1120708 Fri, 28 Dec 2007 16:32:00 +0100 1120708 http://www.medworm.com/index.php?rid=968445&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F173288742%2F Why? The Portsmouth, Va., school board sent a flyer to parents, warning them about the “harmful effects” of the drugs. Apparently, much of the info was taken from the Internet, including a web site run by a group funded by the Church of Scientology, according to The Virginian Pilot. A ruckus ensued - six national organizations and eight local groups sent a letter asking the school board to retract the flier and send a new one stating that ADHD is a disease that requires treatment. The groups include the American Academy of Child & Adolescent Psychiatry, the Virginia chapter of the American Academy of Pediatrics, and a local chapter of Children and Adults with Attention Deficit/Hyperactivity Disorder, or CHADD, which receives funding from pharma. The flier was sent “to in... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=968445 Mon, 22 Oct 2007 12:24:40 +0100 968445 http://www.medworm.com/index.php?rid=880357&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F158052073%2F Two weeks ago, the controversy over antidepressants and Black Box warnings for suicides re-emerged after yet another study in the American Journal of Psychiatry suggested that prescriptions fells due to the publicity given the issue three years ago. Then, CDC data was released showing a rise in suicide among youngsters in 2004 - before the warnings actually showed up on labeling. The American Psychiatric Association complains the warnings are scaring away docs and patients, some of whom may benefit from the meds. So what affect did those Black Box warnings have on antidepressant usage? We asked Medco, the big pharmacy benefits manager, to share annual scrip data and the trend is interesting… Scrips for male and female youngsters between 10 and 19 years old were rising between 2001 an... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=880357 Tue, 18 Sep 2007 12:47:02 +0100 880357 http://www.medworm.com/index.php?rid=850662&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F153453025%2F In the explosion of information yesterday surrounding the use of antidepressants, suicides and Black Box warnings, there was a little noticed item. The study in the American Journal of Psychiatry was authored by eight people, two of whom have rather noticeable conflicts of interest. The study, which received front-page treatment in The Washington Post, was co-authored by Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois at Chicago, who has served as an expert witness for Wyeth, the company that sells Effexor. And J. John Mann, a psychiatry professor at Columbia University, has received research support from Glaxo, which sells Paxil, and served as an adviser to Eli Lilly, which peddles Prozac and Cymbalta. How do we know? These competing interests wer... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=850662 Fri, 07 Sep 2007 13:42:19 +0100 850662 http://www.medworm.com/index.php?rid=847519&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F153058952%2F That’s the conclusion of yet another study in the American Journal of Psychiatry, which finds that teenage suicides rose 14 percent from 2003 to 2004, a year in which the debate that antidepressants actually cause suicide gained widespread publicity. (Here is the abstract). The data suggest that for every 20 percent decline in antidepressant use among patients of all ages in the United States, an additional 3,040 suicides per year would occur, Robert Gibbons, a professor of biostatistics and psychiatry at the University of Illinois at Chicago, who did the study, tells The Washington Post. Meanwhile, the CDC today released new data showing the suicide rate for 10- to-24-year-olds increased by 8 percent in 2004, the largest single-year rise in 15 years. The decline took place from 1990... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=847519 Thu, 06 Sep 2007 17:16:12 +0100 847519 http://www.medworm.com/index.php?rid=751829&cid=t_134004_150_f&fid=35777&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FPharmalot%2F%7E3%2F136616876%2F In a move that is likely to be closely scrutinized, the American Psychiatric Association today named its new task force for overseeing development of its 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-V. The DSM is the handbook used by psychiatrists and other mental health professionals to diagnose and classify mental disorders. The task force has 27 members, who rep scientists from psychiatry and other disciplines, clinical care providers, and consumer and family advocates. This task force, which will revise the DSM over the next five years, holds a great deal of sway, since their actions influence prescribing habits in the US and elsewhere. But it’s more than that. The DSM is where a condition is officially sanctioned as a disorder, which of course... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=751829 Mon, 23 Jul 2007 20:26:25 +0100 751829