Doctors prescribing dangerous combinations of drugs.
Consuelo | 17.07.2013 17:17
Frances’s book is full of examples like this— of powerful antipsychotics given to 3, of doctors prescribing dangerous combinations of drugs at the hint of a disorder. His preferred approach upon encountering someone who might have a problem—“watchful waiting”—is antithetical to the current trend in psychiatry, where the automatic response to any perceived problem is to prescribe, prescribe, and prescribe some more.
But Saving Normal is about a bigger, broader story than simply blaming the drug companies and the media. Rather, the culprit here is a variety of interlocking factors. Complex systems lead to massive over-diagnosis. Take, for example, the sudden and recent “explosion” of ADHD among the nation’s youths. Frances lists six factors that contribute to the “epidemic”: Working changes in DSM-IV; heavy drug-company marketing to doctors and advertising to the general public; extensive media coverage; pressure from harried parents and teachers to control unruly children; extra time given on tests and extra school services for those with an ADHD diagnosis; and finally, the widespread misuse of prescription stimulants for general performance enhancement and recreation.
So while Frances does direct a fair amount of his ire at the drug companies, it’s not just about Big Pharma steamrolling everyone, effectively forcing drugs down their throat. Your kid is falling behind in school, so don’t you want to do anything you can to help? All your colleagues are prescribing their patients a drug that works wonders to promote concentration, so do you really want to be the only doctor in the building who isn’t a part of this exciting new pharmacological breakthrough? The current state of affairs rose up organically out of many individual decisions influenced by inadequate regulation and skewed incentives for the people who manufacture, advertise, and prescribe these drugs.
Frances, having been immersed in various psychiatric bureaucracies, has the eye for how multifaceted, interdependent systems function. But he is a better commentator than a reporter, and the reader gets the sense that he or she is in an airplane, and the captain keeps pointing out landmarks 40,000 feet down, only the most prominent features of which are visible. Frances rarely gets into specifics, but he does give some, well, prescriptions. He argues that it is a mistake to allow drug companies to advertise directly to consumers, which is not the norm in the developed world outside the U.S. But Congress and federal regulators aren’t ever likely to take up the issue, which would open up all sorts of constitutional issues. He also argues that the practice of diagnosing criminal suspects claiming to be mentally ill should be curbed except in the clearest cases. “Bad should usually trump mad,” he writes. But there’s a consensus among reform-minded observers of the criminal-justice system that offenders are dangerously under-treated for mental disorders.
America’s diagnosis is clear. We have convinced ourselves that we are a sick, troubled people, and the result has been endless, largely harmful prescription—and endless profits for the drug companies. The first step toward getting out of this mess is to understand just how many of our psychiatric maladies are pure fictions.
http://www.thedailybeast.com/articles/2013/06/21/america-s-epidemic-of-psychiatric-over-diagnosis.html « Return to news items
Related Posts * New Scientist—The diagnosis of mental illness needs its own therapy (0) * DSM: The Book of Woe—Inside the Battle to Define Mental Illness (2) * ABC News: DSM-5 Criticized for Financial Conflicts of Interest—70% of task force members have ties to Pharma (0) * Psychiatry bible ‘turns sorrow into sickness’ (0) * “Psychiatry’s ‘bible’ could roll out a whole new list of disorders—and more prescriptions for psychoactive drugs” (0)
The Citizens Commission on Human Rights (CCHR) is a nonprofit mental health watchdog, Inspired from the Works of L. Ron Hubbard, responsible for helping to enact more than 150 laws protecting individuals from abusive or coercive practices. See http://www.cchr.org/cchr-reports/child-drugging/introduction.html
But Saving Normal is about a bigger, broader story than simply blaming the drug companies and the media. Rather, the culprit here is a variety of interlocking factors. Complex systems lead to massive over-diagnosis. Take, for example, the sudden and recent “explosion” of ADHD among the nation’s youths. Frances lists six factors that contribute to the “epidemic”: Working changes in DSM-IV; heavy drug-company marketing to doctors and advertising to the general public; extensive media coverage; pressure from harried parents and teachers to control unruly children; extra time given on tests and extra school services for those with an ADHD diagnosis; and finally, the widespread misuse of prescription stimulants for general performance enhancement and recreation.
So while Frances does direct a fair amount of his ire at the drug companies, it’s not just about Big Pharma steamrolling everyone, effectively forcing drugs down their throat. Your kid is falling behind in school, so don’t you want to do anything you can to help? All your colleagues are prescribing their patients a drug that works wonders to promote concentration, so do you really want to be the only doctor in the building who isn’t a part of this exciting new pharmacological breakthrough? The current state of affairs rose up organically out of many individual decisions influenced by inadequate regulation and skewed incentives for the people who manufacture, advertise, and prescribe these drugs.
Frances, having been immersed in various psychiatric bureaucracies, has the eye for how multifaceted, interdependent systems function. But he is a better commentator than a reporter, and the reader gets the sense that he or she is in an airplane, and the captain keeps pointing out landmarks 40,000 feet down, only the most prominent features of which are visible. Frances rarely gets into specifics, but he does give some, well, prescriptions. He argues that it is a mistake to allow drug companies to advertise directly to consumers, which is not the norm in the developed world outside the U.S. But Congress and federal regulators aren’t ever likely to take up the issue, which would open up all sorts of constitutional issues. He also argues that the practice of diagnosing criminal suspects claiming to be mentally ill should be curbed except in the clearest cases. “Bad should usually trump mad,” he writes. But there’s a consensus among reform-minded observers of the criminal-justice system that offenders are dangerously under-treated for mental disorders.
America’s diagnosis is clear. We have convinced ourselves that we are a sick, troubled people, and the result has been endless, largely harmful prescription—and endless profits for the drug companies. The first step toward getting out of this mess is to understand just how many of our psychiatric maladies are pure fictions.
http://www.thedailybeast.com/articles/2013/06/21/america-s-epidemic-of-psychiatric-over-diagnosis.html « Return to news items Related Posts * New Scientist—The diagnosis of mental illness needs its own therapy (0) * DSM: The Book of Woe—Inside the Battle to Define Mental Illness (2) * ABC News: DSM-5 Criticized for Financial Conflicts of Interest—70% of task force members have ties to Pharma (0) * Psychiatry bible ‘turns sorrow into sickness’ (0) * “Psychiatry’s ‘bible’ could roll out a whole new list of disorders—and more prescriptions for psychoactive drugs” (0)
The Citizens Commission on Human Rights (CCHR) is a nonprofit mental health watchdog, Inspired from the Works of L. Ron Hubbard, responsible for helping to enact more than 150 laws protecting individuals from abusive or coercive practices. See
http://www.cchr.org/cchr-reports/child-drugging/introduction.html
Consuelo