psychiatry

Hits of the week: Savage Minds (with a spiffy website redesign) asks Why is there no Anthropology Journalism? Jerry Coyne takes sharp exception to both a paper and a SciAm Mind Matters article by Paul Andrews and Andy Thomson arguing that depression might be an evolutionary adaptation. Dr. Pangloss punches back. (NB: 1. I was founding editor of Mind Matters, but no longer edit it, did not edit the Andrews/Thomson piece, and don't know any of these people. 2. While my recent Atlantic article presented an argument for how a gene associated with depression (the so-called SERT gene) might be…
Neuroskeptic ponders the growing evidence that antidepressants significantly best placebo only in the more (or most) depressed patients. His take is that: antidepressants treat classical clinical depression, of the kind that psychiatrists in 1960 would have recognized. This is the kind of depression that they were originally used for, after all, because the first antidepressants arrived in 1953, and modern antidepressants like Prozac target the same neurotransmitter systems. Yet in recent years "clinical depression" has become a much broader term. Many peopleattribute this to marketing on…
I've been mulling this over for a few days, finally deciding to write about it.  There was an article in the NYT on 13 January 2010 about an NEJM article: href="http://www.nytimes.com/2010/01/14/health/research/14morphine.html"> href="http://www.nytimes.com/2010/01/14/health/research/14morphine.html">Morphine May Help Traumatic Stress By BENEDICT CAREY Published: January 13, 2010 Doctors have long hoped to discover a "morning-after pill" to blunt the often disabling emotional fallout from traumatic experiences. Now it appears that they have had one on hand all along: morphine...In…
Those of us who watch the drug development pipeline have been pining for a nonaddictive anti-anxiety drug.  Occasionally there are glimmers of hope.  One candidate is href="http://en.wikipedia.org/wiki/Emapunil">emapunil, aka XBD-173 or AC-5216.  In 2004, there was an article in the British Journal of Pharmacology about this.  That article described promising findings, in rats and mice.  Now, there is an article in Science that finally show some findings in humans. href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1575165/">Antianxiety and antidepressant-like effects of AC-5216, a…
'Twas the month of orchidness. I had a spotty month posting in December, as book bidness and then the holidays massacred blog production, but got some good traffic despite. The leaders: 1. Are "orchid kids" the same as "gifted children"? was my blog reaction to Lisa Belkin's' blog reaction at the Times to my Atlantic piece, "The Orchid Children." The short answer to the question was No. See the post for why that doesn't quite cover it. 2. Coming sort of soon to a bookstore near you: "The Orchid and the Dandelion" announced my deal to do a book on the orchid or 'sensitivity' hypothesis. But…
 A nice short piece on "The Prehistory of Stress" by Matt Ford at Ars Technica (newly designed site worth checking out). I have heard people say, on multiple occasions, that they think stress is a modern, Western phenomenon. While the psychological phenomenon known as stress has only had a formal name for just over 80 years, knowing when it was first suffered by our ancestors is a daunting task. Was life really better in the past? Is stress an entirely modern phenomenon? Using modern forensic technology and a decidedly modern understanding of biochemistry, researchers from The University of…
I couldn't resist that title, but I must admit it isn't mine; the author's post is href="http://pasadenasubrosa.typepad.com/pasadena_sub_rosa/2009/12/let-them-eat-antipsychotics.html">here.  This is about the NYT article about the finding that children on Medicaid are more likely to be prescribed antipsychotic medication, compared to those with private insurance.  The obvious correlation is that children with Medicaid are from poor families, whereas those with private insurance are from families that have more resources.  It is one of those studies that documents an evocative finding…
Over at the Times Magazine Motherlode blog, Lisa Belkin ran a short post about my Atlantic "Orchid Children" piece a couple days ago, and some of the responses she got strike to an issue that has come up quite a few other places. I posted a note on this at Motherlode, and wanted to expand on it a bit here as well. This is the first what may be several posts of the "FAQ" sort examining reader or blogger concerns. In this case, the concern dominating the Motherlode commenter thread responses, and in a few other places as well, is whether the "Orchid Children" of my title are what many people…
1. Maybe it was just the headline ... but the runaway winner was "No pity party, no macho man." Psychologist Dave Grossman on surviving killing. Actually I think it was the remarkable photo, which looks like a painting. Check it out. 2. I'm not vulnerable, just especially plastic. Risk genes, environment, and evolution, in the Atlantic. The blog post about the article that led to the book. 3. Senator Asks Pentagon To Review Antidepressants 4. Gorgeous thing of the day: Sky's-eye view of the Maldives & other islands 5. The Weird History of Vaccine Adjuvants, even though it was from Oct 1…
This post is about a journal article that describes mortality rates in populations of persons with eating disorders.  It is sort of about that.  The article is in the APA green journal, which is not openly accessible.  Only the abstract is free.  Usually I don't write about closed-access articles.  But this is different, because I am not going to do a traditional post about a peer-reviewed article.  You don't need to have access to the whole article to get the point. href="http://ajp.psychiatryonline.org/cgi/content/abstract/166/12/1342">Increased Mortality in Bulimia Nervosa and Other…
The title of this article is a little bit misleading, although not deliberately so.  The study examined the question of whether telephonic CBT - added to pharmacotherapy - was beneficial, in a primary care population.  Note that the primary care population is NOT the population that psychiatrists typically see.  Consequently, it is not possible to extrapolate these results to most typical psychiatrist's practices.  It also is not applicable to the population of persons seen in many outpatient offices of other mental health specialists. Telephone Psychotherapy Effective, Efficient in…
Ben Cardin, a Maryland Democrat, has asked the Pentagon for info on how many troops in war zones have been prescribed antidepressants while they were deployed. Cardin sent a letter Tuesday to US Department of Defense Secretary Robert Gates expressing concern about how antidepressants are being administered troops in Iraq and Afghanistan. Cardin wants to determine if the Defense Department is prescribing antidepressants appropriately and is concerned about any connection between the meds and suicide rates among troops. In October, for instance, 16 active-duty US soldiers killed themselves,…
The video interview above, with NIH primatologist Stephen Suomi, is embedded within a feature of mine that that appeared today at The Atlantic website -- and is in the December 2009 issue now shipping -- about a new hypothesis in behavioral genetics. This emerging hypothesis, which draws on substantial data, much of which has gone simply unnoticed or unremarked, I call the "orchid-gene hypothesis," for lack of a better name. Some of the researchers have other offerings. It's been around for several years but is now blooming as evidence accumulates. When I came across it at a conference this…
href="http://www.researchblogging.org"> src="http://www.researchblogging.org/public/citation_icons/rb2_large_gray.png" style="border: 0pt none ;">The article I am discussing in this post is the 2008 Heinz Lehmann Award paper, published in the open-access Canadian journal, Journal of Psychiatry & Neuroscience.  It really covers two topics: href="http://nihroadmap.nih.gov/clinicalresearch/overview-translational.asp">translational research, and antipsychotic polypharmacy in which one of the antipsychotic medications is clozapine.  href="http://nihroadmap.nih.gov/…
The standard wisdom in management of Major Depression, is that medication plus psychotherapy is better that either treatment alone.  Many studies have shown this.  But this one does not. href="http://archpsyc.ama-assn.org/cgi/content/short/66/11/1178?home">Cognitive Behavioral Analysis System of Psychotherapy and Brief Supportive Psychotherapy for Augmentation of Antidepressant Nonresponse in Chronic Depression The REVAMP Trial James H. Kocsis, MD; Alan J. Gelenberg, MD; Barbara O. Rothbaum, PhD; Daniel N. Klein, PhD; Madhukar H. Trivedi, MD; Rachel Manber, PhD; Martin B. Keller, MD;…
In 2007, the American Psychological Association commissioned their Task Force on Appropriate Therapeutic Responses to Sexual Orientation.  The background is this: early in the history of mental health treatment efforts, homosexuality was considered to be an illness.  Therefore, it was thought to be appropriate for therapists to try to change the sexual orientation of persons who are homosexual.  This attitude never was universal; it is said that even Sigmund Freud was skeptical of it.  Even so, it was not until 1962 that efforts began to remove homosexuality from the title="Diagnostic and…
This is from an open-access article in the Canadian Journal of Psychiatry: an article featuring a debate about the relevance of randomized, controlled trials to clinical practice.  It is mostly about research on psychotherapy, but with some treatment of psychopharmacology. href="http://publications.cpa-apc.org/browse/documents/468&xwm=true">Are Randomized Controlled Trials Relevant to Clinical Practice? Can J Psychiatry. 2009;54(9):637-643. Steven D Hollon, Bruce E Wampold There is no abstract.  Click on the title to go to the journal page, then click on the title there to download…
Notables from the last 24: Over at Gene Expression, Razib casts a skeptical eye on a study of the neuroanatomical variability of religiosity. The brain areas identified in this and the parallel fMRI studies are not unique to processing religion [the study states], but play major roles in social cognition. This implies that religious beliefs and behavior emerged not as sui generis evolutionary adaptations, but as an extension (some would say "by product") of social cognition and behavior. May be something to that, Razib says â but it would be nice "get in on the game of normal human…
At Gene Expression, Razib casts a skeptical eye on a study of the neuroanatomical variability of religiosity. The brain areas identified in this and the parallel fMRI studies are not unique to processing religion [the study states], but play major roles in social cognition. This implies that religious beliefs and behavior emerged not as sui generis evolutionary adaptations, but as an extension (some would say "by product") of social cognition and behavior. May be something to that, Razib says -- but it would be nice "get in on the game of normal human variation in religious orientation (as…
The new drug is called iloperidone; the brand name in the USA will be Fanapt.  It is yet another antipsychotic that blocks D2 and 5HT2 receptors.  Although there is no universally accepted way of classifying drugs into families, it will be referred to as an atypical or second-generation antipsychotic.  This designation will indicate a loose kind of similarity to risperidone, aripiperazole, ziprasidone, quetiapine, olanzapine, clozapine, and paliperidone.  It turns out that there is a Wikipedia page for href="http://en.wikipedia.org/wiki/Iloperidone">iloperidone.  It is not one of the…