Psychiatrists protest criticism from well-known physician

http://www.latimes.com/health/boostershots/la-heb-psychiatry-angell-20110805,0,1283292.story


Psychiatrists protest criticism from well-known physician

A doctor's book reviews have sparked a debate about how mental illness is diagnosed and treated.


By Shari Roan, Los Angeles Times / For the Booster Shots blog

August 5, 2011, 11:24 a.m.
Psychiatrists say two recent book reviews by Dr. Marcia Angell, the former editor of the New England Journal of Medicine and a Harvard lecturer, are inaccurate and misinformed.

The debate was set off when Angell, whose training is in internal medicine and pathology, wrote two book reviews in the New York Review of Books on June 23 and July 14. She reviewed several books that are critical of various aspects of psychiatric diagnosis and treatment and also evaluated work on the rewriting of the Diagnostic and Statistical Manual of Mental Disorders that is schedule for publication in 2013.

Angell's review supports the charges in several of the books that psychiatry is too reliant on medication, too wedded to the pharmaceutical industry and often over-diagnoses people and even mistreats young children diagnosed with mental disorders.

"In view of the risks and questionable long-term effectiveness of drugs, we need to do better," Angell admonishes in the July 14 essay.

In response the American Psychiatric Assn. submitted a rebuttal to Angell's essay, now online.

"We regret that a more balanced approach was not taken," the letter begins, adding that is incorrect to say that psychiatrists treat only with drugs and in a cavalier manner. "The bottom line is that these medications often relieve the patient's suffering, and this is why doctors prescribe them," APA leaders wrote.

Moreover, some of the issues raised by Angell, such as the influence of industry on medical practice, are not unique to psychiatry, said Dr. John Oldham, president of the APA, in a report Friday in Psychiatric News. "There's a lot of very bad distortion in for someone with her stature to be promoting."

relevant. There are a number of psychiatric conditions that are related to nutritional deficiencies that can be easily identified with urine/blood tests and remedied very easily with proper nutritional supplementation and/or dietary changes. Psychiatric drugs are all to often the first resort. Many psyciatric drugs have very harsh side effects and can cause the very symptoms they are supposed to be treating. The nutritional deficiency example is a problem not only in psychiatry but in the medical field in general. Studies have demonstrated that most physicians have received little or no education/training on these fundamentally important issues.

Psychiatric drugs are appropriate in certain cirumstances, but Dr. Angell is right: they are resorted to far too quickly.

Pharmaceutically "blissed-out" elders make lower demands on staffing, which helps control the bottom line and makes a "health" "care" resource look good on paper, that is until those same elders have to be admitted to hospitals to deal with conditions & situations that would have responded well to consistent, longitudinal, hands-on preventative attention.

"The bottom line is that these medications often relieve the patient's suffering"

Which means we can also say that often times they don't relieve the patient's suffering.

"Moreover, some of the issues raised by Angell, such as the influence of industry on medical practice, are not unique to psychiatry"

So, seeing how the rest of the medical industry does this it's O.K. that we do as well.

Having worked in the pharmaceutical industry for 5 years and having gotten to know some of the doctors and other people in the R&D end of the business they would often tell me that "We really don't know how some of these medications work but as long as we can provide some proof that they don't hurt people we are good to go."

People really need to do their own research on the medications they take and make their own decisions as to if the medications are appropriate for them to use.

a ton.

been or are receiving treatment for depression, anxiety, ADHD or some other mental illness.

Secondly, what is your level of expertise in this area.

Every time this issue comes up here on DU, people post their opinions as fact and most times they are not facts.

I see my psychiatrist tomorrow.

The true problem lies with internal medicine doctors trying to practice psychiatry.It's not their fault,really,since psychiatry isn't universally covered by insurance...and many of the younger patients don't HAVE insurance and try to get treatment through an ER,usually with no follow-up.Many of the nursing home patients are managed by a family practitioner, not a psychiatrist,when it comes to psychotropic meds.Pain management clinics are generally NOT staffed with a psychiatrist who deals with addiction.The psychiatrists in the VA are WAY overworked and,therefore,the soldiers and vets are prescribed mega-doses of psychiatric meds9by medicine doctors) when they need psychotherapy.

Funding for psychiatric counselling programs has been cut tremendously.The only psychiatric facillities in my(dallas) area are for-profit.That lets you know the option for uninsured psychiatric patients...the emergency room.