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Hickey Blog: Lingering Doubts About Psychiatry’s Scientific Status

Firestormm

Senior Member
Messages
5,055
Location
Cornwall England
Behaviorism and Mental Health

An alternative perspective on mental disorders | PHILIP HICKEY, PH.D

Lingering Doubts About Psychiatry’s Scientific Status
26 June 2014

Professor Sir Simon Wessely is a British psychiatrist who works at the Institute of Psychiatry, King’s College, London. He is also the new President of the Royal College of Psychiatrists, and in that capacity, he recently wrote his first blog, titled, appropriately enough, My First Blog (May 24, 2014). The article is essentially a perusal of, and commentary on, the program for the RCP’s Annual Congress, about which Sir Simon expresses considerable enthusiasm. He also engages in a little cheerleading.

“…we [the RCP] are the most democratic of colleges. We welcome the views of patients and carers…”

This statement struck me as odd, because it’s not so long ago (December 20, 2013) that I read a post by British psychiatrist Joanna Moncrieff, Psychiatry has its head in the sand: Royal College of Psychiatrists rejects discussion of crucial research on antipsychotics. In this article, Dr. Moncrieff describes how she approached the RCP 2014 Conference planning committee, and asked that a symposium on “Re-evaluating antipsychotics – time to change practice” be included in the program. To her surprise, this proposal was rejected on the grounds that there were too many competing suggestions.

Dr. Moncrieff’s proposal was based on two ground-breaking studies (Ho, BC, Andreasen, NC, et al; and Wunderink L, et al.), both of which, at the very least, raise serious concerns about psychiatry’s current use of neuroleptic drugs. This certainly seems important, but in fairness to the RCP, perhaps there were topics of even greater moment, and Dr. Moncrieff’s suggestion simply couldn’t be accommodated.

Curious as to what these topics might be, I took a look at the conference schedule, and found a few entries that might conceivably have been nudged aside for Dr. Moncrieff’s proposed symposium. These include:

  • Developing your teaching portfolio
  • Succeeding as a new consultant
  • Leadership development for the jobbing psychiatrist – what we all need to know
  • Private practice
  • Advanced communication skills for public engagement
  • Making parity a reality
  • How to get into Academic Psychiatry
And just possibly:

  • Debate – Hamlet’s Ophelia: was it suicide?
Read more: http://www.behaviorismandmentalheal...g-doubts-about-psychiatrys-scientific-status/
 

biophile

Places I'd rather be.
Messages
8,977
Wessely said:
“we [the RCP] are the most democratic of colleges. We welcome the views of patients and carers”

“…psychiatry, like all branches of medicine…”

“We do not shy away from controversy…”

“[Attenders] will be left in no doubt about the prevalence and public health impact of the illnesses that lie at the heart of psychiatry.”

“…the endless fascination of psychiatry.”

“…the state of psychiatry is good.”

“…the importance of psychiatry in the modern health service.”

“Any lingering doubts that psychiatry is not scientific will hopefully be dispelled, since the science of psychiatry is on constant display from the start to the finish of the conference.”

I wish all that was actually true for ME/CFS and that Wessely's career wasn't partly built on a house of cards.
 

anciendaze

Senior Member
Messages
1,841
There were a number of papers written by the prominent psychiatrist Karl Menninger following the "Spanish flu" of 1918-1919. Some of these are about the dramatic increase in admissions to psychiatric hospitals around Boston following the epidemic. Others are follow-ups on the later course of the illness. We are not talking about ordinary depression here, which is well-known to follow viral illnesses, we are talking about psychoses like schizophrenia which required hospitalization during a time when support for psychiatric hospitalization was weak. He found that a significant percentage of those patients recovered completely enough to resume their previous lives. No treatment for psychoses available at that time would be considered effective today.

First question: do we have any current numbers for spontaneous recovery from psychoses without psychopharmacological treatment? How common is full recovery even with such treatment?

Menninger also reported temporary return to rational behavior in some schizophrenics who came down with influenza. Similar observations led to pyrotherapy, which is now considered discredited, though at one time it was Nobel Prize material. The only effective version of this treatment involved infection with malaria to cause an immune response which definitely could eliminate neurosyphilis, though the treatment was dangerous. Some patients with diagnoses of schizophrenia who tested positive for syphilis really do seem to have been cured of both illnesses at a time when antibiotics and antipsychotics were not available.

The common thread for these peculiar observations is immune response. A possible reason for the effects of influenza emerges in the activation of HERV W, as reported here.

Second question: How much current psychiatric research deals with immune response? Infectious disease? How much with HERVs?

The publications of Simon Wessely show considerable interest in criminal behavior, race, genetic or early developmental disorders, but don't show any strong interest in infectious disease or immunology, except in a negative sense. For example, consider this contribution to the literature.

This same individual was adamant that there could be no virus in CFS, and that treatment with ARVs or antivirals was wildly unethical. Cases where this has worked to change disease, though usually not cure it, were either ignored or ascribed to placebo effect. (And how do you compare psychiatric therapy to placebo effect?)

Perhaps someone with more emotional stamina will look through current psychiatric publications to see if psychiatrists are doing much of anything related to infectious diseases and immunology. The promising work I see originates outside their domain, and is scarcely mentioned in their journals.
 

shahida

Senior Member
Messages
120
This is an ongoing problem- the 'two sides' of scientific research and psychiatry don't 'talk' to one another or communicate constructively. So we constantly witness physical conditions like TB, MS now ME etc regarded as psychiatric. Surely unless we get such a constructive dialogue and maybe some kind of protocol between them in the future, nothing will improve. The likes of Wessely probably aren't invested in knowing other kinds of investigations/research.
 
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alex3619

Senior Member
Messages
13,810
Location
Logan, Queensland, Australia
“Any lingering doubts that psychiatry is not scientific will hopefully be dispelled, since the science of psychiatry is on constant display from the start to the finish of the conference.”

I can see it therefore its science ... interesting hypothesis.

Let me put on my armchair philosopher's hat, and run a few hypotheticals (counter-examples):

I can see clowns in the world. Is clowning a scientific practice? Let us add comedians, pranksters and cartoonists to this list. Suddenly satirical pictures are science?

How about astrology? I can see the stars. I can be shown astrological diagrams. People make their living at this. Suddenly its science?

So, what might they mean?

That they are open to criticism? Some are, some are making the criticism, but most are not interested. Is that science?

Do they use the trappings of science? Well, quite often, but so does most quackery.

Do they have studies they can cite based on objective evidence that cannot be interpreted some other way .... oooh, doubtful!

Are their studies testing their hypotheses, with clear criteria as to what would constitute a fail? Rarely from what I have seen. Its more like waffle and implication.

Let us take the argument that they are open to the input of patients and carers. Does that include ME advocates like me? I really doubt it. Some may be open to our criticisms, but not enough to matter. SW in particular is not open. Claiming one thing and doing another is .... ?