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Monday, May 31, 2010

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Oh yes, better nosology is exactly what we need. It would make everything all better. Uh-huh.

I find this comical! That temper dysregulation DSM-5 proposal is just another way they will prescribe drugs to younger and younger children, and once they get to a certain age, they'll give them the dx they get now: Pediatric bipolar disorder. Conflicted, and paid by pharmaceutical companies, these people writing the new DSM5 will give the ticket for pharma to broaden the ability to add more psych meds to so many 'illnesses', it's disgusting.

I think it was Dan Carlat that called this process a 'bar room brawl' and I think he's right! though he is whining about Dulcan yelling at him at the APA.

Honestly, who needs to read summer junk novels when we have ALL OF THIS to read! pure entertainment, at the expense of our health!

God save us.

I quote the Alan Parsons Project:

"I don't care it's all psychobabble rap to me
Psychobabble all psychobabble
Psychobabble all psychobabble
I don't care it's all psychobabble rap to me"

My own experience as social worker of 35+ years is that the more a colleague tried to dazzle with their knowledge of therapeutic vocabulary, the more I saw a person who really didn't have a clue about working with people. Big words do not make bedside manner.

Thanks Dr. X

btw, what do you (Dr.X) and the above commenters think about Dr.Daniel Carlat stating the problem with psychiatry is that there is a shortage of psychiatrists, therefore the 100,000 psychologists should be enlisted to be able to rx drugs to those people who, he says do not get treatment due to the shortage of psychiatrists? (noting a theme of Carlat's being pharmaceuticals remain in the treatment paradigm) and his epiphany moment, when he finally decides to ask a 'depression treatment resistent' patient, "what's happening in your life?"


I haven't seen any psychology blogs respond to this yet.

Stephany,

Carlat believes that a merger between psychiatry and psychology will bring psychotherapy back into psychiatry. Because there is generally more money in prescribing medications, I fear that the same thing that happened to psychiatry will happen to psychology if psychologists gain prescription privilege. The field will gravitate further away from providing psychotherapy and in-depth assessment.

Dr. Schatzberg may have the wrong approach, but he may have a hold of a real problem. I'm not sure if better terminology would help, however.

There are plenty of disorders pooh-poohed by the denialists of the world, leaving the sufferers with far more difficulty getting treatment. As an ADHD senior, I spent the whole of my life from college onwards performing about half as effectively as I would have done with treatment. About 4.5% of adults are in the same boat, and only 10% of them are getting diagnosis and/or treatment.

I don't blame the Stephanies of the world for my wasted years (there was no "adult ADHD" to deny till the late 70s or so, by which time I had already failed to complete college and a few other programs) but their opinions, asserted in the absence of evidence or life experience, are not helpful.

Thanks, but I'd rather not be referenced as "the stephanies of the world".

ADHD is already in the DSM, and what my point (and other's) is, are the new multi-faceted definitions that will expand from there, so that basically someone wearing spandex on a summer day could be labeled as "Fashion-ill-equipped NOS" and receive an anti depressant for it.

I happen to have an adult child who was mis dx w the Childhood bipolar disorder a decade ago, who consequently became brain injured and disabled to to over medications, and is currently in care of others being rehabilitated to be able to learn how to do laundry, and things again, that after at one time being an Honor Society student and author of a paper based on Teenagers and non-violent protests per Ghandi.

So, the "Stephanys" of this world, are people who advocate for the safety of drug use in children, (not drugging children) and transparency of the drug companies and the KOL's who research the drugs, often paid by the company they research the data for, example: Shire and Biederman for ADHD...consequently, Biederman was investigated for non-disclosure of money from drug companys in the millions$ by Grassley.

I'm not against people taking drugs, do what you want. I'm also just for the record not a Scientologist.

I'm a mental health advocate and mother, of 3 grown children, 2 college grads and one injured by pharmaceuticals. My voice is for her and others like her, she isn't alone in this damage.

Dr.X--that's how I feel about the crossover of psychologists having an rx pad, because certainly some ppl choose to see a psychologist to avoid the psych med paradigm in the psychiatry world.

Stephany, my apologies in letting my buttons get pushed. You definitely have a plate full, and I was wrong to make assumptions.

Yes, we do need to keep the drug companies in line -- I was startled a few years ago to discover my 8 year old nephew was being treated with an antipsychotic (Haloperidol if I recall correctly.)

But I wonder, if we were able to put the overtreated in one bowl of a set of scales, and the under- or un-treated in the other, which way the scales would tip? I meet regularly with a support group, and in several cases it took them years (as adults) before they could get diagnosed, much less treated. It took me roughly 4 years to get into treatment. The scoffers are still out there in force and they do a lot of damage.

Noni

Thanks for responding. I am shocked at Haldol being used in an 8 yr old, as well as any other antipsychotic--and the alarming facts now, is that Abilify and Seroquel are basically being marketed as antidepressants, when in fact they are neuroleptics. This is the problem I can see with a broad definition (and many new definitions of 'mental illness' in the new DSM5; is that people will go on these drugs for something quite benign, not knowing what the drugs are, and often have withdrawals or side effects that are permanent.

I suppose I would now advise people to seek help via non-medication based therapy, and make an informed decision to take any psych med.

That's another issue all on its own, is informed consent.

For interest, read Robert Whitaker's new book, "Anatomy of an Epidemic", it might shed light on someo of your questions, regarding over-dx, over-medication, and how some patients end up in the system for life, on the tax payers dollar. My daughter is in fact on Medicaid and in a state funded facility. The fallout, honestly goes into very many directions for discussion.

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