Thursday, February 25, 2010

On Psychiatry

While I spent most of my last post defending the medical establishment from ill-conceived and ignorant accusations, this defense doesn't mean that I believe that modern medicine is perfect or that there aren't very serious criticisms which can be addressed towards it. I just generally prefer for the criticisms to be valid ones.

In the general spirit of appreciating such criticism, I would like to point out two very good lay-level articles on the topic which I recently came across. The first, a Newsweek piece, focuses on the issue of antidepressant drugs and the criticisms of Doctors Irving Kirsch and Guy Sapirstein towards this particular branch of psychiatry.

Of course, like any lay-level introduction to a scientific issue, it must also cover many of the myriad interconnecting issues and debates which characterize the discussion... and it does a truly spectacular job. It manages to cover publication bias, the difference between statistical and clinical significance (in one particular application), the ethical confusion surrounding antidepressant use, the distinction between exogenic and endogenic depression, and many other issues in a way that should be easily accessible to a lay audience.

The second article, from the New Yorker, covers a number of the criticisms that have been leveled against psychiatry as a whole... and on the history thereof. It's an excellent, excellent read, and one which I highly recommend.

Between the two articles, however, two things are highly worthy of note, especially in the context of Mr. Sequenzia's comments:
  1. Most of the people cited in the articles as making these criticisms are highly respected professors and major parts of the "establishment". Unlike Dr. (Andrew) Wakefield, however, they have decided to follow the rules of science in making those criticisms and have not horrifically violated the established standards of research ethics.
  2. Many of the criticisms raised in the context of depression within the New Yorker piece can be applied just as easily to autism... or many of the other diagnoses within the DSM.
Keep that last point in mind when you read the second article.

No comments:

Post a Comment