In the local paper, a geology professor defends his work.
I must respond to the recent letter to the editor by Ms. Meredith Berg strongly critical of my upcoming talk at the University of Wisconsin-River Falls on St. Croix Valley geology. … Ms. Berg is correct that I will not be spending time on a young-earth or Biblical flood model for the St. Croix Valley. In my 50 years of studying and doing geology here and around the world I have not seen a shred of geological evidence for this, and it would do my audience a disservice to spend time on it.
With his NIH colleague, Tibor Borsos, he wrote a book about complement.
Now immunologists at Cardiff University who study complement are under investigation for research fraud. Image manipulation, among other things.
UCLA’s Semel Institute for Neuroscience and Human Behavior‘s got all sorts of shit going down lately.
There’s Bystritsky, who’s front and center in the Phyllis Harvey lawsuit against that university.
And there’s Strober, a Ghost of Glaxo Past… (see post just under this one)…
On their main page, Semel invites you to PARTICIPATE IN OUR RESEARCH, but I get the feeling it’s not such a good idea.
… your university hospital is the most treacherous part of campus. There’s lots of money at stake, so corruption is highly likely. Conflict of interest among your professors may be rampant. There’s always someone on the staff stealing oxycontin to sell it. Some of your anesthesiologists are addicts.
Cowboys on the surgery team try this and that without bothering with the institutional review board. Since you don’t really pay attention to the doctors you allow to affiliate, some of them will turn out to run pill mills or, like UCLA’s Arnold Klein, will embarrass you in other ways.
You try to make the hospital a big profit center, but that almost never works. Meanwhile, as in this story from the University Medical Center Göttingen, some of your surgeons are managing to make it work quite nicely on a personal basis.
A surgeon identified as Dr. Aiman O. is suspected of fraudulently manipulating dozens of his patients’ test results, making them appear sicker than they were to get them liver transplants more quickly — and possibly putting them ahead of people who more desperately needed them. The case first emerged in late July at the University Medical Center Göttingen, in the northern German state of Lower Saxony, from where the senior physician has been suspended since November for allegedly tampering with some 23 transplant cases. A gastroenterologist suspected of involvement has also been suspended.
There’s huge money in this. Truly rich, truly desperate people will pay amazing sums for an organ, and all you have to do is shove aside other sick people who’ve been following the rules and waiting.
Whether it’s Joe Paterno at Penn State or Dr. J. Paul Muizelaar at University of California Davis, you really want to keep an eye on your overpaid and overlaureled personnel. Eventually the money and adulation will do to them what it does to pretty much everyone. It will make them believe their own publicity, and it will make them consider themselves free to do what they like, immune from consequences.
Immunity is Muizelaar’s medical speciality; he’s a research surgeon who tries to activate patients’ immune systems to fight cancers. Together with another faculty member, he’s been intrigued by the possibility that introducing bacteria into the heads of people with late-stage brain cancer might activate their immune system and in the process attack the disease.
Well and good; but these guys seem not to have felt the need to get institutional approval for this human experimentation. Of course, no problem getting the patients’ approval; they’re desperate. But precisely because people are desperate and therefore susceptible to dangerous and unproven procedures, you’ve got things like institutional review boards and all.
The guys are now banned from human research. Davis risks losing its federal research funding altogether.
The author of a new book about growing is interviewed.
[G]etting a mental-health diagnosis can intersect with the adolescent search for self. Being diagnosed and using medication confers an identity, that of someone with a mental disorder. To an adolescent who is preoccupied with constructing an identity anyway, and looking for clues to who she is, that can be a big deal. Some adolescents feel that having a diagnostic label is clarifying and that it helps them. But others wrestle with it. They ruminate about what it means to be sick. They take that identity deep inside, and sometimes magnify it way out of proportion. A diagnosis event can have lasting, rippling consequences, and I think adults should be very cautious and careful before they impose a diagnostic label, or let a young person self-impose such a label, on what may be ordinary developmental struggles.
But hey. That’s nothing. Because of the work of Joseph Biederman and others, it’s now routine for American toddlers to be given powerful psychotropics.
What? You mean thousands of people aren’t attracted to meetings featuring Charles Nemeroff and Alan Schatzberg?
Allen Frances goes on to say that “Psychiatric diagnosis has become too important to be left in the hands of a small, withering, cash-strapped, incompetent association that feels compelled to regard its bottom line as a higher priority than having a safe, scientifically sound, and widely accepted diagnostic system.”
Look at the Pope over there in Vatican City taking a star turn in What the Butler Saw as his city state fails to “shed its reputation as a scandal plagued tax haven.”
Look at the big happy family of University of Texas scientists who just went ahead and gave the family a huge state grant, without bothering to check with the provost or anything.
And look at another huge bureaucracy, the place UD‘s father spent his entire scientific career: the National Institutes of Health. The NIH just went ahead and gave America’s own tête d’affiche pour conflit d’intérêts (Charles Nemeroff has been called poster boy for conflict of interest so many times, I thought I’d jazz it up by putting it in French) another big grant, since you want to encourage his sort of behavior… or whatever…
I mean, it’s about bureaucracies, isn’t it? In all three cases? You’ve got cronies and histories of you do me and I do you and all… Everybody’s in everybody else’s pocket…
But eventually, as in all three of these cases, things get so brazen that the media notices; and then, if the money involved comes from taxpayers, politicians get all het up about it. As in this what the fuck? letter from Senator Charles Grassley to NIH. Grassley sends a copy to the notorious Donna Shalala.
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More coverage of the nettlesome Nemeroff.
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The latest University of Miami scandal jumps to the Miami Herald. Shalala and Nemeroff are trying out the no comment option, but I don’t think it’s going to work.
… Andrew Scull titles his latest essay in the Times Literary Supplement. It looks to be a good summary of the ongoing scandal of the next edition of the Diagnostic and Statistical Manual of Mental Disorders, but you and I can’t read it without a subscription. Here’s an excerpt (from a post about it in Commonweal):
As diagnostic criteria were loosened [in DSM III], an extraordinary expansion of the numbers of mentally sick individuals ensued. This has been particular evident among, but by no means confined to, the ranks of the young. “Juvenile biopolar disorder”, for example, increased forty-fold in just a decade, between 1994 and 2004. An autism epidemic broke out, as a formerly rare condition, seen in less than one in 500 children at the outset of the same decade, was found among one in every ninety children only ten years later. The story for hyperactivity, subsequently relabelled ADHD, is similar, with 10 per cent of male American children now taking pills daily for their “disease”. Among adults, one in every seventy-six Americans qualified for welfare payments based on mental disability by 2007.
If psychiatrists’ inability to agree among themselves on a diagnosis threatened to make them a laughing stock in the 1970s, the relabelling of a host of ordinary life events as psychiatric pathology now seems to promise more of the same. Social anxiety disorder, oppositional defiant disorder, school phobia, narcissistic and borderline personality disorders are apparently now to be joined by such things as pathological gambling, binge eating disorder, hypersexuality disorder, temper dysregulation disorder, mixed anxiety depressive disorder, minor neurocognitive disorder, and attenuated psychotic symptoms syndrome.
Yet we are almost as far removed as ever from understanding the etiological roots of major psychiatric disorders, let alone these more controversial diagnoses (which many people would argue do not belong in the medical arena in the first place). That these diagnoses provide lucrative new markets for psychopharmacology’s products raises questions in many minds about whether commercial concerns are illegitimately driving the expansion of the psychiatric universe – a concern that is scarcely allayed when one recalls that the great majority of the members of the DSM task force are recipients of drug company largesse.
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New pathologies are breaking out all the time.
There’s a whole other category for Kim Kardashian.
(UD thanks David.)
One quarter of you have already been flushed out and diagnosed!
The massive “naturalist’s field guide” that is the Diagnostic and Statistical Manual of Mental Disorders has already tagged and bagged you.
A most serious problem, common to field guides, is the difficulty of separating entities that are similar in appearance.
The new emphasis on symptoms… has unfortunately encouraged a cursory “top-down” method that relies on checklists and ignores much of the narrative of …patients’ lives.
You coo like a mourning dove. But maybe you’re not depressed!
[P]sychiatrists using the DSM diagnosis “major depression” tend to mingle bereaved patients with both those afflicted by classic melancholia and those demoralized by circumstances. The mixing of similar-appearing patients who have conditions that are distinct in nature probably explains why use of this diagnostic category expanded over time and suggests why the effectiveness of antidepressant medications given to people with a diagnosis of major depression has, of late, been questioned. This tendency to blur natural distinctions may explain why other DSM diagnoses — such as post-traumatic stress disorder (PTSD) and attention deficit disorder — have been overused, if not abused.
And don’t forget Hartz Mountain Industries.
[A] diagnostic category based on checklists can be promoted by industries or persons seeking to profit from marketing its recognition; indeed, pharmaceutical companies have notoriously promoted several DSM diagnoses in the categories of anxiety and depression.
… is the name UD‘s blogpal Allen Frances gives the tendency of the people at the American Psychiatric Association to toss every human behavior they can think of into the soon-to-be released update of the Diagnostic and Statistical Manual of Mental Disorders. The new DSM will guarantee every American man, woman, and child forty acres, a mule, and a diagnosis.
Everybody gets to be something: depressed, pre-psychotic… Everybody gets the same diagnostic-labeling start in life. The children of the very rich will no longer get diagnosed before those of the middle class; everyone starts out with ADD or executive functioning disorder or what have you, and parity is maintained throughout the subsequent years, with adolescent, young adult, middle-aged, and elderly diagnoses following each American all the days of her life. As Frances writes, this “radical expansion of the boundaries of psychiatry … will increase by tens of millions the number of people presumed to be suffering from mental disorders.”
The key is indeed diagnostic exuberance, or what others have called psychosprawl. The combination of a regularly updated official manual massively increasing our diagnosable behaviors, under-informed pill-happy primary physicians, and unremitting advertising, means a psychotropic harvest the likes of which this country has never seen. To picture it, replace the turkey in this woman’s hands with a steaming tureen of tricyclics.
“Is the American Psychiatric Association getting carried away?” as Christopher Lane asks, in an interview about the notorious DSM.
“The risk is that the drug companies will seize on the milder conditions [listed in the DSM] and hype and exaggerate them through very canny marketing to the point where they’re basically represented as an under-reported problem…. The thresholds are [regularly] lowered for these disorders… and consequently vast numbers of the public are suddenly eligible for a diagnosis that they wouldn’t have been before.”
He notes that if the current version of the DSM gets published, children as young as four will be eligible for powerful anti-psychotic drugs, and people still grieving the loss of someone after two weeks will also be eligible for a mentally disordered diagnosis and powerful drugs.
Next month, activists plan to stage an “Occupy the APA” protest in Philadelphia during the organization’s annual conference to show their disdain.
Happy face research articles get published; sad face perish. “Positive studies are exciting and potentially groundbreaking. Negative studies are not particularly exciting,” and tend not to get published in the scientific journals, a pediatrics professor explains in an editorial in one such journal.
Indeed, it’s difficult to get hold of the results of studies showing that this or that drug or class of drugs has no effect on a condition:
Current U.S. law requires that investigators submit a summary of the results of drug trials on ClinicalTrials.gov, a national registry of clinical studies. But often, researchers don’t submit their results, and the information is never published on the government website…
After all, the drug market has hundreds of millions of anti-depressant pills to sell, and, if you’re a researcher, you have a career to make.
Things only begin to get real when someone actually makes an effort to do a meta-analysis.
The Italian professor who led an experiment which initially appeared to challenge one of the fundaments of modern physics by showing particles moving faster than the speed of light, has resigned after the finding was overturned earlier this month.