UD‘s pal Daniel Carlat links to news of a new depressant.

UD thanks David for the tip.

Wired magazine interviews Allen Frances, a retired Duke University psychiatry professor, and editor of the most recent edition [2000 – it’s currently being revised for a new edition] of the profoundly influential Diagnostic and Statistical Manual of Mental Disorders.

Frances has Post-Diagnostic Regret. He regrets the way his edition of the DSM has contributed to what Gary Greenberg, the article’s author, calls “absurdly high rates of diagnosis—by DSM criteria, epidemiologists have noted, a staggering 30 percent of Americans are mentally ill in any given year.” Francis regrets

having remained silent when, in the 1980s, he watched the pharmaceutical industry [America’s Fraud Queen] insinuate itself into the [American Psychiatric Association’s] training programs. [The APA produces the DSM.] (Annual drug company contributions to those programs reached as much as $3 million before the organization decided, in 2008, to phase out industry-supported education.)

The DSM’s vague and proliferating diagnoses have tended to “[create] … mental illness[es] where there previously [were] none, giving drugmakers… new target[s] for their hard sell and doctors, most of whom see it as part of their job to write prescriptions, more reason to medicate.”

As Greenberg notes, “[F]or all their confident pronouncements, psychiatrists can’t rigorously differentiate illness from everyday suffering.”

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After years of reading, thinking, and writing about the university on this blog, UD has concluded that no division of the modern American university has more potential to do harm to the social fabric than academic psychiatry. The most brutal sports program, the most cynical MBA program – these don’t begin to approach the power to harm that organized, respected, and, in some cases, morally compromised diagnosticians have.

… and very few doctors. This fact, reported by the Spokesman-Review, inspires some speculation in the comment thread – as to why.

Even if we build a medical school, why would those doctors want to stay in Idaho? We won’t adequately fund K-12 or college education for those doctors’ children, we won’t provide the kind of social services they can find in other states, and we’ve got religious and political zealots running the state government. What “cream of the crop” doctor would want to run a practice in Idaho?

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You know, you’re right. In fact, I’m surprised ANYONE can stand living in Idaho, when it’s full of inbred, toothless fascists running around, burning books, stealing from the poor and looting the environment so the entire state looks like a barren moonscape. This really is the worst place on Earth. If Obama only accomplishes one more thing during his term, maybe he could revoke Idaho’s statehood.

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Doctors move to cities for the economics and the lifestyle. Given the choice of 9-5 in a burb treating nice people vs pulling buckshot out of an Aryan’s bum at midnight, which would you choose?

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Buckshot out of an Aryan’s bum at midnight. There’s poetry in that.

… plies the steel
That questions the distempered part;
Beneath the bleeding hands we feel
The sharp compassion of the healer’s art
Resolving the enigma of the fever chart.

T.S. Eliot’s morbid poem says “The whole earth is our hospital.”

The wounded surgeon is the subject of a new study.

Surgeons “who practiced in an academic medical center” showed lower rates of suicidal ideation.

… Overdiagnosed: Making People Sick in the Pursuit of Health.

She’s reading it now, and will comment on it when she’s finished.

Drovers Cattle Network reports on a study just out of McGill University:

The Montreal Gazette reports a study by McGill University in Canada says the sight of meat has a calming effect on men, which could help make the upcoming holidays more jolly.

The results are the opposite of what McGill psychology department researcher Frank Kachanoff expected. He anticipated men would become more aggressive, falling back on their instincts like barbarians at the sight of dead animal flesh.

McGill said men associate meat with gatherings of family and friends and thus feel more comfortable when they see a plate of turkey, beef or ham. The study used 82 male subjects who were asked to inflict varying degrees of punishment on actors if they made errors while reading scripts. The subjects also sorted images while the actors read. The study found the subjects were less likely to inflict pain on the actors if they were sorting images of meat when a mistake was made.

According to Diane Fedorchak, director of the Brief Alcohol Screening and Intervention for College Students (BASICS), only a small minority, perhaps five percent of the [student] body, legitimately suffer from ADHD.

Do you think five percent of the students at the University of Massachusetts have ADHD? Do you think five percent – over a thousand students – is a “small minority”? And do you think a syndrome so vaguely formulated that anyone who wants drugs for it can fake it and get them has a solid empirical basis?

An article in the U Mass paper says what we all know: Tons of perfectly normal students get the drugs at the drop of a hat from their doctors at home, or from psychiatrists on campus.

[One] student answered a series of questions such as, “Do you have a hard time concentrating or focusing?” …The student said… yes to questions she felt would ensure she’d be diagnosed with ADD, regardless of [her not] having experience[d] the symptoms repeatedly, if at all. “I basically ‘experienced’ as many symptoms as I thought it would take to convince the doctor I was ADD,” she said.

Her psychiatrist claimed the “test” revealed that the student had nine of the nine signs of ADD; zero of the nine signs of hyperactivity. Her examination lasted less than half an hour before the psychiatrist wrote her a prescription.

It’s not a brilliantly written article, but I like the way the writer puts “test” in quotation marks; and I like the way her use of “claimed” makes the psychiatrist sound exactly like the huckster he is.

Everybody’s all het up because a bunch of Columbia University students sell illegal drugs. Whoop dee doo. Happens on every campus. No one – except a few student journalists – notices that in many cases university and non-university psychiatrists are also pushers. That seems to me a much more significant, much more interesting, story.

… some of America’s best schools of medicine in the last few years involves the painstaking, expensive training of doctors who almost immediately stop practicing and instead go for megabucks as investment managers. Why make half a million a year using the knowledge you’ve learned at Yale medical school to heal people, when you can make five million dollars a year doing trades and not get your hands dirty?

I mean, so what if you took a hotly contested seat in a Yale classroom — a seat hundreds of people actually dedicated to medicine tried to get and failed?

For instance: Chip Skowron, Yale MD and PhD, used a lot of taxpayer money to get himself all educated as a clinician/researcher and then said Fuck it. I’d rather be a hedgie.

Skowron put quite the spin on his decision in this 2003 Bloomberg article on doctors abandoning medicine for hedge funds:

Skowron said that during his residency, senior doctors complained about administrative burdens, declining pay and the strain of paying insurance premiums. “My current job allows me to look at the newest developments in oncology and to translate that into investment opportunities,” said Skowron, who manages health-care investments at Greenwich, Conn.-based FrontPoint Partners LLC, another hedge fund.

I guess I was little dim! Spent years and years in med school and grad school and it never occurred to me to discover the nature of the vocation for which I was training. Finally, in my residency, the horror of medical practice became apparent – the soullessness of paperwork, the growing impoverishment of physicians… I’ve gone from the meaninglessness, the shabbiness, of clinical medicine, to offering the world investment opportunities…

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But you know what they say: No opportunities without risks. Medicine may have its drawbacks, but so does trading.

When FrontPoint Partners came to light on Tuesday as the unnamed hedge fund that federal authorities said had traded on inside information from a French doctor, so did the name of another doctor: Chip Skowron.

FrontPoint said late Tuesday that it had placed Dr. Skowron on leave indefinitely. The firm’s announcement follows the arrest of Yves Benhamou, the French doctor accused of tipping off an unnamed fund manager about setbacks in a clinical drug trial by Human Genome Sciences.

FrontPoint, which is being spun off by Morgan Stanley, would not elaborate beyond its statement. But the firm’s announcement of Dr. Skowron’s suspension provided an obvious No. 1 guess for anyone trying to figure out the identity of that mystery portfolio manager.

… lots of interesting responses. Writers debate in particular the author’s motivations.

The likeliest motivation, which does not appear on the list of possibilities to which I’ve linked you, seems to UD simple intellectual curiosity. Not to get revenge, or reassure yourself you’re hot, or compare notes to confirm you’re normal, or take control of your own narrative, yadda yadda…

Why don’t people take the thesis for what it is? It’s a thesis. This is a woman interested in a perfectly interesting question. How does a particular group of people behave sexually? What are the variants, etc?

Do we look at a Masters and Johnson study and say they did it in order to take control of their personal narratives?

True, their methods were not as unorthodox – or unethical – as those here, but the Owen study wouldn’t be the first in which an observer was in one way or another involved in her own protocol.

… both a Nobel and an Ig Nobel:

… The [Nobel-winning] graphene creation originated in what Dr. Geim and Dr. Novoselov call “Friday evening” experiments, crazy things that might or might not work out.

In one of them, Dr. Geim managed to levitate a frog in a magnetic field, for which he won an Ig Nobel — a parody award for “improbable research” — in 2000. On another occasion they produced a “gecko tape” that mimicked the way geckos and Spider-Man can walk on the ceiling…

[Thanks, Matt F.]

But… talk about LIVING! Dr. David Feinberg himself is soaring, baby. And it takes a lot money to keep his mojo working. You don’t keep the money coming, fuck you.

… [A]t a time of … difficult financial decisions, the [UCLA] regents … [have] antagonized some critics by boosting the annual compensation of UCLA’s top hospital executive by $410,000, to about $1.3 million.

… Feinberg, UCLA’s hospital system chief executive officer, will receive a $210,000 bonus. But in a more divisive matter, UCLA officials also received the regents’ approval to give Feinberg an extra raise of about $410,000, boosting his total compensation to more than $1.3 million.

UCLA Chancellor Gene Block said Feinberg was doing an excellent job and was being wooed by other employers. “Keeping this team together is essential,” he said.

It’s not like Feinberg’s a doctor or anything, who feels a moral commitment to what he’s doing here. If we don’t keep not only giving this guy raises, but giving him extra raises, he’ll… he’ll leave us!

And then what’ll we do? We … we couldn’t go on without Feinberg! The team has to be kept together. And what a great team member Feinberg is, with his willingness to sacrifice for the good of the university…

Yes, it’s essential that this great team player be kept on. Essential. I’m the chancellor, and I’ve just said that to the newspapers.

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So Feinberg knows what he has to do next pay cycle. $500,000 more in bonuses, plus I’ll take an extra raise of … of… $500,000!

Okay! Anything you say.

In yet another sign of what Marcia Angell describes as “the widespread corruption of the medical profession by industry money,” a Columbia University study reveals that

Twenty-five out of 32 highly paid consultants to medical device companies in 2007, or their publishers, failed to reveal the financial connections in journal articles the following year…

Researchers followed the disclosure activities of a group of MDs and PhDs who were paid a million dollars or more by orthopedic device companies in 2007. Most of these people failed to disclose their financial conflicts of interest in the journals that published their articles.

And, as Angell points out, the journals get money from the companies too, in the form of advertisements, so they’re not about to actually enforce their disclosure policy…

Everybody’s getting paid, see. Professors at medical schools are getting paid. Journals are getting paid.

Some in this group might be getting paid twice, as it were. Ghostwriters, possibly hired by the same companies paying their consultancy fees, could be writing their articles for them…

Quelle postmodern! Simulacral research (ghost-written, guest-written), simulacral disclosure, simulacral journals…

UD‘s medical school colleagues labor over their scientific papers.

With a little help from their friends.

It’s win-win for the professors. Don’t lift a finger. Get hundreds of publication credits.

Oh. Except for:

“How many other drugs have been promoted in the same way, but you never find out about them because nobody’s suffered heart attacks?” [Leemon McHenry, a medical ethicist at California State University in Northridge] says. “Nobody finds out about this at all until there’s been some major damage and the lawsuits get filed.”

But he’s talking about the little people.

And really, if it weren’t for their doctors prescribing dangerous drugs to the little people based on ghostwritten papers, how would we find out the drugs are dangerous? That’s how science works.

Harvard University’s Joseph Biederman must be smiling.

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UD thanks David for the link.

… what she used to be…