And I don't like what I see.

Here's how (not) to read a study.

Depends on your definition. Wovon man...

Certain psychiatrists carry considerable weight in determining the policy, the spirit, of psychiatry.  Henry Nasrallah is one of those men, which is why, if you see him write an editorial called, "Should psychiatry list hubris in the DSM-V?" -- especially if it is tongue-in-cheek--- you should strike yourself in the head with a brick until you are unconscious.  You are about to be manipulated with words, and then it will be too late.

The other 4 cars are now completely fine, thanks to early intervention.

After some dozen years' immersion in intelligence, I still find myself reacting uncomfortably to its rather cavalier disregard for the footnote.

This is an example of why the controversy over Pharma influence on doctors is, while accurate, likely irrelevant.

In case you doubted, here is today's front page of USAToday: Economy's stuck, but business is booming at therapists' offices.

If that was the end of the story-- if people had social troubles and turned to psychiatry for help because of those troubles, it would be a good thing.  Get help where you can.

But the larger problem is that in going to psychiatry, their socioeconomic issues get demoted to "factors" and the feelings become pathologized.  Psychiatry doesn't explain, it identifies.  You're not depressed because you lost your house; you have depression, and one of the triggers is losing your house.  See the difference?

You'll say this doesn't happen all the time, maybe not even the majority of the time.  But even if it doesn't happen to a specific individual, it still happens to enough people that it bolsters  psychiatry's role as the necessary player in managing suffering of any kind.

A 20% increase in therapy visits will be interpreted by psychiatry as a 20% increase in depression and anxiety.  It will say depression has a prevalence of X, it will say it is underdiagnosed and undertreated, etc. And it will creep into the social consciousness that these are pre-existing diseases with triggers, not the consequences of external events.

Society needs that illusion, it needs that lie, because it has created unrealistic expectations in people and no way of fulfilling them.   Here's what a society looks like under the similar economic conditions, but without psychiatry:

The absence of hope

Today's popular frustrations over flat-lining living standards have been building for years. The recent boom, felt only by the already well-off, has done little to change that discontent. Labor unrest has been growing for months; violent protests erupted... corporate taxes will be raised and gasoline subsidies cut... The move was designed to take the steam out of boiling anti-government sentiment.

The above article, also from USAToday, has a slightly different title: Egypt's economy soars; so does misery.

And with good reason.

Yes, you read that right.  Drink a big glass of OJ and put away your blotter paper, you won't need 'em in here.

Agreed.  And then let's rename the DSM The Book of Fantastikal Magickal Pixies and incorporate it into the Monster Manual.   And let Mad Libs publish the assessment tools.

And I am ashamed.

Belated, anyway.

In which appears the phrase, "the sticky pages of the New England Journal."

In the tradition of Robert Kagan and the folks at Policy Review, Robert Simon, MD defines foreign policy for the next century.

In which I take the semiotic logic of medication induced suicidality to its inevitable, silly end.

Using nothing more than a Volvo.  And without lawyers.

ABC News, and others, report that the NEJM study found that antidepressants "may be duds." 

Climb on the bandwagon, my bolsheviks, no brakes, no driver, let us see where it takes us.

Do you dare defy the Will of God?

A diagnosis of borderline personality disorder could, theoretically, mean that the psychiatrist made a serious attempt at evaluating defense mechanisms and ego integrity; or at least a matching of symptoms to DSM criteria. It's theoretically possible, yes. Other things that are theoretically possible include alien abduction, peace in our time, dual eigenstates, user friendly Movable Type upgrades, political discussions that don't rely on information from John Stewart, Daleks, recession with low unemployment, Independents, Madonna/whores, a benignly rising Russia.