Month: April 2006

Insight into self-harming from Lovisa Pahlson-Moller, a 22-year-old who said she first self-harmed when she was just six years old. She hasn’t cut herself for two years thanks partly to the relief that’s come from writing a book about her feelings. Interview and book extract.

Also there’s an extended interview here with Chris Holley, the nurse behind a controversial project at St George’s Hospital, Stafford that allows patients to continue harming themselves under supervised conditions. BBC News coverage here.

Today’s New Scientist has two articles of interest to mind and brain enthusiasts: a critical analysis of mood stablising drugs, and an account of a new brain intervention that involves passing a small electrical current through the head.

The article on mood stabilisers is largely an edited version of an article by psychiatrist David Healy published in a special issue of PLoS Medicine (mentioned previously on Mind Hacks).

The other feature article is on a technique called transcranial direct current stimulation (tDCS), something I’ve not heard of before but which seems to have some serious research supporting its use.

It sounds like quackery, but it’s not. A growing body of evidence suggests that passing a small electric current through your head can have a profound effect on the way your brain works. Called transcranial direct current stimulation (tDCS), the technique has already been shown to boost verbal and motor skills and to improve learning and memory in healthy people – making fully-functioning brains work even better. It is also showing promise as a therapy to cure migraine and speed recovery after a stroke, and may extract more from the withering brains of people with dementia. Some researchers think the technique will eventually yield a commercial device that healthy people could use to boost their brain function at the flick of a switch.

Unfortunately, the article isn’t available freely online, but you should be able to get the issue from your local newsagent or library.

Link to table of contents for this week’s issue.

US Judge Wayne Salvant has ordered that Steven Kenneth Staley, a death-row inmate who is so severely mentally ill as to be unable to comprehend his situation, can be forcibly medicated so he can be executed while mentally competent.

A stay of execution was previously granted as he was judged not to understand his situation due to impaired mental functioning.

Staley is not the first prisoner to find himself in this situation. In 2004, Charles Singleton was forcibly medicated and subsequently executed in Arkansas.

His case was considered by an appeals court that decided by 6 votes to 5 that forcible medication for execution was acceptable.

In 1986, the US Supreme Court stated that the execution of the insane was barred by the Eighth Amendment, which prohibits cruel and unusual punishment, although the definition of insanity is left to individual states.

In 2002, the state of Texas executed Monty Delk. His last words were recorded in the state’s execution report:

At his execution, Delk screamed profanities and gibberish. When the warden asked if he had a final statement, Delk shouted. “I am the warden! Get your warden off this gurney and shut up!” At 7:47 p.m., the warden signaled for the lethal injection to begin. After spouting more profanity, Delk blurted out, “You are not in America. This is the island of Barbados. People will see you doing this.” Then, abruptly, he stopped speaking, and his mouth and eyes froze wide open. He was pronounced dead at 7:53 p.m.

Link to article on Staley judgement from The Star-Telegram.
Link to article on Singleton execution from CNN.

Psychiatric nurse and mixed media artist Ben Guiver’s experimental radio broadcast is available to download today.

The show – a kind of remix of texts by Francois Roustang, Will Self, Hakim Bey, Adam Phillips and Jean Baudrillard – complements his exhibition of photographs and paintings at London’s Foundry called “A sense of Scale”, and will also be broadcast on Resonance FM at 7pm (BST).

Guiver, who runs an art group for people with mental health problems, told The Guardian: “The texts I’ve selected for my radio show deal with different types of social matrixes. It is about the privatisation of culture in the west and the cycle of intimidation”.

Link to A Sense of Scale exhibition info and radio downloads.

Open-access journal PLoS Medicine has a special on disease mongering – the practice of promoting medical conditions in an effort to boost drug sales.

Drugs are, of course, incredibly useful in treating suffering and disease, but their reality doesn’t always match the marketing of either the compound or the diagnosis.

For example, the definition of many psychiatric conditions is often based on fuzzy criteria on what constitutes a mental disorder and what constitutes normal human suffering or impairment.

The official acceptance of a diagnosis can involve intensely political decisions because if a group of experiences are defined as a mental disorder, the government or insurance companies can be called on to provide care for the affected people.

If a drug company can get their medication licensed as an ‘approved’ part of the care package, they can obviously make a huge amount of money.

This has led to drug companies funding pressure groups both to get a condition recognised with an ‘official’ diagnosis or to raise awareness of certain diagnoses (which has the effect of increasing the rates of diagnoses, and, of course, prescriptions).

This is not to deny that people may genuinely be suffering, but whether that suffering is best treated by a particular drug is another matter.

Here is where science is supposed to settle the matter, except for the fact that drug companies have been known to suppress drug trials that find no effect, and ghost-write scientific papers to which respected scientists add their names (and prestige).

Individual doctors are persuaded to prescribe certain drugs by free gifts, meals, air tickets to visit conferences, and large-scale sponsorship of academic meetings.

It’s all very murky and quite insidious. The PLoS Medicine collection has articles that point out some of the marketing practices that support this process.

Of particular interest to readers here might be the articles on female sexual dysfunction, bipolar disorder and ADHD, although the whole issue is quite thought-provoking.

The issue coincides with a conference currently being held on the same topic in Australia.

Link to PLoS Medicine collection on disease mongering (thanks Petra!)
Link to conference website.
Link to 2002 British Medical Journal special on disease mongering.
Link to coverage from BBC News.

Steven Levitt, the economist, and Stephen Dubner, the journalist – authors of Freakonomics – appeared on the BBC Radio 4 Today programme yesterday.

The pair are (in)famous for their alternative explanations of historical phenomena, based on their application of economic tools of analysis to social patterns. For example, they’ve argued that the 50 per cent fall in crime in the USA in the last 15 years was caused by the legalisation of abortion in the 1970’s. Unwanted children are known to be at increased risk of becoming criminals, and so the reduction in the number of unwanted kids has meant less crime (so the logic goes).

In this interview they suggest that, so long as it doesn’t spread to humans, the threat of bird flu here in the UK may paradoxically lead to health benefits as a result of millions of anxious people washing their hands more often.