Category: News

The Carlat Psychiatry Blog contacted psychiatrist Prof C. Lindsay DeVane about an article on antidepressant drug interactions he apparently co-authored for the medical journal CNS Spectrums. In reply, DeVane noted that the article was ghost-written on behalf of a drug company and denounced it as “piece of commercial crap” and ‘ridiculous’, ‘inaccurate’ and ‘simplistic’.

DeVane was apparently persuaded to take part in a round-table discussion on the interactions between antidepressant drugs, for which attendees could gain ‘CME’ or ‘Continuing Medical Education’ points, needed for doctors to demonstrate that they are keeping their skills and knowledge updated.

After the discussion, the a commercial medical education company i3CME, produced an article based on a video tape of the session with the participants names listed as authors.

Ghostwriting, the practice where drug companies or medical writing agencies create scientific articles to which established researchers add their names, still occurs, despite recent attempts to clamp down on it.

It relies on an academic system where researchers’ careers depend on the number of publications, and on drug companies’ need to boost the profile of their products by adding the names of high-profile scientists to the relevant research.

It’s a big business, and there are a number of agencies that just specialise in writing scientific articles for commercial companies that later get handed to ‘star’ researchers for, at best, checking, and at worst, just signing.

In this case, it seems the article was written without DeVane’s agreement, so it’s refreshing to see someone disown it, rather than simply add it as another gold star to their CV.

Importantly, DeVane notes that his views on the topic had already been accurately and fairly represented in an earlier article [pdf] which he had personally authored.

The Carlat post has more details on the affair, including DeVane’s own description of what occurred.

Link to further details (via Furious Seasons).

A just published study that looked at the religious beliefs of different types of medical doctors in the US has found that psychiatrists are the least religious among the medical specialities.

The study also found that non-psychiatrist physicians who were religious, were least likely to refer a patient with symptoms of mental illness to a psychologist or psychiatrist, and were more likely to refer them to a member of the clergy or religious counsellors.

There’s also a few interesting facts about the demographics of US psychiatrists:

Compared with other physicians, psychiatrists were more likely to be Jewish (29% versus 13%) or without a religious affiliation (17% versus 10%), less likely to be Protestant (27% versus 39%) or Catholic (10% versus 22%), less likely to be religious in general, and more likely to consider themselves spiritual but not religious (33% versus 19%).

Perhaps the fact that psychiatrists are least likely to be religious is not surprising since they deal with lots of people who have experiences that they explain as neurological disturbance but which often appear as no different from what would otherwise be considered spiritual experiences.

For example, Joan of Arc had experiences which could be easily classified as auditory hallucinations, as did many saints, visionaries and prophets throughout history.

This is still a pertinent issue. In a classic 1997 paper psychiatrist Bill Fulford and psychologist Mike Jackson examined some written records of (admittedly intense and atypical) contemporary spiritual experiences and noted that they would fulfil the diagnostic criteria for schizophrenia – except for the fact that they were of immense benefit to the people concerned.

More recently, psychologist Ryan McKay noted that current neuropsychiatric models of delusions would also include religious beliefs if they were considered under the same criteria [pdf] – although it could be said that this is just as likely to be a criticism of our scientific understanding of delusion as it is a consideration of spiritual belief.

However, it’s probably true to say that spending a great deal of time explaining seemingly mystical experiences as the result of biomedical disturbance probably makes you a little more sceptical of some of the mystical experiences on which many mainstream religions are based.

Link to abstract of scientific study.
Link to write-up from Yahoo! News.

Channel 4 have been putting a number of classic documentaries online, including an optimistic film by legendary American documentary maker Albert Maysles on Soviet psychiatry in 1950s Russia.

The film is interesting historically for a number of reasons, perhaps, most pertinently, because it presents a counter-example to the known abuses of Soviet psychiatry of the time. It is also a striking contrast to American psychiatry of the same period.

Apart from a few isolated examples, the department at Washington University being the most famous, American psychiatry was dominated by Freudians and a psychoanalytic approach to understanding mental illness.

This meant it was largely led by office-based psychiatrists who mostly eschewed biological and scientific approaches to treatment and who mainly treated depression and anxiety.

In contrast, the Maysles documentary notes that Russian psychiatry was largely based on a Pavlovian (behaviourist) approach to mental illness that put a significant emphasis on neuroscience (e.g. the image is of a Russian psychiatrist checking a child’s Babinski reflex – a test of brain or spinal cord damage).

It was also heavily hospital-based, used drug treatments and was more likely to deal with people with schizophrenia and psychoses.

While the treatments themselves now look outmoded, it’s notable that American psychiatry now much more closely matches the Russian model.

Psychoanalysis is now on the fringes and mainstream orthodox psychiatry is largely drug-based, while most practitioners are likely to think of themselves as, at least in part, ‘applied neuroscientists’.

The film is also notable for being so positive about Soviet psychiatry when it was presumably deeply unfashionable, perhaps even career-limiting, for American film-makers to promote Russian initiatives.

Link to page and video link for Maysles film ‘Psychiatry in Russia’.

Please excuse the interruption… I’m doing a little site maintenance today and mindhacks.com is moving over to a new server.

Since you can see this message, you’re looking at the new server which means the maintenance worked. If you notice anything broken around the place, please do let me know (matt at mindhacks dot com). Thanks!

The Dana Guide to Brain Health is a fantastic book that contains a wealth of practical information about keeping your brain healthy, maintaining mental sharpness, and dealing with problems when they arise. Even better, the section on mind and brain disorders has now been made fully searchable and freely available on Dana’s website.

In fact, the book is incredibly comprehensive, and in addition to discussing health and illness, covers how the brain develops, functions normally, interacts with the body, and supports social interaction, emotion and cognition.

However, its coverage of disorders is excellent. Each one described, and is accompanied by a review of what’s currently known about the causes, diagnosis and treatment, so you know what to expect if you, a friend or relative need professional help.

It’s written in a straightforward jargon-free way and is remarkably comprehensive. It covers everything from hearing problems to schizophrenia to the neurological complications of AIDS.

This is the section has now been made freely available and is searchable by topic or keyword. A truly valuable addition to online mind and brain resources.

Link to Dana brain health database.
Link to book details.

The letters page of this week’s New Scientist contains a lively debate about the neuroscience of free will, inspired by neuropsychologist Chris Frith’s recent article on the topic.

Frith’s article (sadly, closed-access) was discussing a classic experiment in neuroscience that seems to suggest that our brains generate an action before we’re consciously aware of making the choice to move, suggesting our experience of having complete conscious control over our actions may be mistaken:

Curiously, considering it is over 20 years old, a single experiment dominated our discussions. Reported in 1983 (and replicated variously) by Benjamin Libet at the University of California, San Francisco, the experiment is crucial because it seems to show we don’t have free will. Using an electroencephalogram, Libet and his colleagues monitored their subjects’ brains, telling them: “Lift your finger whenever you feel the urge to do so.” This is about as near as we get to free will in the lab.

It was already known that there is a detectable change in brain activity up to a second before you “spontaneously” lift your finger, but when did the urge occur in the mind? Amazingly, Libet found that his subjects’ change in brain activity occurred 300 milliseconds before they reported the urge to lift their fingers. This implies that, by measuring your brain activity, I can predict when you are going to have an urge to act. Apparently this simple but freely chosen decision is determined by the preceding brain activity. It is our brains that cause our actions. Our minds just come along for the ride.

In response, two of the correspondent’s question the appropriateness of the experimental task (is finger lifting a good example of free will?) and whether the result equally applies to the situation where we can stop an intended action.

Another draws parallels between our concept of free will and the influence of peer pressure and conformity, while two letters discuss how compatible free will is with a model of a physical deterministic universe.

In other words, if physics can, in principle, mathematically model the interaction of every atom to predict what will happen, how can we influence this process if we’re nothing more than a collection of atoms?

Finally, two other correspondents highlight some weakness in Frith’s ideas, and indeed many current theories of free will, that arise out of more fundamental problems in understanding fully the best way of linking mind- and brain-level theories.

Just reading the letters gives a good overview of some of the major problems when trying to understand both the concepts and science of conscious control of action.

Link to excellent Wikipedia page on free will.

Quick links from the past week in mind and brain news:

Fantastic article in The Boston Globe on the neuroscience of gambling by Frontal Cortex author Jonah Lehrer.

PsyBlog has wonderful post on the neglected area of the psychology of courage.

Scientific American reports that ‘perfect pitch‘ – the ability to identify a musical note without reference to other notes on the scale – is partly genetic, and might be accounted for by a single gene. NPR has a radio segment on the same.

Psychiatrist David Olds writes in SciAm Observations and discusses whether ‘bad genes’ can be adaptive, or whether they always raise the risk for mental disorder.

BBC News reports that a clinical trial has found hypnosis to be effective in easing discomfort during breast cancer surgery.

OmniBrain finds sailing-close-to-the-wind humorous video from The Onion: World’s Oldest Neurosurgeon Turns 100.

BBC News reports on an Afghan community drug addiction clinic that treats opium addicted women.

Cognitive Daily recommends some fresh new psychology and neuroscience blogs.

Study tracks brain during different levels of fear, reports SciAm.

Suicide by ball-point pen. Retrospectacle finds a most remarkable brain scan.

Phantom erection after penis amputation. Neurophilosophy discovers a most remarkable case study.

Recent Western press reports have indicated that the Russian psychiatric system might be experiencing a return to the ‘bad old days’ when it was used in part to suppress political dissidents.

President of the human-rights focused psychiatrists’ organisation the Independent Psychiatric Association of Russia (IPA), Dr Yuri Savenko, has kindly agreed to talk to Mind Hacks about the current situation.

Continue reading “Is Russia entering another dark age of psychiatry?”

I just recorded an interview on psychology and the internet for ABC Radio National’s All in the Mind. Natasha Mitchell was completely charming, the questions informed and on target, but as for me, Miss South Carolina, I know how you feel.

Also, I’m off to the British Association of Cognitive Neuroscience conference for a couple of days, as I’ve kindly been asked to speak in the cognitive neuropsychiatry symposium in honour of the late great Prof Hadyn Ellis. Apologies if the updates are a bit patchy. Not sure how internet access is going to work out.

The New York Times has an article on the burgeoning business of commercial fMRI brain scan services – that offer to do everything from detecting lies to managing pain.

fMRI is a type of scan that can map levels of oxygen-rich blood across the brain. As brain areas need more oxygen the harder they work, fMRI can produce a map of inferred activity.

fMRI is a relatively new technology. Although its now the most popular technique for tracking brain function, it only became widespread in the mid to late-1990s.

We’ve just got to the stage where commercial companies are beginning to sell fMRI-based services.

So far, the offerings are almost entirely based on experimental results that most scientists find interesting but preliminary, and to different degrees, the glitz of neuroscience, and impressive but scientifically meaningless publicity stunts.

This isn’t really a problem with the technology itself. It’s common for companies to sell their product while its still in development, but its worth bearing in mind when you hear the more outrageous claims for what it can do.

You might think that this business is so new and specialised as to be a target for easy-money investors, but it’s surprisingly cut-throat.

For example, VSM MedTech, makers of MEG brain scanners, seem to be running as a support only company after a serious nose dive.

However, this still leaves two other companies who can currently manufacture and install these multi-million pound devices.

The NYT article surveys the sorts of commercial brain scan services currently being offered, and has a critical commentary on some of the companies’ claims.

Link to NYT article ‘Mind Over Matter, With a Machine‚Äôs Help’ (via BB).

The 30th edition of the Encephalon psychology and neuroscience writing carnival has just hit the net – as the last ever post on brain blog Neurofuture.

Luckily, Neurofuture author Sandra is still going to be writing for Omni Brain, PsychCentral and print publications, so it’s less a departure and more a regrouping.

A couple of my favourites from this month’s edition include a post on the how hemispheres of the brain can be specialised for certain tasks, and a video discussion on ‘Is Consciousness Definable?’.

There’s more at the link below.

Link to Encephalon 30.

Scientific American has an interview with neurobiology of addiction tsar Dr Nora Volkow discussing whether we can understand overeating as a form of addiction.

Volkow describes how the reward system, of which the dopamine rich mesolimbic pathway is particularly important, is involved in signalling desire and predicting pleasure.

Needless to say, it plays a key role in addiction. But as it’s involved whenever we do anything pleasurable, from taking drugs to eating to laughing, it’s also central to many non-pathological situations.

In fact, we presume it kicks in when we desire anything pleasurable, to any degree.

So it may be crucial to understand what happens in this pathway in people who have difficulties with over-eating.

Volkow mentions that people with obesity tend to have fewer D2 dopamine receptors in the striatum, perhaps suggesting more food is needed for the same pleasurable response, which could promote over-eating.

A similar thing has been found in addicted drug users, which raises the question, is obesity a ‘food addiction’?

Although not without controversy, drug addiction is usually described as having three main components (the ‘three Cs’): Compulsive use (wanting to do it again), loss of Control (feeling you can’t stop yourself), and continued use despite adverse Consequences (even when you know it’s damaging).

The difficulty is, normal eating fulfils all three criteria. We’re compelled to eat, stopping ourselves is incredibly difficult, and we all continue to eat things we know are bad for us, even when our health suffers.

Notably, Volkow is careful not to describe obesity as an addiction in the interview, although the magazine is quite happy to label it a ‘food addiction’.

Increasingly, we’re finding that problems labelled as separate in the diagnostic manuals can actually have some core features in common.

In this case, similar differences in the reward system in addiction and obesity seem to be important.

However, we always have to beware of over-simplifying complex problems.

Obesity, like high-blood pressure, is simple to define, but is caused by many different things acting together.

Highlighting overlaps can be incredibly powerful, but inappropriately lumping problems together often means missing the other factors which may be equally important.

Scientists are usually pretty good at this, typically discussing the similarities or talking about shared factors, but it’s worth looking out for when the message gets simplified when retold in the press.

Link to SciAm interview on obesity and addiction.

Quick links from the past week in mind and brain news:

Why are visual memories so vivid when visual memory is so limited? Cognitive Daily has another fantastic breakdown.

Science and Consciousness Review has a new feature article on whether language is necessary for self-awareness.

The New York Times has an article on the potential of physical exercise to boost memory and cognitive processing speed. Pure Pedantry picks up on its off-kilter interpretation.

The BPS Research Digest looks at why we’re rubbish at predicting how what happens will affect us emotionally.

Read the latest and ‘in progress’ research on cognitive training and brain fitness at Sharp Brains.

Apparently, we have taste receptors in the gut!

Drug company AstraZenenca have been whitewashing the entries for their drugs on Wikipedia. Bears still shitting in woods.

PsyBlog notes that pessimists have good reason to be pessimistic. People prefer optimists and realists!

The New York Times discusses the importance of getting a therapist you click with to get the most out of psychological treatment.

Mr. Freeze, the Iced-Time Demon. A thought-provoking thought experiment from philosopher Pete Mandik

Is there anything good about men? Psychologist Roy Baumeister’s speech notes that males are much less likely to reproduce than females, and wonders what evolutionary effect this has had on gender psychology.

Jose Padilla’s conviction raises questions about whether detainees who undergo extreme isolation can be given fair trials, according to In These Times.

More on the wonderful ACHOO syndrome that won our AAICS competition.

USA Today is reporting that a toxicology team have developed a method for drug testing a city’s water supply, indicating the level at which certain drugs are being used by the population.

The study was reportedly led by environmental toxicologist Prof Jennifer Field and was presented at the 2006 American Chemical Society conference.

The technique apparently involves taking a sample of water from the city’s sewer plant, and so doesn’t identify individuals, but can estimate the proportions of different drugs in the water to give a guide to which drugs are being used in what quantities.

The science behind the testing is simple. Nearly every drug — legal and illicit — that people take leaves the body. That waste goes into toilets and then into wastewater treatment plants.

“Wastewater facilities are wonderful places to understand what humans consume and excrete,” Field said.

In the study presented Tuesday, one teaspoon of untreated sewage water from each of the cities was tested for 15 different drugs. Field said researchers can’t calculate how many people in a town are using drugs.

She said that one fairly affluent community scored low for illicit drugs except for cocaine. Cocaine and ecstasy tended to peak on weekends and drop on weekdays, she said, while methamphetamine and prescription drugs were steady throughout the week.

Field said her study suggests that a key tool currently used by drug abuse researchers — self-reported drug questionnaires — underestimates drug use.

“We have so few indicators of current use,” said Jane Maxwell of the Addiction Research Institute at the University of Texas, who wasn’t part of the study. “This could be a very interesting new indicator.”

Unfortunately, it seems the American Chemical Society charge for access to the summaries of their conference presentations, but Scientific American has a little more detail on the procedure.

The news is reminiscent of a 2004 Environmental Agency study that found Prozac in UK sewage (incorrectly reported as the ‘Prozac found in drinking water’ story).

Link to USA Today article (via AADT).
Link to SciAm write-up.

Frontal Cortex has just alerted me to a compelling four-part series on the quest to find the molecular basis of memory in Prof Gary Lynch’s neuroscience lab.

It’s not only an account of the science behind the research, but also of the characters and human drives of the people involved.

Old school Russian neuropsychologist A.R. Luria wrote case studies of brain injured patients that not only described the neuroscience of their disorders, but also described the people in such sensitive detail that you really felt you got to know them.

He called this ‘romantic science’ – something which Oliver Sacks cites as a major inspiration for his own work.

These LA Times pieces are not about brain injury, but they have the same quality of human passion intertwined with the story of scientific discovery.

The first time I spoke with the neuroscientist Gary Lynch, the conversation went something like this:

Me: I’m interested in spending time in a laboratory like yours, where the principal focus is the study of memory. I’d like to explain how memory functions and fails, and why, and use the work in the lab as a means to illustrate how we know what we know.

Lynch: You’d be welcome to come here. This would actually be a propitious time to be in the lab.

Me: Why’s that?

Lynch: Because we’re about to nail this mother to the door.

Link to four-part LA Times special ‘Chasing Memory’.

After much debate at the American Psychological Association conference a resolution was passed that condemns torture, bans psychologists from taking part in certain abusive activities, but still leaves significant grey areas for participation in contested CIA interrogation techniques.

The key section of the APA resolution is the following:

This unequivocal condemnation includes, but is by no means limited to, an absolute prohibition for psychologists against direct or indirect participation in interrogations or in any other detainee-related operations in mock executions, water-boarding or any other form of simulated drowning or suffocation, sexual humiliation, rape, cultural or religious humiliation, exploitation of phobias or psychopathology, induced hypothermia, the use of psychotropic drugs or mind-altering substances used for the purpose of eliciting information; as well as the following used for the purposes of eliciting information in an interrogation process: hooding, forced nakedness, stress positions, the use of dogs to threaten or intimidate, physical assault including slapping or shaking, exposure to extreme heat or cold, threats of harm or death; and isolation, sensory deprivation and over-stimulation and/or sleep deprivation used in a manner that represents significant pain or suffering or in a manner that a reasonable person would judge to cause lasting harm; or the threatened use of any of the above techniques to the individual or to members of the individual’s family;

The resolution is widely being interpreted as a snub to the CIA, but notably, participation in detainee “isolation, sensory deprivation and over-stimulation and/or sleep deprivation” are not specifically banned unless they are judged to cause “lasting harm” – without any clear definition of what this amounts to.

Salon points to a publicly available CIA interrogation manual from the 1960s that notes that these techniques quickly provoke hallucinations and stress that become “unbearable for most subjects” although the manual also notes a “profound moral objection to applying duress past the point of irreversible psychological damage.”

Some members were pressing for an outright ban in participation in all CIA interrogations, citing the whole process of internment without due process unethical, but this was not adopted by the APA, meaning the guidelines fall short of those already adopted by psychiatrists and physicians.

One notable aspect of this story is just how important it’s become. At the time of writing, Google News lists over 300 news items on the decision.

Much of the credit for this has to go to Salon who have followed the story since the beginning, at times catching APA with their pants down.

Their dogged investigations have obviously touched a nerve as they report that the APA president refused to answer questions from the publication when approached after a panel session.

Link to APA resolution.
Link to Salon article ‘Will psychologists still abet torture?’.
Link to APA press release on resolution.