On Antipsychiatry

So leading US psychiatrist Stephen Stahl is annoyed at Daniel Carlat (of the The Carlat Psychiatry Blog and many other publications.)

After first surveying the current outlook for the development of new psychiatric drugs - not good, with many companies pulling out - Stahl laments:

Undoubtedly this is to the great delight of the anti-psychiatry community, lights up the antipsychiatry blogs (e.g., Carlat, http://carlatpsychiatry.blogspot.com/), who attract the Pharmascolds, scientologists and antimedication crowd who believe either there is no such thing as mental illness, that medication should not be used, or both.



Did you know that psychiatric illnesses are pure inventions of Pharma and their experts to treat patients that do not exist with drugs that are dangerous and do not work with the purpose only of profiting themselves? Stop the profits! Make mental illness go away by legislation and committee!

Stahl ends with the warning: Be careful what you ask for. You might just get it - "it" being an end to drug development in psychiatry.



Well, I would say the same to him.



Stahl paints opponents of modern pharmaceutical industry behaviour as "antipsychiatrists". They're not. Well, he only names one of them, Daniel Carlat, and he's certainly not. Carlat edits the Carlat Psychiatry Report. Let's take a look at the latest issue:



Benzodiazepines: A Guide to Safe Prescribing - discusses benzodiazepines, including a helpful table of their doses and half-lives. Useful to someone planning to prescribe these drugs, that is, which not many anti-psychiatrists would. Says that "They work quickly and effectively for anxiety and agitation...In most cases benzodiazepines have a benign side-effect profile..." Hardly likely to please the antimedication crowd.



Update on Medications for PTSD - including a review of trials of antidepressants, antipsychotics, and more exotic drugs. Says that psychotherapy is the key to treating PTSD, but that medication can be helpful: "Getting some comfort from meds can often enable a patient to more easily face" the hard task of therapy. Not enormously pro-medication, but very far from being anti.

Combined Antidepressants No More Effective Than Monotherapy - discusses a recent study finding that starting depressed patients on a combo of two antidepressants offers no benefits over just one drug. So, the piece concludes, "We recommend never using antidepressants, and banning them all forever"... no wait, that's what it would have said if Stahl were right. It actually said "we recommend...starting with a single antidepressant". Not none.



Overall Carlat is, as far as I can see, really pretty moderate. Yes, he's been critical of certain drugs, of Pharma-influenced psychiatrists and the culture of giving doctors freebies to promote products. Nonetheless, he believes that mental illness exists, and he thinks that medication can be useful in treating it.



Maybe Stahl's right and Carlat leads a secret double life as a Scientologist. Maybe he is the reincarnation of R. D. Laing, or Thomas Szasz in a rubber mask. If not, though, branding him an antipsychiatrist shows that Stahl is unclear on what "psychiatry" is.



Psychiatry means the diagnosis and treatment of mental illness. Carlat, and indeed many other like-minded critics, are trying to improve that process by encouraging correct diagnosis and appropriate treatment.



When Carlat criticizes, say, the psychiatry textbook that turned out to have been written with "help" from a drug company, he's doing, I assume, because, as a psychiatrist who cares about psychiatry, he doesn't like seeing his field corrupted by propaganda.



This is why Stahl should heed his own warning: Be careful what you ask for.



Because Stahl seems to be asking for all the opponents of the excesses of the modern pharmaceutical industry to be opponents of psychiatry itself. At the moment, they're not. There are many, psychiatrists and others, who are trying to improve psychiatry, by protecting it from what they see as negative influences.



Maybe they're wrong about which influences are negative, maybe Pharma has had a more positive impact than they think, but even if they're wrong, they're not anti-psychiatry, they're pro-psychiatry.



However, if Stahl succeeds in painting all of these people as outside the psychiatric mainstream, he might find that psychiatry, stripped of such voices of sanity, turns into something so crazy that true antipsychiatry becomes the only reasonable option.

On Antipsychiatry

So leading US psychiatrist Stephen Stahl is annoyed at Daniel Carlat (of the The Carlat Psychiatry Blog and many other publications.)

After first surveying the current outlook for the development of new psychiatric drugs - not good, with many companies pulling out - Stahl laments:

Undoubtedly this is to the great delight of the anti-psychiatry community, lights up the antipsychiatry blogs (e.g., Carlat, http://carlatpsychiatry.blogspot.com/), who attract the Pharmascolds, scientologists and antimedication crowd who believe either there is no such thing as mental illness, that medication should not be used, or both.



Did you know that psychiatric illnesses are pure inventions of Pharma and their experts to treat patients that do not exist with drugs that are dangerous and do not work with the purpose only of profiting themselves? Stop the profits! Make mental illness go away by legislation and committee!

Stahl ends with the warning: Be careful what you ask for. You might just get it - "it" being an end to drug development in psychiatry.



Well, I would say the same to him.



Stahl paints opponents of modern pharmaceutical industry behaviour as "antipsychiatrists". They're not. Well, he only names one of them, Daniel Carlat, and he's certainly not. Carlat edits the Carlat Psychiatry Report. Let's take a look at the latest issue:



Benzodiazepines: A Guide to Safe Prescribing - discusses benzodiazepines, including a helpful table of their doses and half-lives. Useful to someone planning to prescribe these drugs, that is, which not many anti-psychiatrists would. Says that "They work quickly and effectively for anxiety and agitation...In most cases benzodiazepines have a benign side-effect profile..." Hardly likely to please the antimedication crowd.



Update on Medications for PTSD - including a review of trials of antidepressants, antipsychotics, and more exotic drugs. Says that psychotherapy is the key to treating PTSD, but that medication can be helpful: "Getting some comfort from meds can often enable a patient to more easily face" the hard task of therapy. Not enormously pro-medication, but very far from being anti.

Combined Antidepressants No More Effective Than Monotherapy - discusses a recent study finding that starting depressed patients on a combo of two antidepressants offers no benefits over just one drug. So, the piece concludes, "We recommend never using antidepressants, and banning them all forever"... no wait, that's what it would have said if Stahl were right. It actually said "we recommend...starting with a single antidepressant". Not none.



Overall Carlat is, as far as I can see, really pretty moderate. Yes, he's been critical of certain drugs, of Pharma-influenced psychiatrists and the culture of giving doctors freebies to promote products. Nonetheless, he believes that mental illness exists, and he thinks that medication can be useful in treating it.



Maybe Stahl's right and Carlat leads a secret double life as a Scientologist. Maybe he is the reincarnation of R. D. Laing, or Thomas Szasz in a rubber mask. If not, though, branding him an antipsychiatrist shows that Stahl is unclear on what "psychiatry" is.



Psychiatry means the diagnosis and treatment of mental illness. Carlat, and indeed many other like-minded critics, are trying to improve that process by encouraging correct diagnosis and appropriate treatment.



When Carlat criticizes, say, the psychiatry textbook that turned out to have been written with "help" from a drug company, he's doing, I assume, because, as a psychiatrist who cares about psychiatry, he doesn't like seeing his field corrupted by propaganda.



This is why Stahl should heed his own warning: Be careful what you ask for.



Because Stahl seems to be asking for all the opponents of the excesses of the modern pharmaceutical industry to be opponents of psychiatry itself. At the moment, they're not. There are many, psychiatrists and others, who are trying to improve psychiatry, by protecting it from what they see as negative influences.



Maybe they're wrong about which influences are negative, maybe Pharma has had a more positive impact than they think, but even if they're wrong, they're not anti-psychiatry, they're pro-psychiatry.



However, if Stahl succeeds in painting all of these people as outside the psychiatric mainstream, he might find that psychiatry, stripped of such voices of sanity, turns into something so crazy that true antipsychiatry becomes the only reasonable option.

Pharmaceutical Company Threatens Blogger

Boiron, a multinational pharmaceutical company, have threatened an Italian blogger with legal action, the BMJ reports.



Many people are concerned when big pharmaceutical companies do this kind of thing. So I don't think we should make any exception merely because Boiron's pharmaceuticals happen to be homeopathic ones.



Samuel Riva, who blogs (in Italian) at blogzero.it, put up some articles critical of homeopathy

which included pictures of Boiron’s blockbuster homoeopathic product Oscillococcinum, marketed as a remedy against flu symptoms. The pictures were accompanied by captions, which joked about the total absence of any active molecules in homoeopathic preparations

Boiron wrote to Riva's internet provider threatening legal action, if the offending references to Boiron weren't taken down. They also wanted them to lock Riva out of his blog, the BMJ says. In response Riva removed the references to Boiron, including the pictures and captions, but kept the posts on homeopathy in general.



Hmmm.



Above you can see a new picture I made of a Boiron product, with some captions you may find interesting. I've made sure to limit these to quotes from Wikipedia, and from Boiron USA's own website, and some simple mathematical calculations.



Beyond that, I make no comment whatsoever.



Turone F (2011). Homoeopathy multinational Boiron threatens amateur Italian blogger. BMJ (Clinical research ed.), 343 PMID: 21840920

Pharmaceutical Company Threatens Blogger

Boiron, a multinational pharmaceutical company, have threatened an Italian blogger with legal action, the BMJ reports.



Many people are concerned when big pharmaceutical companies do this kind of thing. So I don't think we should make any exception merely because Boiron's pharmaceuticals happen to be homeopathic ones.



Samuel Riva, who blogs (in Italian) at blogzero.it, put up some articles critical of homeopathy

which included pictures of Boiron’s blockbuster homoeopathic product Oscillococcinum, marketed as a remedy against flu symptoms. The pictures were accompanied by captions, which joked about the total absence of any active molecules in homoeopathic preparations

Boiron wrote to Riva's internet provider threatening legal action, if the offending references to Boiron weren't taken down. They also wanted them to lock Riva out of his blog, the BMJ says. In response Riva removed the references to Boiron, including the pictures and captions, but kept the posts on homeopathy in general.



Hmmm.



Above you can see a new picture I made of a Boiron product, with some captions you may find interesting. I've made sure to limit these to quotes from Wikipedia, and from Boiron USA's own website, and some simple mathematical calculations.



Beyond that, I make no comment whatsoever.



Turone F (2011). Homoeopathy multinational Boiron threatens amateur Italian blogger. BMJ (Clinical research ed.), 343 PMID: 21840920

The Neuro Week 19th June

Here's The Neuro Week.

Image of the week is this adorable, if anatomically not quite accurate, model of the brain which you can buy. It even has little eyes! This is not new, but what did come out this week was Google's image recognition search, which is how I found out about it.

You've probably heard of Bipolar 1 and 2, but 4 and 6? They're the next big thing, says a guy who's published no fewer than 155 papers in a journal he edits, as The Neurocritic reports.

What if autism Isn't a Neurodevelopmental Disorder? but rather a disorder caused by ongoing neurobiological processes in later life?

According to the BBC, children tend to be similar to their parents, presumably due to shared genes and/or environments. OK, they said that parents influence teenage drinking habits, but this is all the study showed. And maybe not even that. Not a great piece of journalism.

Two books about ethics are reviewed: Patricia Churchland's Braintrust is reviewed here while Blind Spots is covered here. I'm currently working on a joint review of both books so I won't comment further at this stage.

European neuroscientists including David Nutt warned this week that mental health research faces funding cuts, as pharmaceutical companies pull out of the psych market. It's certainly true that Pharma currently funds much of this research, however whether this has helped or hindered the progress of neuroscience and psychiatry is debatable.

"For the first time researchers have monitored the brain as it slips into unconsciousness", apparantly. Actually, people have been doing that for over 60 years, but this time around they did use an interesting new neuroimaging method.

Psych Your Mind blog has a list of psychology-based songs. Kind of. But it doesn't include any songs from the classic "The Mind's I", the only melodic death metal album named after a book about the nature of conciousness. Well, so far the only one. Rumours that In Flames are working on "Consciousness lost and found: A neuropsychological exploration" remain unconfirmed.

I can't read everything. So any tipoffs will be gratefully received. Either leave them in a comment or drop me an email.

The Neuro Week 19th June

Here's The Neuro Week.

Image of the week is this adorable, if anatomically not quite accurate, model of the brain which you can buy. It even has little eyes! This is not new, but what did come out this week was Google's image recognition search, which is how I found out about it.

You've probably heard of Bipolar 1 and 2, but 4 and 6? They're the next big thing, says a guy who's published no fewer than 155 papers in a journal he edits, as The Neurocritic reports.

What if autism Isn't a Neurodevelopmental Disorder? but rather a disorder caused by ongoing neurobiological processes in later life?

According to the BBC, children tend to be similar to their parents, presumably due to shared genes and/or environments. OK, they said that parents influence teenage drinking habits, but this is all the study showed. And maybe not even that. Not a great piece of journalism.

Two books about ethics are reviewed: Patricia Churchland's Braintrust is reviewed here while Blind Spots is covered here. I'm currently working on a joint review of both books so I won't comment further at this stage.

European neuroscientists including David Nutt warned this week that mental health research faces funding cuts, as pharmaceutical companies pull out of the psych market. It's certainly true that Pharma currently funds much of this research, however whether this has helped or hindered the progress of neuroscience and psychiatry is debatable.

"For the first time researchers have monitored the brain as it slips into unconsciousness", apparantly. Actually, people have been doing that for over 60 years, but this time around they did use an interesting new neuroimaging method.

Psych Your Mind blog has a list of psychology-based songs. Kind of. But it doesn't include any songs from the classic "The Mind's I", the only melodic death metal album named after a book about the nature of conciousness. Well, so far the only one. Rumours that In Flames are working on "Consciousness lost and found: A neuropsychological exploration" remain unconfirmed.

I can't read everything. So any tipoffs will be gratefully received. Either leave them in a comment or drop me an email.

So I'm Finally On Twitter

After holding out for years, on the grounds that I "don't have time to spend on Twitter", I have given in and joined Twitter: http://twitter.com/#!/Neuro_Skeptic.

I still don't think I have time for it, but I guess we'll find out.

Please note that I'm Neuro_Skeptic, not "neuroskeptic", who is someone else entirely.

So I'm Finally On Twitter

After holding out for years, on the grounds that I "don't have time to spend on Twitter", I have given in and joined Twitter: http://twitter.com/#!/Neuro_Skeptic.

I still don't think I have time for it, but I guess we'll find out.

Please note that I'm Neuro_Skeptic, not "neuroskeptic", who is someone else entirely.

The Neuro Week 12th June

Image of the week is this rather striking picture showing that slime moulds love to digest herbal sleeping tablets. This makes sense, because slime moulds are well known to experience severe insomnia. Because they're moulds, and moulds don't sleep.

Story of the week is that evolutionary biologist and writer Steven J. Gould relied on dodgy statistics in his classic book about race, science and intelligence, The Mismeasure of Man. That's according to a new paper, and there are excellent blog discussions here and here. Gould's to my mind the greatest science writer of all time. But you can write well without always being right.

Many neuroscience and psychology studies could be flawed because the "healthy controls" are just too healthy. This is a serious issue which doesn't get discussed enough.

Did dinosaurs sleep during the day, or the night? Until we get a working time machine, we'll never know for sure, but by examining the shapes of the eyes of different species, a new study has shed light on this question.

Studying psychology at university is not a good idea if you want to get a high salary, according to an upcoming paper.

An interesting legal case from the U.S: judge overturns federal law to impose less than the minimum sentence in a child pornography case. According to Forensic Psychologist blog, the ruling contains discussions of everything from neuroimaging to the arguments over DSM-V.

Psych Your Mind blogger posts his 'favourite' anonymous peer review judgements, along with the suggestion that psychology reviewers seem to be especially vicious compared to those in other fields.

British doctors, charities, and politicians all agreed that antipsychotic drugs are being over-used in dementia this week. Which is something, because they don't agree about anything else right now. I previously blogged about how an earthquake in Italy caused a spike in local elderly people getting these drugs.

The LA Times has an excellent piece on the attempts to build prosthetic limbs with a sense of touch. We've already got artificial retinas, but an artificial sense of touch is even harder, because it requires implanting electrodes directly into the brain.

Mind Hacks discusses a major study into Alzheimer's disease, conducted with the help of a Columbian family with a hereditary form of the disorder.

I can't read everything. So any tipoffs will be gratefully received. Either leave them in a comment or drop me an email.

The Neuro Week 12th June

Image of the week is this rather striking picture showing that slime moulds love to digest herbal sleeping tablets. This makes sense, because slime moulds are well known to experience severe insomnia. Because they're moulds, and moulds don't sleep.

Story of the week is that evolutionary biologist and writer Steven J. Gould relied on dodgy statistics in his classic book about race, science and intelligence, The Mismeasure of Man. That's according to a new paper, and there are excellent blog discussions here and here. Gould's to my mind the greatest science writer of all time. But you can write well without always being right.

Many neuroscience and psychology studies could be flawed because the "healthy controls" are just too healthy. This is a serious issue which doesn't get discussed enough.

Did dinosaurs sleep during the day, or the night? Until we get a working time machine, we'll never know for sure, but by examining the shapes of the eyes of different species, a new study has shed light on this question.

Studying psychology at university is not a good idea if you want to get a high salary, according to an upcoming paper.

An interesting legal case from the U.S: judge overturns federal law to impose less than the minimum sentence in a child pornography case. According to Forensic Psychologist blog, the ruling contains discussions of everything from neuroimaging to the arguments over DSM-V.

Psych Your Mind blogger posts his 'favourite' anonymous peer review judgements, along with the suggestion that psychology reviewers seem to be especially vicious compared to those in other fields.

British doctors, charities, and politicians all agreed that antipsychotic drugs are being over-used in dementia this week. Which is something, because they don't agree about anything else right now. I previously blogged about how an earthquake in Italy caused a spike in local elderly people getting these drugs.

The LA Times has an excellent piece on the attempts to build prosthetic limbs with a sense of touch. We've already got artificial retinas, but an artificial sense of touch is even harder, because it requires implanting electrodes directly into the brain.

Mind Hacks discusses a major study into Alzheimer's disease, conducted with the help of a Columbian family with a hereditary form of the disorder.

I can't read everything. So any tipoffs will be gratefully received. Either leave them in a comment or drop me an email.

The Neuro Week 5th June 2011

A couple of months back Mind Hacks stopped doing their weekly "Spike Activity" round-up of neuroscience and psychology news. That's a pity because it was really handy. So I've decided to step in and fill the gap.

So...


Image of the week is this, which looks like some kind of delicious glazed doughnut covered in sprinkles. Mmm. It's actually a disk on which mouse hippocampal neurons are growing thanks to some clever work at Pittsburgh.

The big story this week is that Science asked for the retraction of the famous 2009 paper implicating a virus, XMRV, in chronic fatigue syndrome. The authors are holding fast, for now, but there's growing evidence that the results may have been caused by contaminated lab products. Mind Hacks has a good overview and there's a detailed discussion going on at VirologyBlog.

Acupuncture has minimal benefits for "medically unexplained symptoms", according to a new trial. Despite flawed methods that mean it's the kind of study that gives big placebo effects, it still barely worked, say skeptics.

Horrific undercover footage of serious abuse at a British hospital for people with autism and learning disabilities was shown on British TV. Not for the faint-hearted, at all.

Mobile phones "possibly" cause brain cancer, said a group of experts at the World Health Organization, who reviewed all the evidence. But they also found that the literature was poor. Skeptics say it's implausible.

Jonah "Proust Was A Neuroscientist" Lehrer is not a neuroscientist... and he's quoted some dodgy data on the 'wisdom of crowds', says new blog Neuroself in a blistering critique. Lehrer replies in the comments. I haven't read Lehrer's books so I'm staying out of this one.

There's a review of three books critical of modern psychiatry over at the NYROB. One of them is Daniel Carlat's Unhinged which I praised in my review a while back.

I'm sure more happened, but I can't read everything. So any tipoffs will be gratefully received, and ought to help make next week's round-up a bit bigger. Either leave them in a comment or drop me an email.

The Neuro Week 5th June 2011

A couple of months back Mind Hacks stopped doing their weekly "Spike Activity" round-up of neuroscience and psychology news. That's a pity because it was really handy. So I've decided to step in and fill the gap.

So...


Image of the week is this, which looks like some kind of delicious glazed doughnut covered in sprinkles. Mmm. It's actually a disk on which mouse hippocampal neurons are growing thanks to some clever work at Pittsburgh.

The big story this week is that Science asked for the retraction of the famous 2009 paper implicating a virus, XMRV, in chronic fatigue syndrome. The authors are holding fast, for now, but there's growing evidence that the results may have been caused by contaminated lab products. Mind Hacks has a good overview and there's a detailed discussion going on at VirologyBlog.

Acupuncture has minimal benefits for "medically unexplained symptoms", according to a new trial. Despite flawed methods that mean it's the kind of study that gives big placebo effects, it still barely worked, say skeptics.

Horrific undercover footage of serious abuse at a British hospital for people with autism and learning disabilities was shown on British TV. Not for the faint-hearted, at all.

Mobile phones "possibly" cause brain cancer, said a group of experts at the World Health Organization, who reviewed all the evidence. But they also found that the literature was poor. Skeptics say it's implausible.

Jonah "Proust Was A Neuroscientist" Lehrer is not a neuroscientist... and he's quoted some dodgy data on the 'wisdom of crowds', says new blog Neuroself in a blistering critique. Lehrer replies in the comments. I haven't read Lehrer's books so I'm staying out of this one.

There's a review of three books critical of modern psychiatry over at the NYROB. One of them is Daniel Carlat's Unhinged which I praised in my review a while back.

I'm sure more happened, but I can't read everything. So any tipoffs will be gratefully received, and ought to help make next week's round-up a bit bigger. Either leave them in a comment or drop me an email.

Do Antidepressants Work? The Internet Says...

..."yes and no". A while back I blogged about some researchers who analysed internet discussions of antidepressants to work out what users thought about them. Now a new paper's just come out, doing much the same thing but focussed on a single comment thread: Miracle Drug, Poison, or Placebo.

Back in 2008, MSNBC ran this article, prompted by the recent publication of the famous Kirsch paper. The article itself was short but the ensuing discussion in the comments rapidly grew to epic proportions. By the end of it there were a total of 1,629 posts by a total of over 1,200 people.

In the new paper, author Michael Montagne presents an analysis of the thread. He read through all of the postings and focussed on the ones written by people who had personally taken antidepressants. After excluding obvious spammers and other undesirables (see the picture...), there were still 960 antidepressant users who wrote 1,231 posts.

He first looked to see how many people thought antidepressants were "miracle drugs, poisons, or placebos", which was the title of the original article. However, only a handful of people used those terms in their comments. Almost everyone agreed that antidepressants were not just placebos.

Users employed a range of metaphors to describe the experience. 45 people described them as "livesaving" and 8 said they were a "Godsend". But 21 accused them of turning them into "a zombie".

Down at the bottom of the list were some more unique phrases that only one person used such as "Unleashes a 100 blind monkeys in your brain with instructions to rewire", "Uberpositive girl" and "Robot-zombie wrapped in 4 inches of insulation". That last one could be quite a good horror movie actually.

While there were a small number of absolutely negative comments like "evil" and "Devil's drug", the most consistent theme in the metaphors was that of emotional numbing, with the idea that these drugs remove the symptoms by removing the ability to feel (see e.g. "zombie", "robot", "disconnected", "in a bubble", "band aid".) which seems rather ambivalent. However, only about 10% of the users used any metaphors at all, so take that with a pinch of salt.

Even more salt is required for this graph I made from the table showing the number of positive, negative and mixed judgements on each antidepressant. I've not shown the data from drugs like tricyclics where there were less than 20 total responses. It's interesting, though, that people tended to be more positive about specific drugs than they were when talking about "antidepressants" in general.

There were various other themes in the comments including an ongoing debate between people who said that depressed people ought to seek help from God (who tended to be non-users) vs those who disagreed (who tended to be users). Overall it's an interesting read, but I think it's one of those papers that's more interesting than it really deserves to be. At the end of the day, it's one comment thread on one article on one site.

Montagne M (2011). Miracle drug, poison, or placebo: patients' experiences with antidepressant medications as described in postings on an online message board. Substance use & misuse, 46 (7), 922-30 PMID: 21599508

Do Antidepressants Work? The Internet Says...

..."yes and no". A while back I blogged about some researchers who analysed internet discussions of antidepressants to work out what users thought about them. Now a new paper's just come out, doing much the same thing but focussed on a single comment thread: Miracle Drug, Poison, or Placebo.

Back in 2008, MSNBC ran this article, prompted by the recent publication of the famous Kirsch paper. The article itself was short but the ensuing discussion in the comments rapidly grew to epic proportions. By the end of it there were a total of 1,629 posts by a total of over 1,200 people.

In the new paper, author Michael Montagne presents an analysis of the thread. He read through all of the postings and focussed on the ones written by people who had personally taken antidepressants. After excluding obvious spammers and other undesirables (see the picture...), there were still 960 antidepressant users who wrote 1,231 posts.

He first looked to see how many people thought antidepressants were "miracle drugs, poisons, or placebos", which was the title of the original article. However, only a handful of people used those terms in their comments. Almost everyone agreed that antidepressants were not just placebos.

Users employed a range of metaphors to describe the experience. 45 people described them as "livesaving" and 8 said they were a "Godsend". But 21 accused them of turning them into "a zombie".

Down at the bottom of the list were some more unique phrases that only one person used such as "Unleashes a 100 blind monkeys in your brain with instructions to rewire", "Uberpositive girl" and "Robot-zombie wrapped in 4 inches of insulation". That last one could be quite a good horror movie actually.

While there were a small number of absolutely negative comments like "evil" and "Devil's drug", the most consistent theme in the metaphors was that of emotional numbing, with the idea that these drugs remove the symptoms by removing the ability to feel (see e.g. "zombie", "robot", "disconnected", "in a bubble", "band aid".) which seems rather ambivalent. However, only about 10% of the users used any metaphors at all, so take that with a pinch of salt.

Even more salt is required for this graph I made from the table showing the number of positive, negative and mixed judgements on each antidepressant. I've not shown the data from drugs like tricyclics where there were less than 20 total responses. It's interesting, though, that people tended to be more positive about specific drugs than they were when talking about "antidepressants" in general.

There were various other themes in the comments including an ongoing debate between people who said that depressed people ought to seek help from God (who tended to be non-users) vs those who disagreed (who tended to be users). Overall it's an interesting read, but I think it's one of those papers that's more interesting than it really deserves to be. At the end of the day, it's one comment thread on one article on one site.

Montagne M (2011). Miracle drug, poison, or placebo: patients' experiences with antidepressant medications as described in postings on an online message board. Substance use & misuse, 46 (7), 922-30 PMID: 21599508

Kanazawa's Black Day

Satoshi "The Scientific Fundamentalist" Kanazawa has suddenly become the most talked-about neuro/psychology blogger in the world, getting a BBC News article all to himself.


There's no need for the rest of us to feel jealous though. There may be no such thing as bad publicity, but I think that being accused of being a racist and a sexist who should be sacked, for something you wrote on your blog, something that swiftly got pulled, must come pretty close.

You can read the controversial article here, and in other places, because it was helpfully archived. It used to be here.

Kanazawa based his argument on the Add Health project which was a massive observational study of American adolescents and young adults.

Add Health is huge. It's produced over 3,000 scientific papers, presentations and other documents. That's because it collected a wealth of data on everything from genetics to blood chemistry to social relationships and emotional issues.

Kanazawa looked at the data on physical attractiveness. Attractiveness was rated by an interviewer. Each subject got interviewed for a couple of hours by one interviewer and at the end the interviewer rated how hot they found them.

The fateful post claimed that, according to the Add Health data, black women were rated less attractive, on average, than white, Asian and Native American ones. Let's assume that he's done his sums correctly and that this is true of the data.

The obvious problem is that maybe the interviewers were biased against black women, and rated them lower for that reason. Kanazawa didn't consider this in his post, which is unquestionably an oversight, but he did go on to speculate as to the biological reasons why they might be less attractive.

However, looking at the original Add Health data, can we check whether this bias was at play or not?

Short answer: I found no evidence either way.

Long answer: I first looked over the Add Health website but it doesn't seem to mention anything about who the interviewers were. It doesn't mention their own ethnicity, which would be helpful, although even if they were all black themselves, they might have internalized racism, so that wouldn't be conclusive. They were trained, but then, you can't train someone to not be a racist.

Then I decided to look at the publications. I searched Google Scholar for "Add Health" + attractiveness. This reveals a number of articles, including a 2007 one by Kanazawa ironically, but only one seemed really relevant: Weight Preoccupation as a Function of Observed Physical Attractiveness. (There are other hits, but I skimmed the most likely looking ones and they didn't address bias.)

The details are unimportant, but it involved race and attractiveness, so the authors had to deal with the question of potential rater bias. Unlike Kanazawa they didn't just brush this under the carpet:

Although the interviewers were different races and ethnicities, there is no information about the race or ethnicity of the interviewer for any one respondent to examine systematic bias.

However, post hoc cluster analyses that controlled for an interviewer effect yielded similar results; thus, it is unlikely that interviewers had any substantial biases against any one ethnic group or that they rated attractiveness significantly differently from each other.

The point about "post-hoc cluster analysis" is the key here. To try to control for rater effects (not just racial ones) they analyzed the data covarying for which interviewer rated each girl. They didn't know what races the interviewers were, but they did know which girls got rated by the same interviewer. They found that controlling for the rater did not affect their results.

So does that mean there was no bias? No. Because - this only applies to their results, which were not about attractiveness per se, but about the interaction of attractiveness with other factors to predict an outcome variable (dieting and concern about weight) within a given race.

Even supposing that half of the raters were KKK members who cruelly subtracted, say, a million points from the rated attractiveness of any given black subject, so long as they still rated some black subjects as more attractive than others, all of the comparisons within the black subjects would still work fine: the millions would all cancel out.

So in my judgement, we just can't tell. Unless I've missed something, in which case, please tell us about it in the comments.

Kanazawa's Black Day

Satoshi "The Scientific Fundamentalist" Kanazawa has suddenly become the most talked-about neuro/psychology blogger in the world, getting a BBC News article all to himself.


There's no need for the rest of us to feel jealous though. There may be no such thing as bad publicity, but I think that being accused of being a racist and a sexist who should be sacked, for something you wrote on your blog, something that swiftly got pulled, must come pretty close.

You can read the controversial article here, and in other places, because it was helpfully archived. It used to be here.

Kanazawa based his argument on the Add Health project which was a massive observational study of American adolescents and young adults.

Add Health is huge. It's produced over 3,000 scientific papers, presentations and other documents. That's because it collected a wealth of data on everything from genetics to blood chemistry to social relationships and emotional issues.

Kanazawa looked at the data on physical attractiveness. Attractiveness was rated by an interviewer. Each subject got interviewed for a couple of hours by one interviewer and at the end the interviewer rated how hot they found them.

The fateful post claimed that, according to the Add Health data, black women were rated less attractive, on average, than white, Asian and Native American ones. Let's assume that he's done his sums correctly and that this is true of the data.

The obvious problem is that maybe the interviewers were biased against black women, and rated them lower for that reason. Kanazawa didn't consider this in his post, which is unquestionably an oversight, but he did go on to speculate as to the biological reasons why they might be less attractive.

However, looking at the original Add Health data, can we check whether this bias was at play or not?

Short answer: I found no evidence either way.

Long answer: I first looked over the Add Health website but it doesn't seem to mention anything about who the interviewers were. It doesn't mention their own ethnicity, which would be helpful, although even if they were all black themselves, they might have internalized racism, so that wouldn't be conclusive. They were trained, but then, you can't train someone to not be a racist.

Then I decided to look at the publications. I searched Google Scholar for "Add Health" + attractiveness. This reveals a number of articles, including a 2007 one by Kanazawa ironically, but only one seemed really relevant: Weight Preoccupation as a Function of Observed Physical Attractiveness. (There are other hits, but I skimmed the most likely looking ones and they didn't address bias.)

The details are unimportant, but it involved race and attractiveness, so the authors had to deal with the question of potential rater bias. Unlike Kanazawa they didn't just brush this under the carpet:

Although the interviewers were different races and ethnicities, there is no information about the race or ethnicity of the interviewer for any one respondent to examine systematic bias.

However, post hoc cluster analyses that controlled for an interviewer effect yielded similar results; thus, it is unlikely that interviewers had any substantial biases against any one ethnic group or that they rated attractiveness significantly differently from each other.

The point about "post-hoc cluster analysis" is the key here. To try to control for rater effects (not just racial ones) they analyzed the data covarying for which interviewer rated each girl. They didn't know what races the interviewers were, but they did know which girls got rated by the same interviewer. They found that controlling for the rater did not affect their results.

So does that mean there was no bias? No. Because - this only applies to their results, which were not about attractiveness per se, but about the interaction of attractiveness with other factors to predict an outcome variable (dieting and concern about weight) within a given race.

Even supposing that half of the raters were KKK members who cruelly subtracted, say, a million points from the rated attractiveness of any given black subject, so long as they still rated some black subjects as more attractive than others, all of the comparisons within the black subjects would still work fine: the millions would all cancel out.

So in my judgement, we just can't tell. Unless I've missed something, in which case, please tell us about it in the comments.

Writing Emotions

A handy guide to some of the emotional states that you may feel in the process of writing.

DELation - The relief and sense of freedom that comes from deleting a passage you've been endlessly trying to get right, as you realize that you don't need it there at all.

Obsessive Compul-Save Disorder - A state of chronic dread based on the fear that your computer will crash and all your work will be lost, leading to ritualistic clicking of the Save button at least six times after changing each sentence. Often seen in people who have suffered a catastrophic experience (when it is called Post Traumatic Save Disorder).

Keyophobia - A state in which you will do anything to avoid actually typing some words. e.g. choosing the best font, bolding and unbolding the title to see which looks better, browsing for some illustrations, or tidying up your references.

Character Count Down - The sense of crushing disappointment when you realize that the huge number you're looking at is the character count, not the word count, and you actually have 5,000 words to go.

Paste Haste - The seductive sense of accomplishment that comes from boosting your word-count by copying-and-pasting something you've previously written into your current project "just to get provide a backbone". This often ends up slowing you down in the long run, as you have to adapt and update the old stuff and this can take longer than just rewriting it. More paste, less speed.

Writer's Blaaah-k - Writer's block is when you can't think of anything to write. Writer's blaaah-k is when you're wondering why you should. This all so boring! Why am I doing this, again? This can be a sign that what you're writing really isn't interesting, but it's often just a response to the fact that you've been working on it for so long. Of course it will seem boring to you, but the readers will come to it with fresh eyes. To rekindle your enthusiasm, try re-reading your original pitch or notes.

Writing Emotions

A handy guide to some of the emotional states that you may feel in the process of writing.

DELation - The relief and sense of freedom that comes from deleting a passage you've been endlessly trying to get right, as you realize that you don't need it there at all.

Obsessive Compul-Save Disorder - A state of chronic dread based on the fear that your computer will crash and all your work will be lost, leading to ritualistic clicking of the Save button at least six times after changing each sentence. Often seen in people who have suffered a catastrophic experience (when it is called Post Traumatic Save Disorder).

Keyophobia - A state in which you will do anything to avoid actually typing some words. e.g. choosing the best font, bolding and unbolding the title to see which looks better, browsing for some illustrations, or tidying up your references.

Character Count Down - The sense of crushing disappointment when you realize that the huge number you're looking at is the character count, not the word count, and you actually have 5,000 words to go.

Paste Haste - The seductive sense of accomplishment that comes from boosting your word-count by copying-and-pasting something you've previously written into your current project "just to get provide a backbone". This often ends up slowing you down in the long run, as you have to adapt and update the old stuff and this can take longer than just rewriting it. More paste, less speed.

Writer's Blaaah-k - Writer's block is when you can't think of anything to write. Writer's blaaah-k is when you're wondering why you should. This all so boring! Why am I doing this, again? This can be a sign that what you're writing really isn't interesting, but it's often just a response to the fact that you've been working on it for so long. Of course it will seem boring to you, but the readers will come to it with fresh eyes. To rekindle your enthusiasm, try re-reading your original pitch or notes.

The Wordpress Version

So here is the WordPress version of this blog:

Clarissa's Blog

Do check it out and tell me how you feel about it. Don't be too critical just yet because it already took me forever to establish it and move all the posts, pages, archives, and most of the comments to the new blog.

I know that everybody is going to hate it at first and it takes time to get used to the new format, etc. Believe me, I'm already freaked out about the entire thing. But it does seem like WordPress is more secure, it offers a lot more options for bloggers and there is a Blackberry app that will make blogging on the go even easier. 

Please visit and express opinions. What's good, what's bad, what's missing? 

Nothing is final yet and I can always cancel the transfer to WordPress.

Should I Back the Blog Up on Wordpress? Or Move Altogether?

After the Blogger collapse last week, Blogger is still not functioning properly. Several widgets on my blog are not working and it takes longer than usual to load. The Dashboard has been working poorly for several weeks now. Other people who blog with Blogger report continued issues with posting and commenting. After the unpleasant experience of Blogger being down for 23 hours last week, I have realized that I don't want to remain without my blog. I love blogging with a passion and want to continue doing it for a very long time to come. I'm only just getting started here, and I've got a lot more things to say. A real lot. 

So I've started thinking that maybe Blogger should not be relied on. I read that there is an option to export one's blog to WordPress and leave it there as a back-up option. In this case, if Blogger goes down again, readers will simply go to the WordPress version and continue reading there. Or is it a stupid idea?

Or maybe I should move the blog to WordPress altogether? Are there any distinctive advantages that WordPress has over Blogger? Or is it an even more stupid idea? 

Does it make sense to buy one's own domain name? What are the benefits of doing that?

Please help, people, I'm torn and confused. I'm placing a poll in the top right-hand corner and will also be grateful if you elaborate in the comments.