very interesting article in The New Yorker. Some highlights:

Quote:

Kirsch’s claims appeared to receive a big boost from a meta-analysis published in January in the Journal of the American Medical Association and widely reported. The study concludes that “there is little evidence” that antidepressants are more effective than a placebo for minor to moderate depression. But, as a Cornell psychiatrist, Richard Friedman, noted in a column in the Times, the meta-analysis was based on just six trials, with a total of seven hundred and eighteen subjects; three of those trials tested Paxil, and three tested imipramine, one of the earliest antidepressants, first used in 1956. Since there have been hundreds of antidepressant drug trials and there are around twenty-five antidepressants on the market, this is not a large sample. The authors of the meta-analysis also assert that “for patients with very severe depression, the benefit of medications over placebo is substantial”—which suggests that antidepressants do affect mood through brain chemistry. The mystery remains unsolved. Read more: http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100301crat_atlarge_menand?currentPage=all#ixzz0gqpqXjcW [...] In 1952, a British psychologist, Hans Eysenck, published a summary of several studies assessing the effectiveness of psychotherapy. “There . . . appears to be an inverse correlation between recovery and psychotherapy,” Eysenck dryly noted. “The more psychotherapy, the smaller the recovery rate.” [...] Depressed patients in psychotherapy do no better or worse than depressed patients on medication. There is little evidence to support the assumption that supplementing antidepressant medication with talk therapy improves outcomes. What a load of evidence does seem to suggest is that care works for some of the people some of the time, and it doesn’t much matter what sort of care it is. Patients believe that they are being cared for by someone who will make them feel better; therefore, they feel better. It makes no difference whether they’re lying on a couch interpreting dreams or sitting in a Starbucks discussing the concept of “flow.” Read more: http://www.newyorker.com/arts/critics/atlarge/2010/03/01/100301crat_atlarge_menand?currentPage=all#ixzz0gqq60RDG

After I chatted with you briefly on this yesterday Conrad I had a few other friends post up links.

Apparently:

1. A lot of this is a new concept to people: That pharma may be over-used, etc.. This really surprised me as the people taking notice were friends of mine I'd just assumed would have come across much of this before.

2. The NYT has an impact: A psychologist friend found the article pretty important to read and I'm guessing there will be a lot of therapists rolling their eyes this morning as people show up with this tucked under their arm over and over: "Did you see this?".

Why it is that people legitimize issues once a mag like NYT publishes them, but ignore the issues until then, I don't know. I guess it takes a kind of respect for the source to pay attention.

My favorite line, paraphrased: "Is Pharma evil, or just useless?"

Yep. That is a very famous test, though I don't remember the name of the experiment or experimentors. You can usually find that one in a list of "top 25 experiments in psychology" type of thing.

And yeah : "humans are afraid to be out of the consensus opinion", and on all the strangest things sometimes. What I mean is that people I think of as 'hip' I might figure to have classic counter-culture type opinions on things, even if just for conformity's sake. But what I do find when I look is that people tend to have a mashup of conformities and a few issues they take a personal position on beyond heresay.