Wednesday, November 23, 2011

Irving Kirsch to debate Ian Anderson on antidepressants

And in other events-related-to-topics-I've-covered news, there will apparently be a debate this week at the 4th International Congress on Psychopharmacology of the Turkish Association for Psychopharmacology between Irving Kirsch and Ian Anderson on the proposition "Antidepressants are useful in the treatment of depression."

I agree with PZ about the usefulness of debates in deciding empirical matters, but I would love to see the video of this one!

(Duncan Double at Critical Psychiatry, where I first read about the debate, takes issue with a statement from Daniel Carlat, and I have a problem with it as well. Carlat says: "Unfortunately we know a good bit less about what we are doing than you might think...When I find myself using phrases like 'chemical imbalance' and 'serotonin deficiency', it is usually because I'm trying to convince a reluctant patient to take a medication. Using these words makes their illness seem more biological, taking some of the stigma away." Setting aside momentarily the ethics of claiming knowledge you don't possess and even suspect to be false in order to convince someone to take a drug, the question of removing an alleged stigma is an empirical one. Carlat is making an assumption here about medicalization and biologization that I don't believe holds up. I coincidentally came across a link recently to this 2009 article by Ben Goldacre - "A genetic cause for ADHD won't necessarily reduce the stigma attached." "[M]ore compelling than any individual study," Goldacre offers,
a review of the literature to date in 2006 found that overall, biogenetic causal theories, and labelling something as an "illness", are both positively related to perceptions of dangerousness and unpredictability, and to fear and desire for social distance. They identified 19 studies addressing the question. Eighteen found that belief in a genetic or biological cause was associated with more negative attitudes to people with mental health problems. Just one found the opposite, that belief in a genetic or biological cause was associated with more positive attitudes.
As a side note, excessive biologization and medicalization are problems in multiple regards, but a significant and insufficiently appreciated one is political. I have some significant criticisms of Bruce Levine's Surviving America's Depression Epidemic, but a compelling argument Levine (amongst many others over time) makes concerns the effects of treating psychological responses to a capitalist, consumerist, unequal society and its destructive hypercompetitive, alienating, standardizing culture as individual problems or medical pathologies rather than political issues. As Levine argues, this general tendency has been around from the beginning, when "Father of American Psychiatry" Benjamin Rush diagnosed an excessive desire for liberty as a "form of insanity": anarchia.)

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