Debunking Denialism

Defending science against the forces of irrationality.

Monthly Archives: April 2012

Antidepressants, Psychotherapy and Emergent Suicidality

A while back, I cam across an interesting study published in the American Journal of Psychiatry. Bridge et. al. (2005) looked at the number of new cases of emergent suicidality during a clinical psychotherapy trial for depression in adolescents and what important predictors were at play. Emergent suicidality can be defined as an increase in the rate of suicide, suicidal attempts, preparation for suicide and suicidal thoughts during the early stages of treatment, although definitions sometimes varies across studies (Meyer et. al. 2010).

The general message of the Bridge et. al. study was that the rate of emergent suicidality in the drug-free psychotherapy trial was 12.5% (this was not attributable to the therapy itself). They also found that the strongest predictor of emergent suicidality was the level of self-reported suicidal thoughts at the baseline rather than what was recorded during the intake interview. So the more suicidal thoughts you have at the start of psychotherapy, the more likely you are to experience suicidality during the psychotherapy treatment.

In this clinical trial, which enrolled subjects similar to those enrolled in pharmacotherapy clinical trials, rates of emergent suicidality in patients receiving psychotherapy but no pharmacotherapy were comparable to rates observed in antidepressant trials. Self-reported suicidality in the week before intake predicted the onset of emergent suicidality to a much greater extent than did interview-rated suicidality, indicating that self-report may be a necessary component to the assessment of adolescent suicidal risk.

This is an important finding, because it casts a shadow of doubt over studies purporting to show an increase level of suicidality during treatment with antidepressants. Read more of this post

Swatting through Luke Barnes’ Review of “Why Evolution is True”

Luke Barnes is a postdoctoral researcher in the field of astronomy at the University of Sydney. He is probably a very competent astronomer. However, he seems to have some issues with modern evolutionary biology but dislikes being labeled a creationist. Despite his statements being very carefully engineered, he repeats many classic tactics and tropes of creationists.

Barnes wrote a three-part book review of Jerry Coyne’s book “Why Evolution is True” a while back that I will take pleasure in disentangling. I’m not someone who would defend Coyne no matter what, as I have strongly criticized his anti-psychiatry stance a couple of times before on this blog.

Barnes alludes to the stereotype that physicists tend to march into a field not closely related to physics and make sweeping proclamations about conclusions and problems in that field, especially if this field is perceived as being less stringent than physics. There are a few notable examples of where this has not turned out that good such as Freeman Dyson and climate change, Roger Penrose and consciousness as well as Linus Pauling (quantum chemist) and high doses of Vitamin C.

Generally speaking, the three parts roughly corresponds to criticizing the positive case for evolution, opposing the positive and negative case against intelligent design creationism and the supposedly negative effects of evolutionary biology on society. However, I will do my review of the review in one single post because I can focus on the core claims and misunderstandings.

No flies were actually harmed during the production of this post. Read more of this post

“That’s Just a Brain Disease!” – The Poverty of Anti-psychiatry Dualism

While having the same basic ideological base as vaccine rejectionism, anti-psychiatry has received considerably less attention in the skeptical community, some even going so far as to embrace it. It is hard to explain, but maybe it is the combination of the stigma associated with mental conditions, the complex and interdisciplinary nature of the area and political ideology, although like vaccine rejectionism, anti-psychiatry is not associated with any particular politics, but smeared out over many different groups.

A fairy standard tactic of anti-psychiatry is to outright deny the existence of mental conditions by claiming that there is no biological basis for their existence. They may preface their rejection of modern psychiatry by stating that, of course, they do not deny the suffering of the individuals, but that it is really no basis for psychiatry. While it is true that psychiatry is not as evidence-based as, say, physics or cardiology, it is still an area we should not neglect or dismiss out of hand. To be sure, there are improvements to be made, but don’t let us throw out the baby with the bathwater.

Anyways, the equally standard rebuttal by proponents of science-based medicine is to point to evidence of the biological basis of many of these conditions as well as discussing other conditions such as Huntington’s or Alzheimer’s that produce real psychological symptoms and detailing the biological background. Surely, we think, this would be enough to disprove their position.

Alas, this is where things start getting even more bizarre than normal: Read more of this post

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