Debunking Denialism

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Tag Archives: psychotherapy

Antidepressants, Psychotherapy and Emergent Suicidality

3 Comments Posted by Emil Karlsson on April 14, 2012

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

Anti-psychiatry, Skepticism antidepressants, depression in adolescents, psychotherapy, suicide

Why Jerry Coyne is Still Wrong about Antidepressants

7 Comments Posted by Emil Karlsson on August 21, 2011

A few months ago, Jerry Coyne, Professor in the Department of Ecology and Evolution at the University of Chicago and an staunch supporter of evolution against creationists, made a series of remarkably flawed claims about medical psychiatry in general and antidepressants in particular. He did this after reading a couple of book reviews on a few controversial books on psychiatry and asserted that medical psychiatry was a scam. Needless to say, I confronted his claims in Why Jerry Coyne is Wrong about Medical Psychiatry and shown that Prof. Coyne made several glaring errors: he incorrectly characterized the mainstream view on the causes of depression, he claimed that the effectiveness of a drug was not evidence for the underlying model (thus implicitly agreeing with HIV/AIDS denialists that the effectiveness of antiretroviral treatment is not evidence that HIV causes AIDS), he did not understand the difference between genetic mapping and estimations of heritability, he advocated Big Pharma conspiracy theories, incorrectly claimed (based on Kirsch flawed studies) that antidepressants are no better than placebo and contradicted himself by claiming that mental disorders were not caused by chemical factors in the brain while at the same time claiming that antidepressants cause psychopathology without any evidence.

After this, I stopped regularly visiting his blog, so it is only now that I noticed that he wrote a follow-up article called Peter Kramer defends antidepressants. In it, Prof. Coyne repeats many of the same flawed arguments as before and it reads like an advertisement of Kirsch book on antidepressants. It is now clearer than ever that Prof. Coyne has gone of the deep end with regards to this topic. It is clear that his pseudoskepticism is deepening and that is why I have decided to write another criticism. There will necessarily be some repeats of content that I discussed in previous entries, but will try to keep it to a minimum.

Let’s get started, shall we? Read more of this post

Anti-psychiatry, Skepticism active placebo, antidepressants, depression, effect size, jerry coyne, Kirsch, psychotherapy, side-effects

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"I realize that 'complementary and alternative medicine' (CAM) or, what quackademics like to call it now, 'integrative medicine' (IM) is meant to refer to 'integrating' alternative therapies into SBM or 'complementing' SBM with a touch of the ol’ woo, but I could never manage to understand how 'integrating' quackery with SBM would do anything but weaken the scientific foundation of medicine."

- David Gorski, cancer surgeon and debunker of pseudoscience (source).

"Denialists [...] replace the rigorous and open-minded skepticism of science with the inflexible certainty of ideological commitment."

- Michael Specter, author and responsible science journalist (Denialism, pp. 2-3).

"If I am ignorant about a phenomenon, that is a fact about my state of mind, not a fact about the phenomenon; to worship a phenomenon because it seems so wonderfully mysterious, is to worship your own ignorance; a blank map does not correspond to a blank territory, it is just somewhere we haven’t visited yet"

- Eliezer S. Yudkowsky, rationality expert and AI researcher (source).

"As an aside, it is ironic that CAM proponents often simultaneously tout how individualized their treatment approach is, but then claim that one product or treatment can cure all cancer. Meanwhile they criticize the alleged cookie-cutter approach of mainstream medicine, which is actually producing a more and more individualized (and evidence-based) approach to such things as cancer."

- Steven Novella, neurologist and founder of the New England Skeptical Society. (source).

"While Galileo was a rebel, not all rebels are Galileo."

- Norman Levitt, mathematician and critic of anti-science postmodernism (quoted in Paul Offit's Autism's False Prophets, p. 37).

"If chiropractic manipulation of the neck had been a pill, it would have been pulled by the [regulatory authorities]. Even if the risk for vascular injury is low, the risk is not outweighed by the a demonstrated benefit."

- Mats Reimer, Swedish pediatrician, scientific skeptic and blogger (source, my translation).

"It is so addictive to make videos to people like Fringe [an unreasonable race realist - Emil Karlsson's note] simply because of that pleasing wet snap that you hear inside your head every time you smash up their worldview and show it to be based on bullshit and half-truths. It is enjoyable. It is better than most drugs and I think that is why I make Youtube videos. It is interesting to see how people's minds work when they have a preconception they start with and then work from there as oppose to enter into something trying to actively not acknowledge any preconception and go were the evidence leads them."

- TheSkepticalHeretic, Youtube skeptic and debunker of race realists (source).

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Why Jerry Coyne is Still Wrong about Antidepressants

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