February 21, 2017
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Anti-psychiatry is a pseudoscience that downplays or rejects the existence and severity of psychiatric conditions, denies the efficacy of established treatments and demonizes medical doctors. Not all anti-psychiatry activists are committed to all of these three positions, but they are common beliefs within the movement. It is thus very reminiscent of anti-vaccine activists who wrongly think that vaccine-preventable diseases are natural and not very harmful, reject vaccines and demonize pediatricians. In terms of debating tactics, anti-psychiatry activists make use the same standard denialist toolkit: quoting scientists out of context, cherry-picking data, misunderstanding basic science and so on.
A recent paper by Jakobsen and colleagues (2017) claims to have shown that the antidepressant class SSRI has questionably clinical efficacy. It turns out that they base this claim on a piece of highly deceptive statistical trickery: they erect an arbitrary and evidence-free effect size threshold for clinical significance and then reject all treatments that do not fulfill it.
Because the threshold they picked was so large, they would be forced to reject both psychotherapy and a considerable portion of medications used in general medicine as well. The researchers cite National Institute for Health and Care Excellence (NICE) as support for their criteria, but NICE dumped this criteria as flawed around eight years ago. In the end, SSRIs are effective and a useful treatment for depression (but do not work perfectly for everyone) and clinical significance is a spectrum and not a black-and-white issue.
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November 3, 2013
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Out of all the pseudoscience that are criticized on this website — from creationism and the anti-vaccine movement to anti-GM sentiments and alternative medicine — no subject has attracted more malicious attention from denialists trolls than the articles refuting anti-psychiatry. I often respond and end up in never-ending debates where they simply repeat the same arguments over and over again despite having had their errors explain to them in great detail with references to the scientific literature. When they fail their misguided war of attrition, they resort to verbal abuse by calling me fascist, pig, dickhead, Führer etc. and claim that I must consider individuals with mental conditions who receive evidence-based treatment to be “roadkill” (I do not). After a while this comes very tiresome, so those individuals have their comment privileges removed for violating the comment guidelines. However, they do not let this stop them from spouting their nonsense. They simply use proxies, new names and email addresses to continue with their behavior (while keeping the assertions exactly the same). Some even try to impersonate me. I ban the new identities or turn off comments. This makes things calm down for a while, but it starts back up again the next time I publish a post debunking anti-psychiatry.
Recently, a previously banned user now going by the name of Tin attempted to post an anti-psychiatry diatribe on an argument describing some common anti-psychiatry archetypes that scientific skeptics are likely to come across when they take on anti-psychiatry proponents online. Although using a new name and IP, he still used the same email address as he did when he was banned the first time, thereby giving it away and so the comment got caught by the spam filter. Usually I would not bother to write anything about it and just empty the spam queue, but some of the claims he made in that comment was absurdly wrong on so many different levels that it could be useful for other scientific skeptics to have access to a detail refutation of those assertions.
In his comment, Tin confuses a debate about the scientific details with a debate on the validity of the entire field and tosses in appeals to false balance. He also makes a number of other flawed arguments, such as calling Psychology Today an academic journal, when it is really just a magazine and blog website. He also asserts that antidepressants are not better than placebo despite the fact that meta-analyses taking publication bias into account show that they do outperform placebo in a clinically significant way. Tin even fails to understand that ICD-10 also has an ADHD diagnosis and that ADHD is diagnosed outside the U.S. Finally, the five papers that allegedly show that anti-psychiatry is based on evidence either do not support his position, directly contradicts his position or is irrelevant to the discussion. The rest of this article examines those anti-psychiatry claims in additional detail. Read more of this post
November 19, 2011
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Another couple of months has passed since Jerry Coyne, Professor of Ecology and Evolution at the University of Chicago, made his latest claims about psychiatry and psychiatric drugs. I have dissected many of his unreasonable claims about psychiatry on two occasions previously, in Why Jerry Coyne is Wrong about Medical Psychiatry and in the follow-up post Why Jerry Coyne is Still Wrong about Antidepressants. Since I feared that Prof. Coyne had started to slide down that dangerous path into denialism and pseudoskepticism, I decided to send him an email with a few critical questions against his stance to see what he thinks about them. Could it be that he has changed his mind, or has he become frozen in his views?
The email is too long to cite in its entirely (used a lot of references and such, which can be found in the two posts linked above), so I will just summarize my 6 questions. I identified additional problems besides these six, but I feel that these are the main questions I would like to see what Prof. Coyne thinks about at this time.
1. Why does Prof. Coyne describe the mainstream explanatory model for depression as “chemical imbalance”, when most descriptions in elementary level psychology textbooks emphasize a large number of interacting biological, psychological and environmental factors that are each important in their own right?
2. Why does Prof. Coyne think that the fact that the genetics of mental illness is rife with uncertainties undermine the notion that many mental illnesses have genetic predispositions when studies on identical twins and adoption studies show that the heritability is often moderate? Surely, there is a different between knowing that a genetic predisposition exists and knowing the exact mechanism on a molecular level? To take an analogy: even though we may not have all the details of how common descent happened (is this taxon more related to that taxon than this other taxon?), we can be pretty sure of common descent. Read more of this post
August 21, 2011
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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